Podcasts about abilify

Send us a textRuth Johnston shares her harrowing journey as the mother of an autistic son who developed schizophrenia, and how this experience drove her to advocate for Assisted Outpatient Treatment (AOT) in Allegheny County, Pennsylvania following a family tragedy.• Ruth's son was diagnosed with autism as a teenager, after she had already been homeschooling him for years• Around age 13, he began showing signs of developing schizophrenia, though it took a decade to recognize the condition• Current laws prevented intervention despite clear evidence of his deteriorating mental state• Expert testimony revealed 5-34% of autistic individuals may develop schizophrenia as adults• Anosognosia (inability to recognize one's own mental illness) prevents many from seeking help voluntarily• AOT programs allow civil courts to mandate treatment before dangerous situations occur• The "black robe effect" of a judge's order can help individuals comply with treatment• Modern medications like Abilify can dramatically improve quality of life without severe side effects• Patient advocacy groups often oppose AOT but don't represent those with severe schizophrenia• Ruth founded AOT4AlleghenyCounty.com to advocate for these needed programsTo learn more about Ruth Johnston's advocacy efforts or to get involved, visit AOT4AlleghenyCounty.com or email AOT4AlleghenyCounty@gmail.com.https://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)

Welcome back! Today we are talking about Aripiprazole, brand name Abilify.

What if your mental health diagnosis wasn't entirely accurate? Join us in this compelling episode of "Triumph Over Trauma" as my cousin Deborah shares her harrowing journey through misdiagnoses and the critical discovery that changed her life. Initially diagnosed with paranoid personality disorder and schizophrenia, Deborah faced the adverse effects of inappropriate medications. It took multiple hospitalizations and a second opinion to uncover that thyroid issues were contributing to her symptoms, leading to an accurate diagnosis of bipolar disorder. Deborah's story is a powerful reminder of the importance of accurate diagnosis and the complex interplay between physical and mental health.Managing mental health and achieving stability is a journey, and Deborah's experience is a testimony to that. Discover how recognizing and addressing symptoms like insomnia and anxiety, and understanding the effects of hyperthyroidism and menstrual cycles on mental well-being, were pivotal in her recovery. Deborah's self-care routine, which includes Abilify, dream journaling, sound baths, yoga, meditation, and faith-rooted affirmations, has been instrumental in maintaining her mental and spiritual balance. This episode emphasizes the transformative power of self-care practices and the significance of putting oneself first to enhance mental wellness.In our heartfelt discussion, Deborah opens up about the healing process through massage therapy and the power of spiritual grounding. The support of her family, faith, and prayer were crucial during her recovery, showcasing the immense strength found in collective support and spiritual practices. Deborah shares how integrating peace and meditation into her career as a traveling massage therapist has not only helped her return to normal life but also fostered a peaceful state of mind for her clients. Tune in to learn how therapeutic practices can transform lives and the importance of maintaining a spiritual practice for overall mental health, as we express our gratitude for these enlightening discussions and thank God for guiding us through triumph over trauma.To book a massage with Deborah For those who live in the Southern New Hampshire, Northern Massachusetts area please use this link….. https://justrelaxnow.as.me/     Enter coupon code Triumph to receive $20 off your next massage And for those in the South Jersey area please send an email me to justrelaxnow11@gmail.com  What is Trauma?                                                                                                                                               Trauma is a deeply distressing or disturbing experience.  An emotional response to a terrible event like an accident, rape, abuse, neglect or natural disaster.     How to cope with Trauma                                                                                                                     Talk to a few trusted people, open up about your struggle, seek online support groups, read self-help books or practice small acts of self-care such as meditation, breathwork, yoga and exercise can help you regain some feeling ofSupport the Show.2 Corinthians 2:14 Now thanks be unto God, who always causes us to Triumph!

Episode 170: Schizophrenia: An OverviewFuture Dr. Chng explains the diagnostic criteria and describes how to treat schizophrenia. Dr. Arreaza mentions additional risk factors and social aspects of schizophrenia.  Written by Tiffanny Chng, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Schizophrenia may be an intriguing disease for many, even for health care providers. Schizophrenia is frequently misunderstood and stigmatized. Receiving a diagnosis of schizophrenia can be life-altering and cause significant distress in patients and their families, but it can also impact their work, relationships, and even their communities.Epidemiology of schizophrenia: Schizophrenia has a prevalence of about 1% worldwide, and a prevalence of about 0.6% in the US. Although the distribution between males and females is comparable, males will typically present with their first episode, sometimes known as a “psychotic break” in the early 20's as opposed to women who may present in their late 20s or early 30s. Despite having a low prevalence, the NIH lists schizophrenia as one of the top 15 leading causes of disability and disease burden in the world. In 2019 the economic burden of schizophrenia in the US was $343 billion. For comparison, in 2019, diabetes had an economic burden of $760 billion in the US, however, the prevalence of diabetes that year was 11.6%, more than 10 times that of schizophrenia. Patients who are diagnosed with schizophrenia are also at increased risk of a multitude of co-occurring medical conditions: alcohol and substance abuse disorders, mood disorders, and metabolic disturbances (diabetes, hyperlipidemia, and obesity, which may be exacerbated with the use of antipsychotics). These patients have a two-to-four-fold increased risk of premature mortality with an estimated potential life loss of ~28.5 years. Of note, 4-10% of patients with schizophrenia die secondary to suicide.Pathogenesis:The exact pathogenesis of schizophrenia is unknown, but we do know that it is a combination of genetic, neurological, and environmental factors. Genetics: Twin studies conducted in mono and dizygotic twins have shown that schizophrenia is highly inheritable (~80%). Although there are no specific genes that directly cause the disease state, genome-wide association studies have shown polygenic additive effects of 108 single nucleotide polymorphisms. This includes genes involved in the dopaminergic and glutamate pathways, which are the basis of antipsychotic medications. Epigenetics: Studies have also shown that epigenetics is a potential factor that plays into the risk of developing schizophrenia. Having a history of obstetric complications, for example, has an almost two-fold increased risk of schizophrenia in the child during early adulthood. Such complications include maternal infections, preterm labor, and fetal hypoxia. Certain infections and pro-inflammatory disease states, such as Celiac and Graves' disease have also been associated with schizophrenia. The suggested pathophysiology is thought to involve pro-inflammatory cytokines crossing the blood-brain barrier inducing or exacerbating psychosis or cognitive impairment. Trauma: As in many other psychiatric conditions, childhood trauma or severe childhood adversities, especially emotional neglect, have also been shown to increase the risk of schizophrenia later in life.Cannabis and Immigration: So, you mentioned the role of genetics, epigenetics, and inflammation. I'd like to mention the use of cannabis as a risk factor for developing psychosis as well, more specifically the THC component of cannabis. Something to keep in mind during these times when cannabis is being studied in more detail. Also, this is interesting: immigration puts you at risk for schizophrenia, and the risk can be as high as four-fold, depending on the study. Some explanations for this are increased discrimination, stress, and even low vitamin D. Tiffany, how do we diagnose schizophrenia?DSM-5 Diagnostic Criteria: The DSM-5 identifies 5 diagnostic criteria for schizophrenia: Patient must have two or more active phase symptoms for one month or longer: (1) Delusions, (2) Hallucinations (auditory, visual, or tactile) (3) Disorganized speech, (4) Negative symptoms (flat affect, avolition, social withdrawal, anhedonia), or (5) Catatonic behavior (which can be a collection of abnormal physical movements, the lack of movement or resistance to movement, psychomotor agitation). For the first criterion to be met, the patient must have delusions, hallucinations, or disorganized speech as one of their two presenting symptoms. Arreaza: The 1-month duration can be less if the patient is successfully treated.The symptoms experienced by the patient must impair their level of functioning in one or more major areas (professional career, relationships, and self-care). In addition, the disruption must be present most of the time since the onset of symptoms. There must be continuous signs of disturbance for at least 6 months. Within these 6 months, there must be at least 1 month where the patient experiences symptoms mentioned in the first criteria (delusions, hallucinations, disorganized speech, negative symptoms, or catatonic behavior). The disturbance may only be negative symptoms or attenuated positive symptoms (unusual perceptual experiences, odd beliefs, etc.)Mood disorders must be ruled out. This includes bipolar disorder with psychotic features, depressive disorder with psychotic features, and schizoaffective disorder. The behavioral disturbances must not be attributable to any substance use or medical conditions. After the diagnosis of schizophrenia has been made for 1 year or more, specifiers can be added to further categorize the disease state, according to the DSM-V: Acute episode: a period in which all symptomatic criteria are met.Partial remission: a period in which symptomatic criteria are only partially met and symptoms are improved from a previous episode.Full remission: a period in which no symptomatic criteria are met (for a minimum of 6 months).Continuous: symptoms prevalent for the majority of the illness course.Goals of Treatment: Reduce acute symptoms to allow patients to return to their baseline level of functioning. Prevent recurrence and maximize a patient's quality of life using maintenance therapy.There are 2 components of treatment: Pharmacotherapy and Psychosocial Intervention.Pharmacotherapy.Pharmacotherapy is initiated with second-generation antipsychotics as first-line agents due to their decreased risk of extrapyramidal side effects, compared to our first-generation antipsychotics. Commonly used medications include aripiprazole (Abilify), lurasidone (Latuda), risperidone (Risperdal), and quetiapine (Seroquel). These antipsychotics also have a more favorable side effect profile, showing a lower incidence of seizures, orthostatic hypotension, QT prolongation, weight gain, impaired glucose metabolism, and hyperlipidemia. Of note, younger patients being treated for their first psychotic episode are more likely to experience metabolic side effects while on antipsychotics. Hence, it is important to start at lower doses in these patients and slowly titrate to a therapeutic dose. Antipsychotics are implicated in the development of obesity, and obesity is one of my favorite topics. As a PCP, you need to have close communication with the psychiatrist before you change any doses of any antipsychotics, in my case, I just avoid making changes.Older patients, who are likely on other medications should be started at doses that are ¼ to ½ the adult dose initially to monitor for any potential drug interactions. After therapy initiation, routine monitoring for symptomatic response is done weekly for the first 3 months. Signs of any extrapyramidal symptoms should also be evaluated at each visit. Special care must be taken to patients with risk factors, for example, a metabolic profile should be ordered every 6 to 12 weeks depending on a patient's comorbidities, and an EKG should be done before and 3 months after therapy initiation to monitor for QT prolongation.QT prolongation is higher with ziprasidone, quetiapine, chlorpromazine, and intravenous (IV) haloperidol. Normal QTc intervals: Before puberty: NORMAL

There are medications that can drop milk supply. In this episode, listen in as Shelly discusses one of these medications.   In this episode of the Baby Pro podcast, Shelly and Maria discuss various factors that may influence these findings, including socioeconomic disparities and research biases, while also examining claims about breastfeeding's link to higher IQs and healthy eating patterns. Additionally, Shelly tackles the delicate balance between breastfeeding and the use of medications like Abilify, which can potentially impact milk supply. Don't miss out on this essential conversation about the science and struggles of nursing infants. In this episode, you will learn the following:   The validity of studies linking breastfeeding to higher IQs and healthier eating patterns, and advocate for systemic changes.   How Abilify can affect milk supply by lowering prolactin levels, potentially reducing milk production.   Guidance for parents balancing mental health and breastfeeding, stressing the importance of consulting healthcare providers before altering medications.   A call for systemic changes such as better lactation support and access to nutritious food. Connect with Shelly: website: Massachusetts IBCLC | Lactation Consultant - Shelly Taft insta: Instagram (@shellytaftibclc) Article mentioned:    Research Reveals The 1 Breastfeeding Benefit We Never Saw Coming  

Through my energy medicine training, I have learned to use energy testing techniques to assess patients' function. From my testing results, I have come to believe that many of my patients have difficulty with detoxification beyond the typical issues with methylation due to single nucleotide polymorphisms (SNPs).They also struggle with inadequate metabolic pathways involving glutathione and/or metallothionein. Glutathione helps with the detoxification of chemicals such as medications and metallothionein helps with the detoxification of heavy metals.Imagine how difficult it would be not to be able to detoxify these toxins at the necessary rates. Over time, these toxins accumulate and overwhelm the ability of the body to handle normal, daily amounts of toxins.Typically as toxins increase, anxiety symptoms increase as well. However, it's difficult to remove toxins using supplements without increasing negative side effects such as experiencing even more anxiety. Because of this, I turned to energy medicine for additional help.This podcast records a session where I am using energy medicine to try to strengthen the glutathione and metallothionein systems and to help the patient, Cindy, recover from being injected with Abilify, an antipsychotic medication.Almost all psychiatric medications are xenobiotics, foreign substances, that require detoxification to clear them properly from the body. Unfortunately, not all patients have what it takes to do so properly.This podcast records Cindy's energy healing process to benefit others. Cindy was happy to have the opportunity to share how the energy healing felt and also her experience after being injected with Abilify.I hope that you will be able to share this podcast with those who experience anxiety, because they may also have underlying problems with detoxification. I hope this recording will benefit those who might be open to a free source of healing energy.Click here to listen to all of The Holistic Psychiatrist Podcast episodes If you like this podcast, please give it a 5-star rating and share this with others! Thank you! For more about Dr. Alice W. Lee, please visit: Website: www.holisticpsychiatrist.com More stories and insights: Holistic Articles YouTube: The Holistic Psychiatrist To schedule consultations or appointments, call Dr. Lee's office at 240-437-7600 Dr. Lee has office locations in Lehi, Utah and Yonkers, New York. The content provided by this podcast is for informational purposes only and has not been approved by the U.S. FDA. This podcast is not intended to provide personal medical advice, which should be obtained from a medical professional.

Dr. Mindy talks about her 4th and then answers questions about Prime energy drinks, intentionally gaining weight, supplements, Plan B, knee pain, Splenda, Abilify, Snap-Crackle-Pop knees, Shingles, Dementia, therapy, action packed dreams and never pooping again...See omnystudio.com/listener for privacy information.

This is the 20th podcast episode for the Psychiatric Medication Podcast Series. Series Description: Current literature indicates that podcasts can be an effective educational format to reach health professionals across the continuum of medical education, addressing a myriad of topics pertinent to providers. This episode serves as an overview of Aripiprazole/Abilify & Iloperidone/Fanapt. This podcast season is the second released by East Carolina University's Office of Continuing Medical Education and may be beneficial for physicians, residents, fellows, nurse practitioners, physician assistants, and nurses. This podcast season is comprised of approximately 30 episodes, each focusing on different psychiatric medications for the non-psychiatric provider. Those tuning into the podcast's second season will receive a primer on the "bread and butter" behavioral health medications for primary care: antidepressants, antipsychotics, and mood stabilizers. Episodes will be released weekly on Wednesdays.Jennifer B. Stanley, MD & Maxwell Miller, DO

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we analyze the 2013 psychological thriller "Side Effects." Did ya'll remember that Channing Tatum was in this movie becauwe we didn't and it was a nice surprise! Too bad he died. In this episode, we explore Rooney Mara's portrayal of what we initially believe is major depressive disorder but then discover is actually manipulative behavior more consistent with malingering of a sociopathic level. We also discuss all sorts of medications and their side effects, including antidepressants, mood stabilizers, and antipsychotics. We hope you enjoy! Instagram TikTok YouTube Website [00:10] Dr. Katrina Furey: Hi, I'm Dr. Katrina Fury, a psychiatrist. [00:12] Portia Pendleton: And I'm Portia Pendleton, a licensed clinical social worker. [00:16] Dr. Katrina Furey: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. [00:23] Portia Pendleton: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. [00:28] Dr. Katrina Furey: There is so much misinformation out there, and it drives us nuts. [00:31] Portia Pendleton: And if someday we pay off our student loans or land a sponsorship, like. [00:36] Dr. Katrina Furey: With a lay flat airline or a major beauty brand, even better. [00:39] Portia Pendleton: So sit back, relax, grab some popcorn. [00:42] Dr. Katrina Furey: And your DSM Five and enjoy. [00:57] Portia Pendleton: Today we're going to be talking about side effects, which I had never seen before, which I think some people might find, like, shocking. This is like a movie about a lot. Therapy, mental health, medications. [01:10] Dr. Katrina Furey: Yeah. [01:11] Portia Pendleton: So we're going to be talking about that today. I'm really excited, and I kind of just wanted to say briefly, wow. Like, Channing Tatum was in it, and I was like, is this why everyone watches the movie? Hello, Andrew Law? [01:26] Dr. Katrina Furey: Yeah. [01:27] Portia Pendleton: How long did it take you to figure out who was running the show? [01:32] Dr. Katrina Furey: So I've seen this movie several times. The first time not till the very end. I remember being really surprised. What about you? [01:41] Portia Pendleton: Same. [01:41] Dr. Katrina Furey: Yeah, right. I didn't get it the first time I watched it, I thought I think I thought this was supposed to be a medication side effect. And that was like the whole premise. And then when they got into the insider trading and all this stuff, I was like, oh, whoa. Yeah, I didn't see that coming at all. And then when I rewatched it before recording this episode, I remembered the plot. And so I was really watching Rooney Mars character a lot more closely to see if I could pick up on sort of subtle things that would suggest she was malingering. And they even used that word correctly, which is kind of feigning symptoms for what we call secondary gain, which means, like, to get out of work or to get money in a settlement or to stay out of prison or stuff like that. What did you think about Rooney mara's portrayal of what we think at first is a woman with depression? [02:41] Portia Pendleton: I thought it was great. I thought it also shows how we can be, like, functional. [02:47] Dr. Katrina Furey: Yes. [02:48] Portia Pendleton: So she's working, she is dressed well, but behind the scenes, like someone who's really suffering with kind of it appears, maybe more like major depressive disorders. She's having these episodes versus kind of more persistent depressive disorder, which would just be like persistent depressive depression with periods that you can also have major depressive disorder popping into. [03:13] Dr. Katrina Furey: Right. And they allude to again, I think we'll talk about her before the twist. So when we think she's just depressed and I'm saying just depressed, not to minimize the depression, but because there's more that comes out later, but I thought her eyes. She just looks subdued. She looks sad. She looks flat. She's not really super joyful. Even when they get him out of prison, she hugs him and stuff, but there's not a lot of animation there. And again, maybe that's just her personality, but she does have this suicide attempt where she rams her car into a wall in a parking garage, and when Channing goes to the hospital, he's like, oh, I thought we moved past this to suggest, like, this has happened before. And that's where she meets Jude Law's character, Dr. Banks, in the Er as the psychiatrist evaluating her. [04:08] Portia Pendleton: So what did you think of that? [04:09] Dr. Katrina Furey: Who was he evaluating before her? [04:12] Portia Pendleton: Oh, the man who was kind of delusional. No, I'm sorry. He was not delusional. [04:17] Dr. Katrina Furey: He was Haitian. Yes. [04:18] Portia Pendleton: And so he had seen the ghost of his father driving a cab, and so he kind of attacked the cab. [04:26] Dr. Katrina Furey: I'm glad I brought that up, because I remembered that's a good portrayal. I think that's something we do learn about in our training is putting the symptoms of various mental health conditions within a cultural context, because sometimes what we might think of in the American culture as delusional, like seeing ghosts of relatives who have recently died in other cultures, is not it's, like, normal in those cultures. So that was an interesting depiction of that. And again, an interesting depiction of a black man in New York City coming in and speaking a language the officer can't understand and wanting to sort of restrain him or punish him or take him to jail. And the doctor, in this case, being able to apparently speak French or Creole I think it was French and get a sense for what's really going on and keep him out of jail. So that's an example of not malingering. That's not malingering. That's like the law psychiatry or mental health interface, like, working appropriately. [05:32] Portia Pendleton: That was really great, and I thought it was just, like, a good check mark for him, for his character. [05:40] Dr. Katrina Furey: Yeah. And then now that we're talking about it, like a really interesting juxtaposition to him then moving next door, wherever, and evaluating Emily. Again, a white woman, someone later calls her, like, a fragile bird, attractive and just I guess you're right. I do pick up a lot on the background or the setting. I didn't love that. He didn't close the curtain right away. He starts the interview standing over her. I didn't love that. Just, again, like, a man towering over you and you're feeling really emotional and vulnerable. I don't love sit down so you're level. Don't get too close, though. I like that he didn't get too close. I think eventually he sat. Eventually he closes the curtain. I thought his line of questioning was pretty good in the way that she was saying, like, oh, my head hurts. They said I might have a concussion. And he's like, well, we got to wait for the CT scan. How's your head been lately? That's kind of weird. That's kind of a clunky thing to say. He didn't introduce himself as a psychiatrist right away. I'm not sure why or if that was intentional to see again. Maybe he already suspected she'd withhold things. If he did so, maybe he wanted to see if she'd reveal anything before she knew. That. That, to me now that I'm saying it should have been his first sign that something was off here. He says to her, usually when someone's in a car accident, there's skid marks. You try to avoid hitting the wall, but you went right for the wall. So to us, that suggests a suicide attempt. I can't believe she wasn't hospitalized. [07:27] Portia Pendleton: Well, that was what I was thinking. I was like, she didn't come in with kind of a thought of suicide and now is presenting, after waiting in the air for many hours as safe and has a caregiver or a partner and is evaluated and is sent home and non hospitalized. That happens a lot. Maybe sometimes it shouldn't, but this was an attempt, and this was a really serious attempt. [07:52] Dr. Katrina Furey: Like she rammed her car into the wall. I thought, though, that they did a good job portraying what we sometimes look for, which is called future oriented, like having plans for the future. Like, oh, no, I can't be outside. I have to go to work tomorrow. My husband just got home. I can't do that. At the same time, when I was working in Ers with evaluating patients like this, I don't care how future oriented you are, when you ram your car into the wall, you need to be hospitalized. And the fact that she was able to talk him out of it when that was his first instinct to me is, like, in retrospect, red flag number one. Yeah, right. The fact that she's like, you have an office, right? I'll come see you a handful of times. [08:33] Portia Pendleton: And to me, that was red flag number two, because I don't think that that happens often. I don't know of the ethics behind it, but I just don't think that that's typically available. [08:46] Dr. Katrina Furey: No. Right. [08:47] Portia Pendleton: Like, you'd be referring to, like, a PHP partial hospitalization program, tense about patient program through your hospital. You know what I mean? That would be the treatment exit. [08:55] Dr. Katrina Furey: Not just like, I just ran my car into the walk. I'm going to go see an outpatient psychiatrist. That's not an appropriate level of care for that severe thing that just happened. I think you need at least a couple of days. But again, unfortunately, this should always happen, right? Unfortunately, there's not enough hospital beds. Patients wait and wait and wait in the Er forever. Sometimes insurance won't cover it, even after something like that. I'll never forget my training, working on the inpatient child unit and being told by insurance it was my job to do the peer to peer review because they were denying ongoing a hospitalization for like a twelve year old girl for suicidal thoughts and depression because she hadn't actually attempted anything. So they thought we should discharge her. And it was like, unreal that they told us they're not going to pay for it because she hadn't made an attempt drives me nuts. But anyway, she had made an attempt. She should have been hospitalized. So the fact that she was able to manipulate him into going against his better judgment by appealing to well, I'll see you in your practice. I couldn't tell if he was affiliated with the hospital. It didn't seem like it. It seemed like he was like what we call moonlighting or like picking up. [10:11] Portia Pendleton: Side shifts, which he does talk about later because he's working all these multiple jobs. [10:16] Dr. Katrina Furey: Right, exactly. So maybe he's like, oh, a patient, oh, a couple of times a week maybe it seems like he needs the money. And then we sort of start seeing her meeting with him. And again, the boundary crossings just continue our favorite. So, yeah, we see her starting to open up to him. He starts talking about medication, which again is is warranted. Yeah. When someone presents with significant symptoms of depression status post a suicide attempt, I think that's when she brings up Dr. Seabird's name, which is played by Katherine Zeta Jones, and she gives consent for them to talk to each other about her case, all of which is normal. And then somehow he sees Dr. Sebert at, like it looks like a pharma. By pharma I mean pharmaceutical company, like dinner or talk or something. And Dr. Sebert like, very casually mentions, oh, oblixa, I did write down, being a psychiatrist, the medications Dr. Sebert said she had tried Emily on, wellbutrin, Prozac affects her, and she apparently had problems with sleep and nausea. So that's interesting because those can be common side effects. And we have medications in different classes. We have Prozac, which is an SSRI, effects are an SNRI, and then Wellbutrin, which has a different mechanism of action in which we think of as sort of in this category of medications called like, atypical antidepressants, which just means, like other they work in different ways. So looking at that, my thought as a psychiatrist is did she have adequate trials on any of these? Like, could she tolerate them long enough to see did they really work because these medications take several weeks to kick in? Or did she stop them pretty early because of side effects? Problems with sleep and nausea are really common early side effects that usually go away if you can stay on it and you can prescribe things to sort of help with that in the early stages. It's weird to me that she was only on one SSRI. Then we jump and again, I'm assuming we started with Prozac because that's typical practice, but maybe we didn't. But then you jumped to an SNRI then you jumped to this other thing. It's pretty atypical to jump around so quickly. And then it sounds like she was taking, as prescribed by Jude Lav's character Zoloft, 100 milligrams, which is a pretty high dose. So pretty high to get to 100 so quickly. Those are kind of my thoughts. [12:47] Portia Pendleton: Is that dosage more like along the lines of an OCD patient? [12:53] Dr. Katrina Furey: Not quite. That's a great question. So usually, like with Zoloft, you start around 50. You could start lower if you've never been on medication before to help ease the side effects as you're starting them, or if it's like, a young person or really thin person, you might start lower. 100 is, like, a pretty good dose for depression. I think the way it was depicted in the movie, I just felt like they got there really quick, which, again, you might want to given the severity of her suicide attempt, but usually you might go a little slower. But maybe again, I'm just assuming this was, like her first dose was 100. OCD definitely responds to higher doses of SSRIs compared to things like anxiety and depression. So for Zoloft, the therapeutic windows anywhere from 50 all the way to, like, 400 milligrams for OCD. Oftentimes people with OCD end up somewhere between two to 400, depending on the situation, but 100 could do it. Okay. Some other early boundary crossings that we see between Emily and Dr. Banks first, not hospitalizing her. The second, I would say, is when she found him. It looks like in it looks like maybe like some common area. So his office must be near the hospital or something. Almost gave me the vibe of, like, a cafeteria or something like that atrium that's right where he was sitting with his wife, who was preparing for a job interview, and he gives her a Pranal, and I thought, oh, gosh, he doesn't have great boundaries. You should never prescribe for your spouse or for someone you know? I mean, do do doctors do that sometimes? I'm sure proprietary is a pretty benign medication, but I think it just speaks to his own poor boundaries and why a patient like Emily might be able to sort of sniff that out and use it to her advantage. So all of a sudden, he gets a call with Emily kind of rambling on the phone, I think after she had tried to maybe jump in front of the subway train. And then the officer saved her at the last minute. But then she shows up as he's. [15:09] Portia Pendleton: Trying to his wife staring at a poster of oblixa right in the train station for a while, just like looking at it. And then she kind of walks over. [15:18] Dr. Katrina Furey: To the edge and then toes it. I didn't notice that, but you're probably right, because we'd heard about Oblixa from Dr. Sebert, like, in the scene before, and they kept talking about how you see the ads. You see the ads, and I will say, I hear this all the time from patients. I remember when I started my training, Abilify, there were a lot of ads out there for Abilify, and I had a patient who was like, I want to switch from this medicine. I've been on and been stable on for 20 years to Abilify. So this does come up. I thought that was I wanted to. [15:49] Portia Pendleton: Ask you, so if a patient comes in and they have seen like, a new medication on TV and it looks and they're excited about it, does that typically make it work better at all? I think Placebo mentioned that in the movie a little bit. [16:06] Dr. Katrina Furey: Yeah, you're right, she did. She was like, I think with your positive endorsement, it could work better. I mean, so certainly we know that the placebo effect is real. So by the placebo effect, I mean, they've done studies and stuff where if you give patients, like a sugar tablet, but you say it's an antidepressant or something, then sometimes the patients start to feel better, like they believe in what you're giving them. And that is part of the art of prescribing medications, I think, is not necessarily using that to your advantage. But it's really important when you're prescribing a medication, whether it's for psychiatric issues or something else, to get buy in, right? Like, if you're prescribing a medicine to someone because they have high blood pressure and you want them to work on it with lifestyle modifications, like with diet and exercise, you want to get buy in that all three methods of targeting the problem are going to be effective. So I think that's the kind of thing where if you come to me and I'm like, well, we could give you Zola, but it doesn't really work, are you going to be like, sure, I'll take that. [17:15] Portia Pendleton: That makes sense. I feel like even with therapy, I think some protocols actually, I don't want to say require, but really you're supposed to kind of speak to the results that have been studied. You're supposed to really kind of like, I don't want to say Hype up the program, but Hype is effective. This works for people, really, to get the bind. So it sounds like it's almost along that line. It's not necessarily like placebo effect in our practice, right? That's a lot of in research trials and stuff like that. But you have to get people's kind of excited to what you're trying to have them do. [17:52] Dr. Katrina Furey: Right? And I think patients will show up having seen ads and commercials and stuff like that for newer medications and wonder about it and some I mean, gosh talk about like buy in. I mean, the the like people like, make these commercials with the goal of, like, kind of manipulating you into wanting to take this specific medication so they can make money from it. And some of these commercials are really intense. [18:18] Portia Pendleton: So I thought at this point, in the movie, this was where we were going. Right. I thought like big pharma was like trying to kind of push this pill. I almost felt like in a little bit of a way it was going to be like the oxy. We secretly know that it's not effective or there is this really bad side effect. We're brushing it on the rug, don't tell anyone. Prescribers. [18:39] Dr. Katrina Furey: Push it, push it. [18:40] Portia Pendleton: But that was not the way this movie ended. But at this point that's what I was thinking. [18:46] Dr. Katrina Furey: Yeah, that's what I thought too is it was going to be all about Big Pharma. And I think unfortunately, you're right. There are stricter laws now about you see, in the movie pharmaceutical reps taking doctors like out to lunch or dinner. And they talk about how back they could be a quote unquote spokesperson for a pill and be flown out to some conference in an exotic location, give a talk for 15 minutes and have their whole vacation comped. Those sorts of things did used to happen. I didn't get to do any of that because they have these stricter laws which are good. Which are good because they did find like surprise, surprise, doing stuff like that did in fact influence physicians prescribing practices. Which makes sense. [19:33] Portia Pendleton: Yeah. And I was thinking same along the lines of this used to be a big practice for residential treatment centers, doing kind of the same thing with big pharma as big Pharma. So they would invite you to come tour their facility in Palm Beach and then you're going to refer your patients with substance use disorders there. It really primarily was kind of a big business with substance use all around this kind of same time. [20:01] Dr. Katrina Furey: Right. [20:01] Portia Pendleton: I feel like this is really popular to do. They want kind of to push patients. And now we are seeing and have seen the effects of this. So specifically talk a little bit about the state of Florida kind of being famous for having a lot of rehab centers. There was kind of in the news, a lot of unethical drug testing. So they'd be billing at really high rates these really expensive complex blood tests and labs and that's kind of how they're getting paid. And all these people have ended up in Florida and then kind of like homeless and then using drugs. Again, like a halfway highland houses. There's this whole pipeline. [20:40] Dr. Katrina Furey: It's very interesting that's the thing is, unfortunately, there is a nefarious pipeline. Where? I don't remember all the details, but unfortunately there have been then, like, big business partnerships, I guess, between a rehab center and a halfway house or where the patient would go afterwards, where then the patient does rehab. They pay out the wazoo they charge for these tests, like you're saying. Then they go to this halfway house that's contracted with the rehab center. And then the halfway house, they get reintroduced to the drug, sometimes on purpose. I think that's the most nefarious egregious thing that's come out. I mean, how disgusting is that? And then they go back to the rehab and it's just a cycle, and it's all for money making, and that just makes me want to vomit. [21:25] Portia Pendleton: Yeah, I mean, it's horrible. And I think that's right. And we've seen that with Big Pharma too, and that's why we don't get this anymore. [21:33] Dr. Katrina Furey: But I thought this was going to be like a movie, like anti Big Pharma. Anyway, we got derailed, but hey, big Pharma. So Emily somehow finds where he is in the atrium again, like, how unclear? And interrupts his combo with his wife. You can tell his wife's annoyed. She's, like, wanting some emotional support from him. This is a really awkward conversation to have in public. Again. He's like, if this just she sort of makes a provocative comment alluding to, like, sort of happened again. And he's like, well, if that's the case, I need to admit you to the hospital. Yes, that's the right step. And then she's like, no, I just need five minutes. I have to get to work. Can we go talk somewhere? And the answer is no. The answer should be no. But she manipulates him or something. [22:24] Portia Pendleton: I thought that it was interesting that his wife was I understand why she was upset. Like, she needed support, and her husband was kind of getting called to this work duty. But I feel like I'm assuming that this doesn't happen ever. This is a strange thing, right? Like a patient coming up to him. So I felt like her reaction almost felt, like, a little strange. If I was out in public and out to dinner with my partner, and we're sitting there and a patient comes up to me and starts talking about what seems to be, like, active suicidality, that would be not normal. My partner would be like, what the **** is happening? [23:06] Dr. Katrina Furey: They wouldn't even get up and leave. [23:08] Portia Pendleton: Right? Sad or mad at me. They would just be like, this is strange. [23:14] Dr. Katrina Furey: Weird. Yeah. [23:15] Portia Pendleton: So I felt like her being mad. [23:17] Dr. Katrina Furey: Just, like, felt off. I think she was mad that he chose to go, but I feel like. [23:25] Portia Pendleton: Within the context, you have to handle that. You don't need to meet with him. You know what I mean? But you have to handle the situation. Whether it's like talking to them outside and saying, this is wildly inappropriate. [23:38] Dr. Katrina Furey: I don't know. Asking her wife, can you go get a security guard? [23:45] Portia Pendleton: Maybe she was pretty. [23:46] Dr. Katrina Furey: That's the thing. I was wondering if there was some competition and if that was intentional. I think now we know it probably was to stir up some feelings of jealousy and stuff. And then they have this mini session, like, on some couch somewhere, and there's that Victoria Secret. Yeah. So they're sitting, like, really close together. Their body language was interesting because she's, like, face toward him with her legs up on the couch. You can see her bare legs. She's just sort of talking to him and pulls out, like, a Victoria's Secret bag, saying, like, I'm really trying. And he acknowledges again, I was like, oh, ick, ick, ick, ick, ick. Yeah. [24:23] Portia Pendleton: And again, the boundary crossing is when he agrees to meet with her also, like, in this public place, so on and so forth, and just meeting with her. But besides that, what he's saying. He's not flirting with her. He's not doing anything, like, inappropriate. Inappropriate in that moment within that context. But I think then we learn later a picture gets taken of them in this moment where she is holding up this Victoria's Secret bag, and they're comfy, quote, unquote, on this couch. But it's like, that is not what was happening. [24:58] Dr. Katrina Furey: Right, exactly. That's why you always have to be so careful. Totally. And this is why boundaries are so important. And this is why it's important to listen to your own gut feelings when you're evaluating new patients, because I think you could pick up some of these subtle red flags really early on and see how this could unfold. And so again, he doesn't hospitalize her against his better judgment, and then things really unravel. So he's like that's when she, Emily, asks, can you start me on Oblixa? Like, my friend so and so is on it. I hear it works. And he'd heard that from Dr. Sebert, who then we find out is, like, really pushing Oblixa. I loved what Dr. Sebert was like. Oh, you can have an Oblixa pen. Yeah. I was like, we should make analyze script pen. [25:49] Portia Pendleton: I have a lot of residential treatment pens. [25:52] Dr. Katrina Furey: I bet you do, right? It's just so classic. So then he puts her on Oblixa instead of Zoloft. And getting back to one of your questions, certainly there are more and more new antidepressants out there. Oblixa. I thought it was so funny the way they picked this fake name because it was like a combo of Abilify. And I thought, like, Trntilix, which are both too. Abilify has been around longer. What about Selexa and Selexa oblixa? They just sort of, like, combined it all. [26:22] Portia Pendleton: And it sounds real. It totally sounds like a medication sounds. [26:26] Dr. Katrina Furey: Like a medicine name. So I thought that was funny. And then I think it kind of starts to work, but she starts having these quote, unquote, like, sleepwalking episodes, which seemed convincing right at first, and then that's why he eventually prescribes this new medicine deletrix or something, which, again, sounds like a convincing medicine name. And that's where he's now participating as a consultant with a pharma trial being paid being paid, like, $50,000, which, again, sounds like a lot. I would have cautioned Dr. Banks to say, okay, after taxes, how much are you really getting, and is it worth it? [27:07] Portia Pendleton: And he does disclose that he did it. Again, it seems some things pretty by the book he's with another patient who he's telling about this trial that he's in and that he is being compensated for it. And he gives her this information that she'll receive the medication at no cost. And it's like, that why people agree. [27:27] Dr. Katrina Furey: To the trial, right? And that's what I think the pharmaceutical industry uses to its advantage. They still provide free samples, which I. [27:35] Portia Pendleton: Think can be right on the one hand, a way to assist people who cannot pay for it initially, or there's just problems with that, too, but that still happens. People still do get free samples of lots of things. Birth control antibiotics, or, like, Vivams, like. [27:56] Dr. Katrina Furey: A new Stimulant, which is really expensive, works great. I prescribe it a lot, but it can be expensive if you don't have good health insurance coverage. So they might give you, like, a quote unquote drug coupon where you can get, like, the first month free, and then you have to pay $600 the rest of the time. Anyway, as we're thinking about this, shout out to Mark Cuban's Pharmacy because they are providing a lot of medications at very affordable rates. Mark Cuban, if you want to sponsor the podcast, please feel free. Anyway, so they add in this new medicine, and then it turns out she murders her husband, basically, right? Like, she again has another one of these quote unquote sleepwalking episodes, ends up stabbing him multiple times, and then goes to sleep and he dies. Before we saw the end of the movie. What did you think about that whole scene? [28:45] Portia Pendleton: I thought that it was I was shocked, but based on another episode of prior episode of her kind of sleepwalking, I was like, I don't want to say, like, it wasn't surprising, but that didn't shock me. Something was going to happen in the movie. I was like, okay, this is it. And then she's going to be like, how are they going to go after her? [29:04] Dr. Katrina Furey: Right? [29:06] Portia Pendleton: Are they going to blame the drug? Are they going to blame her? How will they do this? That's what I was thinking. I was sad to see Channing Tatum go. Martin is his name in the movie, right? [29:21] Dr. Katrina Furey: He's not a Martin. I'm always sad to see Channing Tatum go. Yeah. I like to watch him walk away. Yeah. [29:30] Portia Pendleton: But he you know, he did not walk away. He laid on the floor and blooded out. [29:35] Dr. Katrina Furey: So then she gets shirtless. I know. [29:37] Portia Pendleton: Like, come on, haven't they seen Magic Mike? [29:40] Dr. Katrina Furey: What did you think about Rooney Mara's acting in that scene? Did you buy it? [29:46] Portia Pendleton: I did. [29:46] Dr. Katrina Furey: Yeah. Too the first time. Totally bought it. And that's where I thought the movie was going. Let's see what happens here. And I thought, actually, their depiction of the whole legal process, the not guilty by reason of insanity, the NGRI, I thought that was actually pretty accurate. And again, I'm not a forensic psychiatrist. We hopefully will be having one on in. The next couple of months. But I thought overall, that was a pretty accurate depiction of how that process works. And thank God for things like not guilty by reason of insanity so that people who do commit crimes or murders or what have you when they are in the throes of a mental health episode instead of just being locked up in jail, which unfortunately has become how sad is this? The largest place where mental health treatment is delivered because we don't have enough mental health hospitals in the country. That's a whole other episode and issue. But anyway, those patients can go to, like, a forensic psychiatric unit and receive treatment. Unfortunately, I think oftentimes what then happens is once their sanity is restored sometimes, then they're tried again. I'm not a forensic psychiatrist. Do you understand that differently? [31:01] Portia Pendleton: Yeah. And I think it's interesting why it would go either way. Right. Some people are charged with not guilty by reason of insanity go on to serve their time in an inpatient unit and then are let out right into society. And other people are get off temporarily not guilty by reason of insanity, receive the care and then have to and then are tried. [31:25] Dr. Katrina Furey: Yeah, exactly. [31:25] Portia Pendleton: I'm curious what the differences are. I'm sure it's clear. I just don't know it. [31:29] Dr. Katrina Furey: Well, hopefully when we have her case. [31:31] Portia Pendleton: It sounded like she got the she was going to get R. Right. [31:35] Dr. Katrina Furey: And that's the part where I'm not sure. Does that actually happen? When we have dr. Tobias wasser on in a couple of months, we will ask him. [31:43] Portia Pendleton: And it was a really short time. Right. And I think they also had to kind of convince her because at first she was like, no, I don't want to have to go there. I'm not going to be able to leave. And they were like, no, this is the golden egg. You got the best offer. It's 1% that this actually works. [32:00] Dr. Katrina Furey: I thought it was really weird that the state and the defense both wanted her psychiatrist to be their expert witness and that he would agree either way. Didn't you think that was weird? [32:14] Portia Pendleton: So I thought at first, before the twist, that the state was involved somehow with big pharma. I thought it was very strange that he was being approached. That lawyer, that guy. [32:29] Dr. Katrina Furey: I just felt like that would, like. [32:31] Portia Pendleton: It seemed like he had some other motive. [32:34] Dr. Katrina Furey: And that's what I was just like. [32:36] Portia Pendleton: And I was wondering if they were trying to get him, the psychiatrist on board so that he could speak to that it's not the drug. Right. And try to get the drug off. That's what I was thinking. [32:47] Dr. Katrina Furey: But again, Dr. Banks, like, what a conflict of interest. I feel like that's pretty like Psychiatry 101 where you should not be you. [32:58] Portia Pendleton: Can'T be the actions treating and her psychiatrist. You have to be one or the other. [33:05] Dr. Katrina Furey: Not only her past treater. Like when this happened, but you continue to treat her while she's in the forensic unit. Again, that doesn't track for me. That's not really what happened. No, I think any psychiatrist who would unfortunately find themselves in this situation would a, call your malpractice, who will appoint your defense, and B you're not involved anymore. [33:28] Portia Pendleton: Right. [33:28] Dr. Katrina Furey: So the fact that he kept getting involved, I think speaks to how she kind of had her hooks in him and he felt compelled, do you think, to clear his own name? [33:37] Portia Pendleton: I think so. [33:38] Dr. Katrina Furey: I think it was both. [33:39] Portia Pendleton: I think he wanted to clear his own name because at this point, he was being harassed by people who were really unhappy with him. His wife seems unhappy with the situation. His practice seems unhappy with the situation. I think he was trying in half to clear his name and then on the other half, I think he felt sorry for her and wanted to help her. [34:03] Dr. Katrina Furey: And he probably felt like some degree of responsibility, having been the prescriber. And I think prescribing something that he's in getting a kickback for. And even though he's, like, upfront about it, I think maybe he had some guilt there. But in the real world, that's not what happens. Actually, this does happen where attorneys will try to get you to be their expert witness. That actually happens all the time. But you're taught pretty early on and pretty clearly that that's a really bad idea because it's such a conflict of interest. Even if it's like your patients involved in a lawsuit and you're not really related, but your testimony, I guess, could support they're getting more damages or something. That's such a conflict of interest because if you do it or you could just affect the therapeutic alliance and you don't want to mess with that. [34:54] Portia Pendleton: We only really do it if we are like, subpoenaed. And sometimes subpoenas, I think we really only have to follow through if it's like they're from the state. I think you can kind of fight sometimes a subpoena or push back on it for what they're asking for when it's like a private attorney. [35:12] Dr. Katrina Furey: And that's why you always just call your malpractice and they tell you what to do. So anyway, I don't think his malpractice. [35:18] Portia Pendleton: Would have advised him to do this. [35:20] Dr. Katrina Furey: You see his colleagues telling him, like, you need to stop. Get off the case. And then he asks his colleague for Adderall because he's kind of a mess. And I was like, oh, gosh, no. [35:38] Portia Pendleton: So then this twist happens, right? [35:40] Dr. Katrina Furey: So then, you know, we love a twist. Like, one day we'll have a boundaries jingle and then we'll also have, like, a twist. Yeah, that sounds like a tornado. [35:48] Portia Pendleton: So I feel like for me personally, I got a little confused initially. Like, I maybe I was doing two things at the same time. I wasn't totally engrossed in the movie. I don't know. It took me a couple of minutes to be like, okay, so we're going. [36:05] Dr. Katrina Furey: In a totally different direction here, right? Yeah. It felt like whiplash. Yeah. [36:09] Portia Pendleton: So Rudy Mara's character is Malingering. [36:12] Dr. Katrina Furey: Yeah. Turns out this whole time we see. [36:14] Portia Pendleton: That she is working with Katherazada Jones's character. Dr. Sebert was her old psychology and love interest. Yes. Which is very inappropriate, obviously. I feel like we don't even need to talk about that. It's obviously inappropriate. [36:27] Dr. Katrina Furey: And I feel like Hollywood loves to depict psychiatrists and patients boning. They just do. And it just really drives me nut. Yeah. [36:37] Portia Pendleton: It's really like any other really horrible thing to happen in any other field. Yes, it happens, but it's so rare, so bad. This isn't the norm. [36:50] Dr. Katrina Furey: So teacher thing. That's like, less, probably less. Right. But I did not see that coming. Like, the first time I saw this movie that turns out like they've been in cahoots the whole time and to get money. [37:08] Portia Pendleton: So that's their plan is to get this payout from causing which is kind of wild to think about all of these chain reactions to make them rich. That's how it is. So they apparently have been kind of planning to take down Dr. Banks. Right. They send him pictures. They send his wife pictures of him and her, Emily, together, which looks really sexually compromising. They float this past patient of his into his practice. So they want him out. It sounds like there was, like a death of a past patient. She took her life and she named. [37:46] Dr. Katrina Furey: Him right, in her suicide note. And he said, this is all delusional. This relationship never happened. [37:52] Portia Pendleton: Which I don't think it did. [37:54] Dr. Katrina Furey: I think he's telling the truth. And unfortunately, things like that do happen. Yeah. And so, gosh, what a lot of planning. [38:02] Portia Pendleton: It almost seems like too much, too. [38:05] Dr. Katrina Furey: Far fetched for it all to fall into place that way. [38:08] Portia Pendleton: But he starts to get, like he starts to figure it out. And he is appearing to be, like, crazy. Right. He's, like, staying up late. [38:15] Dr. Katrina Furey: He has this whole wall of all these pictures they always do with, like, a red pen and X's and, like, string taped up. And then he does give the sodium what is it? Ambutol? Truth serum. Basically. He supposedly gives her truth serum to. [38:31] Portia Pendleton: See if and at this point, we still think that he did. [38:34] Dr. Katrina Furey: Right. [38:35] Portia Pendleton: So we find out later that it was just like saline when he is telling the police or the lawyer for the state about it. And first of all, what he did is so unethical. Like unethical. And he can get in a lot. [38:48] Dr. Katrina Furey: Of trouble for it. [38:48] Portia Pendleton: So the lawyer is like, I don't. [38:50] Dr. Katrina Furey: Want to hear this. I don't want to know. [38:51] Portia Pendleton: You need to delete this. You need to get rid of it. [38:53] Dr. Katrina Furey: Because he films her. Right. [38:54] Portia Pendleton: And you can't be tried twice. So the lawyer is like, even if this is true, we have these laws that prohibit double jeopardy, I think it's called. Again, things are moving really fast, and we're starting to see that apparently she has concocted this plan with her old psychiatrist, and they were going to pin. [39:11] Dr. Katrina Furey: It on whoever evaluated her. It just happened to be him, and he just happened to have this history that sort of helped with their case. And then he's like, oh, no, you're not going to pin it on me. I'm going to pin it on you. And then it turns out that then Dr. Sebert and Emily are sort of pinning it on each other, but he starts lying and deceiving and manipulating almost as bad as Emily was to begin with. Yeah. So it's just really interesting. [39:37] Portia Pendleton: So it seems like they get her to wear a wire, emily, when she goes and meets with Dr. Sebert and gets her to kind of confess what's going on, and then Dr. Sebert feels because they're going to have sex. So she feels this pack on her back, and then the door opens and the police are there. [39:57] Dr. Katrina Furey: I know. [39:57] Portia Pendleton: And then I'm like, oh, Emily gets away. [40:00] Dr. Katrina Furey: Right? [40:01] Portia Pendleton: You think that she made this deal, she can't be tried again, and that's not the case. [40:08] Dr. Katrina Furey: So then you see they're all trying to pin it on Dr. Banks. They want her to be restored to sanity so that she can be discharged from the unit and sort of go live her happy life with Dr. Seabird. But she's supposed to keep seeing him to avoid being hospitalized. And she thought it was just going to be like, okay, let's pretend I'm seeing you, but not really. Like, you know the drill. I was malingering the whole time. I don't really need medications, blah, blah, blah. But then he's like, no, I'm going to prescribe you Thorazine and Depicote, both of which are they work. They're heavy hitters, man. Like, Thorazine is really sedating Depicode again, the side effects they mentioned from these meds were spot on. You can lose your hair with Depicode. You also gain a ton of weight. You're really sluggish cognitively. You can get a lot of acne. [40:57] Portia Pendleton: So who would be prescribed those? Like, what kind of a patient would be prescribed Thorazine and Depicote? Or either? [41:05] Dr. Katrina Furey: Yeah. So Depicote is under the class of medications called mood stabilizers, which we use for things like bipolar disorder. You do not use it in women of childbearing age because it has been shown to be associated with a birth defect, specifically neural tube defects, which lead to things like spina bifida. In pregnancy, you always take a high dose Folate, and you can take extra. If you have to be on Depicode, if that's, like, the only mood stabilizer that's ever stabilized your bipolar disorder, then by all means, you need to stay on it. But it's not the first one we use. Also, so many side effects, and there's newer mood stabilizers like lamctal. Lithium has been around forever. But it's like a really good one that's effective. It has low side effects, too. And then Thorazine is an older antipsychotic, which he does acknowledge and is true. It's what we call like a typical antipsychotic like Haldol that is used for psychotic disorders. So things like schizophrenia, we use it a lot in the emergency room and inpatient setting to also help with sedations. Like, if you're so psychotic or manic that you are unable to sleep, you'll often get Thorazine to sort of help promote sleep. So you can imagine how much fatigue goes along with it. Sluggishness. It can be very drying. Like your mouth is really dry. It's not pleasant. So he's basically, like putting her into a pharmacological prison is basically what he's doing and making sure that she has to go get drug tested to show that she's actually taking it or she's going to go back in the hospital. So he gets the final one over. [42:38] Portia Pendleton: So she is like, no, right, and runs out of there, tries to escape, and that's when she is not then right following. And I think he knows this, that she's going to have this reaction. So she kind of goes to get in the cabin, run away, and the police are waiting for her. He kind of knew all along. [42:55] Dr. Katrina Furey: I think he tipped him off that this is going to happen. He probably didn't say, like, I'm going to do this and she's going to do that. He probably was like, she's been acting odd. Can you be waiting? And then she goes back, I think to the forensic psych unit, which honestly, that's where she belongs. Yeah, that's where she belongs. Given everything that happened. Gosh, that movie had a lot of twists and turns, lots of ups and downs. I feel like there's probably so much more we could talk about, but this episode has already been really long. I thought it was interesting, Portia, that you didn't seem as into this movie as I was. Do you think it's because I prescribe? [43:30] Portia Pendleton: I don't know. What's funny, too, is that one of my friends who's not in the field at all, really loved this movie and recommended it. And I don't know, I feel like. [43:42] Dr. Katrina Furey: I was a little bored, actually. Yeah, you yawned a lot as we were recording this. [43:48] Portia Pendleton: I don't know what that says. [43:50] Dr. Katrina Furey: That's why I feel like I also. [43:51] Portia Pendleton: Missed things throughout it. [43:54] Dr. Katrina Furey: Do you think it's because we've been talking a lot about psychopaths, like with you, and maybe you're just kind of over it for right now. Maybe Tatum died. Yeah. Maybe this Zach grief is too much for you to bear. Maybe, yeah. [44:09] Portia Pendleton: I have no idea. I think that's interesting though. I was like bored. I feel like, oh, no, pay attention. Pay attention. [44:16] Dr. Katrina Furey: I know. And I couldn't wait for us to record this episode and watch it again. And you're like, over here, yawning. And I'm like, and then they got the side effect right, and then they did this right. Then they did this wrong. Maybe someday we'll have a patreon and we can record a bonus episode where we explore that reaction further. Maybe. [44:34] Portia Pendleton: This felt unbelievable to me. [44:36] Dr. Katrina Furey: I think it did. [44:37] Portia Pendleton: It did. And I think that's where I was. [44:39] Dr. Katrina Furey: Just like, this wouldn't really happen. No, it's totally I mean, again, I think once the twist came into play, then you're like, oh, God, that's what this movie is. That's so unbelievable. You know what? I think it's important that we do analyze scripts that we don't like. Yeah. All right, well, I don't want to hold you up any longer. We'll wrap up this episode. Thanks for listening. I hope that whoever's listening isn't Yawning. We'll see. Please don't forget to rate, review and subscribe follow us on Instagram at Analyze scripts. DM us. Send us an email, analyze Scriptspodcast@gmail.com and let us know what you want us to analyze next. Put you to sleep. Like this movie put portion to sleep. [45:23] Portia Pendleton: Thanks so much for listening. [45:25] Dr. Katrina Furey: See you later. Bye. [45:31] Dr. Katrina Furey: This podcast and its contents are a copyright of Analyzed Scripts. [45:35] Dr. Katrina Furey: All rights reserved. [45:37] Dr. Katrina Furey: Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with. [45:44] Dr. Katrina Furey: Your friends and rate, review and subscribe, that's fine. [45:47] Dr. Katrina Furey: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended. [45:56] Dr. Katrina Furey: Or should be inferred. [45:58] Dr. Katrina Furey: This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Like any prescription medication, Abilify, Risperdal, Clozapine, and other anti-psychotics have side effects. And like any medication, they are prescribed to help a person manage an illness. Anti-psychotics can help with a number of different illnesses, but often used to help manage a person's symptoms of schizophrenia, including paranoia, delusions and hallucinations. However, there's a movement that wants to shift mainstream thinking away from using medication to manage the symptoms of a serious mental illness. It's encouraging people to accept and live with the symptoms of serious mental illness, symptoms like voices, hallucinations, and other symptoms. It's a controversial topic and we've brought back a familiar voice from our first season – Dr. Diane McIntosh, Psychiatrist and Clinical Assistant Professor at the University of British Columbia. In this episode, we talk about the use of medications in treating serious mental illnesses like schizophrenia. Resources:Dr. Diane McIntosh - BioBlindsided - Dr. Diane McIntosh's podcastAntipsychotic Selection Is Important for Reduced Nonadherence in SchizophreniaLook Again Season 1, Episode 5: The Truth Behind Psychiatric MedicationAnti-Psychotic Medication - CAMHSee omnystudio.com/listener for privacy information.

Regular blueberry consumption may reduce risk of dementia, study finds University of Cincinnati, May 11, 2022 Researchers found that adding blueberries to the daily diets of certain middle-aged populations may lower the chances of developing late-life dementia. The findings were recently published in the journal Nutrients.  Krikorian said his team has been conducting research on the benefits of berries for people with greater risk for Alzheimer's disease and dementia for several years.  The researchers enrolled 33 patients from around the Cincinnati area between the ages of 50-65 who were overweight, prediabetic and had noticed mild memory decline with aging. Krikorian said this population has an increased risk for late-life dementia and other common conditions.  Over a period of 12 weeks, the patients were asked to abstain from berry fruit consumption of any kind except for a daily packet of supplement powder to be mixed with water and consumed either with breakfast or dinner. Half of the participants received powders that contained the equivalent of one-half cup of whole blueberries, while the other half received a placebo.  Krikorian said those in the blueberry-treated group showed improvement on cognitive tasks that depend on executive control.   Patients in the blueberry group also had lower fasting insulin levels, meaning the participants had improved metabolic function and were able to more easily burn fat for energy.   Krikorian said the blueberry group displayed an additional mild degree of higher mitochondrial uncoupling, a cellular process that has been associated with greater longevity and reduced oxidative stress. Oxidative stress can lead to symptoms like fatigue and memory loss.  Regular exercise with dietary advice linked to better mobility in frail older people Yale University, May 11, 2022 A program of regular exercise along with expert dietary advice is linked to a reduction in mobility problems among frail older people living in the community, finds a trial published by The BMJ today. The combination of aerobic (walking), strength, flexibility, and balance exercises alongside personalized nutritional counseling reduced mobility disability by 22% over three years. Their findings are based on 1,519 men and women (average age 79 years) with physical frailty and sarcopenia (a combination of reduced physical function and low muscle mass) recruited from 16 clinical sites across 11 European countries between 2016 and 2019. Women in the intervention group lost less muscle strength (0.9 kg at 24 months) and less muscle mass (0.24 kg and 0.49 kg at 24 months and 36 months, respectively) than control women, but no significant group differences were seen in men.  Study: Side effects emerge after approval for many US Yale University, May 9, 2022  Almost one-third of new drugs approved by U.S. regulators over a decade ended up years later with warnings about unexpected, sometimes life-threatening side effects or complications, a newanalysis found. The results covered all 222 prescription drugs approved by the U.S. Food and Drug Administration over ten yers.  The 71 flagged drugs included top-sellers for treating depression, arthritis, infections and blood clots. Safety issues included risks for serious skin reactions, liver damage, cancer and even death. “The large percentage of problems was a surprise,” and they included side effects not seen during the review process, said Dr. Joseph Ross, the study's lead author at Yale University.”We know that safety concerns, new ones, are going to be identified once a drug is used in a wider population. That's just how it is,” Ross said.  While most safety concerns were not serious enough to prompt recalls, the findings raise questions about how thoroughly drugs are tested before approval The study counted black-box warnings for dozens of drugs; these involved serious problems including deaths or life-threatening conditions linked with the drugs. There were also dozens of alerts for less serious potential harms and three drug withdrawals because of the potential for death or other serious harm. Among the drugs with added warnings: Humira, used for arthritis and some other illnesses; Abilify, used for depression and other mental illness; and Pradaxa, a blood thinner. The withdrawn drugs and the reason: Bextra, an anti-inflammatory medicine, heart problems; Raptiva, a psoriasis drug, rare nervous system illness; and Zelnorm, a bowel illness drug, heart problems. Exercise during pregnancy may yield metabolic benefits in grandchildren Harvard University, May 11, 2022 If grandma liked working out, her pain may be your gain. It may seem unlikely, but recent research out of the Joslin Diabetes Center says it just might be the case. Laurie Goodyear, a professor of medicine at Harvard Medical School, has found that a grandmother's exercise during pregnancy may make her grandchildren healthier metabolically, with less body fat, better insulin control and, in some, healthier bones. We are looking for epigenetic alterations in the DNA, because epigenetic alterations can be changed as rapidly as two generations. We analyze micro RNAs, some methylation situations in the F1 generation eggs and sperm to see what's going on. We are currently investigating how mothers' exercise affects their children's gametes. I'm confident in saying that women who are pregnant should try to be as physically active as they can, depending, of course, on the condition of their pregnancy. There's strong human data showing that exercise during pregnancy improves the mother's health; numerous animal studies showing improved first-generation health; and now we have evidence that maternal exercise will positively impact the health of the second generation. I'm not an obstetrician, and there are certainly conditions where a woman cannot perform exercise during pregnancy, but, when medically approved, being physically active is important—for the mother, the first generation, and now even the grandchildren. New Study Finds Simply Believing You Can Do Something To Improve It Is Linked With Higher Wellbeing University Of Southern Denmark And University Of Copenhagen, May 11, 2022 The number of people struggling with poor mental health and mental disorders has been rising around the world over the past few decades. Those who are struggling are increasingly facing difficulties accessing the kind of support they need – leaving many waiting months for help, if they even qualify for treatment. In our recent study, we asked 3,015 Danish adults to fill out a survey that asked questions about mental health – such as whether they believe they can do something to keep mentally healthy, whether they had done something in the past two weeks to support their mental health, and also whether they were currently struggling with a mental health problem. We then assessed their level of mental wellbeing using the Short Warwick–Edinburgh Mental Well-being Scale, which is widely used by healthcare professionals and researchers to measure mental wellbeing. As you'd expect, we found that mental wellbeing was highest among those who had done things to improve their mental health compared with the other participants. Interestingly, however, we found that – whether or not our respondents had actually taken action to improve their mental wellbeing – people who believed they could do something to keep mentally healthy tended to have higher mental wellbeing than those who didn't have this belief. So while it's most beneficial to take steps to improve your mental health, even just believing that you can improve it is associated with better overall mental wellbeing.The effect of night shifts—gene expression fails to adapt to new sleep patterns McGill University (Quebec).  May 7, 2022  Have you ever considered that working night shifts may, in the long run, have an impact on your health? A team of researchers from the McGill University has discovered that genes regulating important biological processes are incapable of adapting to new sleeping and eating patterns and that most of them stay tuned to their daytime biological clock rhythms. “We now better understand the molecular changes that take place inside the human body when sleeping and eating behaviours are in sync with our biological clock. For example, we found that the expression of genes related to the immune system and metabolic processes did not adapt to the new behaviours,” says Dr. Boivin, a full professor at McGill University's Department of Psychiatry. It is known that the expression of many of these genes varies over the course of the day and night. Their repetitive rhythms are important for the regulation of many physiological and behavioural processes. “Almost 25% of the rhythmic genes lost their biological rhythm after our volunteers were exposed to our night shift simulation. 73% did not adapt to the night shift and stayed tuned to their daytime rhythm. And less than 3% partly adapted to the night shift schedule. “We think the molecular changes we observed potentially contribute to the development of health problems like diabetes, obesity, cardiovascular diseases more frequently seen in night-shift workers on the long term,” explains Dr. Boivin.  Videos: 1. Will the Future Be Human? – Yuval Noah Harari (Start @ 2:13) 2. The Invention Of Whiteness.. (Start @ 0:28) 3. Jonathan Pie's Rant On Cultural Appropriation 4. Breakthrough deaths comprise increasing proportion of those who died from COVID-19 (5:44)

Flosch war mehrere Jahre sehr stark an ME/CFS erkrankt und konnte sich teilweise nicht selbt ernähren. Glücklicherweise geht es ihm heute wieder viel besser. Was zu seiner Genesung beigetragen hat, erzählt er in dieser Episode.

Nicole Lamberson is a Physician Assistant residing in Virginia. She obtained a BS at James Madison University in 2000 and then went on to complete the Master of Physician Assistant program at Eastern Virginia Medical School in 2004. She practiced in Urgent Care and Occupational Medicine settings until severe illness from prescribed psychiatric medication polypharmacy and a subsequent protracted withdrawal syndrome left her unable to work. Aside from her role with Medicating Normal doing marketing, distribution and outreach, she co-founded The Withdrawal Project, an effort of the nonprofit, Inner Compass Initiative. She also serves on the Medical Advisory Board of Benzodiazepine Information Coalition and is a founding member of the Colorado Consortium's Benzodiazepine Action Work Group. She also founded and co-administrates a small support group for those injured by prescribed psychiatric medication. In the future, Nicole hopes to practice again with a focus on prescribed medication withdrawal management and also participate in education initiatives around psychiatric drug withdrawal for medical prescribers.Award-winning filmmaker, and co-director/producer of Medicating Normal, Lynn Cunningham produced, directed and edited films/TV for PBS and the History Channel in the 1980s and 90s (A Quiet Revolution: The Emergence of Alternative Education in Japan; Twenty Years of Co-Education; A Family in Progress; An Innovator's Story, Behind the Scenes, Walter Reuther & the Birth of the UAW, Tadao Ando, Butoh: A Body on the Edge of Crisis, etc).Twenty years ago, as she was becoming a parent herself, Lynn witnessed with crushing despair the dramatic transformation of a beloved family member. Once a bright, high-functioning scholar/athlete having graduated from an elite college, Lynn's relative had become in a few short years– a terrified, suicidal shell of her former self— diagnosed with serious mental illness. Putting their faith in the best psychiatric standard of care at the time in the late 90s, Lynn and her family were initially reassured by the relief and stability provided by medication and therapy. After a ten-year period, however, one medicine had become ten, and income from a vibrant, self-sufficient career was replaced with monthly disability payments. Unable to provide an answer to her relative's persistent self-doubt, “Is everything going to be OK?”” Lynn began searching for answers. She joined with her filmmaking partner Wendy Ractliffe, embarking on five years of research into the complex world of mental health treatment. After discovering Robert Whitaker's Anatomy of an Epidemic, they interviewed 100s of psychiatric patients and consulted with scores of experts across the country about their experiences. A personal quest to help one suffering individual turned into a mission to tell an untold story. In Medicating Normal, Lynn and Wendy began to piece together a stunning new perspective on the safety and efficacy of psychiatric drugs and society's over reliance on them to relieve pain and suffering.https://medicatingnormal.com/http://withdrawal.theinnercompass.org/http://www.theinnercompass.org/http://www.benzoinfo.com/https://corxconsortium.org/work-groups/benzodiazepine/***********************************Please visit our podcast website at https://therehab.comAnd Dr. Leeds' professional website at https://drleeds.comThank you!

In dieser Episode spreche ich mit Flosch über seinen Kampf mit ME/CFS, welche Rolle "Surrendering" bei seiner Genesung gespielt haben und wie er es geschafft hat, von Bell 0 auf Bell 70 zu kommen Links aus dem Podcast: IG von Flosch: https://www.instagram.com/me_vs_meandcfs/ Floschs Blog: https://cfsistkeineidylle.me/ Infos zur Polyvagal-Theorie von Therapeutin Ramona Fischer https://traumata-verstehen-lernen.jimdofree.com/trauma-und-k%C3%B6rper/die-polyvagal-theorie/ Facebook-Seite zu Abilify: ttps://www.facebook.com/groups/2433702210269370 IG von Superhelden Ohne Cape: superheldenohnecape E-Mail: superheldenohnecape@yahoo.com This podcast is hosted by ZenCast.fm

SUMMARY In Part 2 of this podcast on Schizophrenia, we're joined again by Katrina Tinman (peer support worker with lived experience of schizophrenia), Chris Summerville (CEO of the Canadian Schizophrenia Society), and Dr. Phil Tibbo (clinical/research psychiatrist who specializes in psychosis-related illnesses). They dig deep into emerging holistic recovery approaches that integrate biological, psychological, social, vocational, and spiritual supports. They also explore stigma, impacts of COVID-19, needed changes to public policy and the mental healthcare system, and the world of schizophrenia 20-30 years from now. TAKEAWAYS This Part 2 podcast will help you understand: Emerging diagnostic practices and medications Integrated healing that incorporates biological, psychological, social, vocational, and spiritual recovery supports Benefits of meditation/mindfulness and positive lifestyle choices Benefits of creative therapies that use art, music, drama, and writing Advances in personalized/precision medicine Advances in technology and the Internet to support recovery Effects of COVID-19 Stigma's impact on recovery Challenges for families of people with schizophrenia What medical professionals need to know about schizophrenia What public policy changes would support recovery Why changes should be made to the mental healthcare system What the world of schizophrenia could look like in the future SPONSORS RESOURCES RECOVERY: Research Into Recovery Recovery Model of Mental Illness: A Complementary Approach to Psychiatric Care A National Framework for Recovery in Mental Health Recovery-oriented Practice − An Implementation Toolkit PEER SUPPORT: Peer Support  The Future is Peer Support Using Peer Support in Developing Empowering Mental Health Services MENTAL HEALTH STIGMA: Fighting Stigma and Discrimination Is Fighting for Mental Health Stigma and Discrimination Addressing Stigma Five Ways to End Mental Health Stigma SCHIZOPHRENIA: Hope and Recovery Schizophrenia Treatment and Self-help   GUESTS  Katrina Tinman Katrina Tinman is a peer support worker for Peer Connections Manitoba, formerly the Manitoba Schizophrenia Society, and is located at the Mental Health Crisis Response Centre in Winnipeg, Manitoba. Katrina is currently working toward formal peer support worker certification with Peer Support Canada, though she already has peer support certification through the Ontario Peer Development Initiative. Katrina received a university education in journalism and political science in 1998, from North Dakota State University in Fargo, North Dakota. Since then, she's had a wide range of life experiences from working in the professional arena, extensive travel, motorcycle riding, alpine skiing, and SCUBA diving, to homelessness and mental illness. Regardless of some negative life experiences, Katrina's greatest achievement was a sense of fearlessness that carried her through along with hope for the future. Now she's able, through her peer support work, to use her life's insights to help others in their recovery from crisis and mental illness. Email: k.tinman@peerconnectionsmb.ca Website: www.peerconnectionsmb.ca  Facebook: www.facebook.com/katrina.tinman.5 Twitter: https://twitter.com/tinman_katrina Linkedin: www.linkedin.com/in/katrinatinman Chris Summerville, BA, MDiv, M.Miss, D.Min, LLD (Honorary) Chris Summerville is from a family with mental health challenges (father and brother with bi-polar disorder, a brother with schizophrenia, siblings living with depression, and two suicides). He has also received mental health care himself, which has informed and inspired his work as CEO of the Schizophrenia Society of Canada since 2007. Chris has been involved with the schizophrenia-recovery movement for nearly 30 years, having served on the boards of the Mental Health Commission of Canada, Mood Disorders Society of Canada, National Network for Mental Health, and Psychosocial Rehabilitation Canada. Chris earned a doctorate from Dallas Theological Seminary, is a certified psychosocial rehabilitation recovery practitioner (CPRRP), and received an honorary Doctor of Laws from Brandon University in 2014. He is a regional, provincial, and national leader and advocate for a transformed, person-centered, recovery-oriented mental healthcare system, and believes mental health concerns should be addressed using integrated bio-psycho-social-spiritual-vocational approaches.  Email: Chris@schizophrenia.ca Website: www.schizophrenia.ca Facebook: https://www.facebook.com/SchizophreniaSocietyCanada Twitter: https://twitter.com/SchizophreniaCa LinkedIn: https://www.linkedin.com/company/schizophrenia-society-of-canada Phil Tibbo, MD, FRCPC Phil Tibbo was named the first Dr. Paul Janssen Chair in Psychotic Disorders, an endowed research chair, at Dalhousie University in Halifax, Nova Scotia, Canada. He is a professor in the Department of Psychiatry with a cross-appointment in psychology at Dalhousie University, and an adjunct professor in the Department of Psychiatry at the University of Alberta. He is also director of the Nova Scotia Early Psychosis Program (NSEPP) and co-director of the Nova Scotia Psychosis Research Unit (NSPRU). Dr. Tibbo is funded by local and national peer reviewed funding agencies and well published in leading journals. His publications are primarily around schizophrenia, and his current foci of study include individuals at the early phase of, and individuals at risk for, a psychotic illness. Dr. Tibbo's areas of research include application of in vivo brain neuroimaging techniques, to study psychosis as well as research interests in co-morbidities in schizophrenia, psychosis genetics, addictions and psychosis, stigma and burden, pathways to care, education, and non-pharmacological treatment options. Dr. Tibbo is president of the Canadian Consortium for Early Intervention in Psychosis (CCEIP), helping to advance early intervention care at the national level. He is a recipient (2015) of the Michael Smith Award from the Schizophrenia Society of Canada for research and leadership in schizophrenia, recipient of the Canadian Alliance on Mental Illness and Mental Health's Champion of Mental Health Research/Clinician award in 2017 and, most recently, recipient of the 2018 Regional Prix d'excellence – Specialist of the Year – Region 5 by the Royal College of Physicians and Surgeons of Canada. Email: phil.tibbo@nshealth.ca LinkedIn: https://www.linkedin.com/in/phil-tibbo-62170b18/ HOST Jo de Vries is a community education and engagement specialist with 30 years of experience helping local governments in British Columbia connect with their citizens about important sustainability issues. In 2006, she established the Fresh Outlook Foundation (FOF) to “inspire community conversations for sustainable change.” FOF's highly acclaimed events include Building SustainABLE Communities conferences, Reel Change SustainAbility Film Fest, Eco-Blast Kids' Camps, CommUnity Innovation Lab, Breakfast of Champions, and Women 4 SustainAbility. FOF's newest ventures are the HEADS UP! Community Mental Health Summit and HEADS UP! Community Mental Health Podcast. Website: Fresh Outlook Foundation Phone: 250-300-8797   PLAY IT FORWARD The move toward optimal mental health becomes possible as more people learn about the challenges, successes, and opportunities. To that end, please share this podcast with anyone who has an interest or stake in the future of mental health and wellness. FOLLOW US For more information about the Fresh Outlook Foundation (FOF) and our programs and events, visit our website, sign up for our newsletter, and like us on Facebook and Twitter.   HELP US As a charity, FOF relies on support from grants, sponsors, and donors to continue its valuable work. If you benefited from the podcast, please help fund future episodes by making a one-time or monthly donation. Katrina Tinman, Chris Summerville, Phil Tibbo Interview Transcript You can download a pdf of the transcript here. The entire transcript is also found below: RICK  0:10 Welcome to the HEADS UP Community Mental Health podcast. Join our host Jo de Vries with the Fresh Outlook Foundation, as she combines science with storytelling to explore a variety of mental health issues with people from all walks of life. Stay tuned. JO  0:32 Hey, Jo here. Thanks for joining me again with my three incredible guests as we continue our conversation about schizophrenia, this time focusing on integrated recovery support, emerging science, and advancing technology. We'll also touch on the stigma faced by people with the illness, and gaps in the current mental health care system. But before we dig back in, a big shout out to our amazing sponsors, the Social Planning and Research Council of BC, Emil Anderson Construction, WorkSafe BC, and AECOM Engineering Canada. We celebrate them as their continued support is fueling our passion for improving mental health literacy. Again, my three guests are Katrina Tinman, a peer support worker with Peer Connections Manitoba, Chris Summerville, Executive Director of the Schizophrenia Society of Canada, and Dr. Phil Tibbo, a Canadian psychiatrist who studies, treats, and advocates for people with psychosis and schizophrenia. In Part 1 of this podcast, we heard personal stories and learned about signs of the illness, myths, and recovery movements. Dr. Phil Tibbo also talked about past diagnostic practices. To start this episode, we'll connect with Phil again about diagnostic practices today, and what research is telling us about them. PHIL  2:06 It's a big area of research. And I think I mentioned earlier, we're still not at a point where we can do a blood test similar to other medical illnesses, and from that result in a diagnosis. So there's still a lot of work going on here, and especially at early phases of illness as well. And so a lot of the research is looking at multimodal or multifaceted approaches to diagnosis, that can include not only from interview and behavioral, looking at symptoms, but as well as what we call the biological markers, biological indices, which can be some of the neuroimaging research. Some very exciting work going on even EEG type of research within brainwaves, but as well as in genetics too. The one difficulty with schizophrenia, and again, different from some other medical illnesses where it's a single gene, and something wrong with that gene causes a medical illness. We know that's not the case for psychosis and schizophrenia. And often what it's called is an illness with multiple genes of small effect. Research is active in here, but really that focus is to really help us to identify early. But it'll probably be, like I say, multifaceted or a multimodal sort of approach to diagnosis. I wish I can kind of drop in in 20 30 years time and see what the approach is going to be. I think we're going to see a difference from how we're approaching things now to what it will be in the future, which is of course, the way that it should be. I mean, we're doing things differently than what we were doing 20 30 years ago as well. JO  3:38 Let's now hone in on current treatment strategies that focus on integrating biological, psychological, social, and vocational support, as well as psychosocial rehabilitation. And we're gonna break that down, so don't worry about all those big terms. Starting with biological support, Phil from what I understand, biological or brain-related effects are still best treated with anti-psychotic medications, which ideally, are only one part of an overall treatment plan. Is that what you're seeing? PHIL  4:17 Yes, you still have to consider that schizophrenia is a brain illness which needs to be treated, and medication can be a cornerstone of that treatment. But as a result of the illness, there are other things that may be needed when we were looking at other non-biological therapies. Definitely have psychotic medications are a cornerstone. Now that said, the amount of medication or the length that somebody is on a medication really depends on the individual and really what their needs are as well. Because I have individuals that I see that may need medications for actually a fairly short period of time, and they've been doing well with no medications at this point. It really is kind of individual, but yet yes from biological standpoint, the anti-psychotic medications are a cornerstone treatment. JO  5:04 Kat and Chris, in your personal experience and as shared by your peers, what are the pros and cons of anti-psychotic medication? And are people's responses changing over time as the medications change? KATRINA  5:21 It gets to symptoms versus side effects. As I went through the process of finding what medication would work, it was a journey that lasted about 10 years. And I'd ran the gamut of, well, three I can remember Lexapro, Risperdal, and Zyprexa. But nothing really fit. Remember the description of the spectrum, and trying to find where things fit. And for me, it wasn't until 2013 when I ended up fortunate enough to have a doctor to work with me at length, to find the right medication that would actually be the best fit for me, in communication with me. And it turned out it was one of those that hadn't even been invented until right around that timeframe. Abilify turned out to be the right one for me. CHRIS  6:15 Well, certainly, antipsychotics and antidepressants can address the symptoms of psychosis and mood disorders and minimize them. But as one of our former chiefs of psychiatry here in Manitoba said, "If only the medications did everything that we hoped that they would do." Unfortunately, as Katrina stated, there can be significant side effects. And there are many side effects that we don't have time to go into. But the two that I would mention most pronounced are cardiovascular illnesses and metabolic illnesses. And that's one reason why many people don't want to take the medications or discontinue after a while, because of that fear. JO  6:57 Phil, what advances are being made to make these medications more accessible and effective with fewer side effects? PHIL  7:05 There's a lot of research and development going into newer medications. And I think we always have to be careful in our discussion around this. Because while there may be cardiovascular, may be metabolic side effects, it's not a given. Significant number of individuals that I see that do not have any side effects with their medications. That's with our open and honest discussions. But we have to be mindful of when that can occur, and just be able to catch it early. I know we'll talk about stigma, but there is a stigma about medication that has resulted and it's probably from the older medication. The research and development these days, the focus is on developing an effective medication with little to no side effects. With a better understanding of the illness, with better understanding of brain receptors, there's more targeted, more focused research on the development of these types of medications. I have to agree that there was a period of time where there's a lot of sort of what I call 'me to' medications being developed, very similar to ones that are already out there. But what we're seeing now is just that more focused, more targeted development. JO  8:14 Phil, what about options for people who might forget to take their medications, or choose not to take them for whatever reason? PHIL  8:21 We've had, I'll use the term LAI's, long-acting injectable medication. We've had them for a while. But for similar reasons Katrina and Chris mentioned, you know, they've kind of fell out of favor because of their side effect profile. But recent developments have allowed us to have newer medications in that particular format with much fewer side effects. People can just be on a once-a-month injection medication, or once every three months. And there's product and development for other medications for once every two months. I have this conversation with individuals that I see. It allows them to focus on their recovery, because they don't have to remember to take their medication. And I think that's an important piece. What some of young adults tell me is that they have to take a pill every day that just reminds them that they have an illness. But if they just need to come into the clinic once a month, or every three months for an injection, that helps them focus on their recovery as well. JO  9:18 And Phil, while doing research for this episode, I came across information about using cannabis to treat psychosis. Is that legitimate? PHIL  9:27 No. First of all, a couple of points around that. When we talk about cannabis, keep in mind if we're talking about just overall cannabis plant, there's over 100 active compounds within that. The two most common compounds people hear about, of course, are THC and CBD. And we know that THC is actually more of the risk factor with respect to psychosis development, and poor outcomes after the development of psychosis. There have been some studies trying to look at CBD, cannabidiol, and its potential role within a psychosis, but honestly, there's not a lot. And we just recently published a position statement for the Canadian Psychiatric Association as well as a systematic review and meta-analysis, examining this literature and looking at randomized, controlled trials of different cannabis or cannabinoid products. There's actually only six studies in schizophrenia where they've looked at cannabinoid products, really not much effect. I'm not being negative about it. But just highlighting that we do need a lot more research into this area. And we have to be very clear on what sort of cannabinoid product that we're talking about. JO  10:39 Let's talk about another piece of the recovery puzzle, which is psychological support. Psychological or mental and emotional effects associated with schizophrenia can include depression, anxiety, substance-use, suicidal ideation, and others. These often respond well to treatments such as cognitive behavior therapy, and other emerging approaches such as reality therapy and cognitive remediation. Phil, how do these work? And how can they be integrated with biological solutions? PHIL  11:16 Well first of all, our approach is integrated. We look at, say, medication plus as well as the psychotherapy and psychosocial treatments as well. Having more tools in our toolkit to be able to address the illness. We will have some people who will definitely benefit from cognitive behavioral therapy for psychosis. And that really allows an individual to learn how to adapt, and respond, and develop strategies to work with their symptoms, for example, so that an individual is not as stressed by their symptoms or able to manage them so that they can do what they want to do, basically, in their day-to-day lives. There's a number of different strategies and therapies along these lines. Some are more similar to each other than not. We have a sort of service and commitment therapy as well, ACT, plus as you mentioned, CBT. But they're really there to help augment that individual's experience with their symptoms, or for example, with comorbid symptoms as well, such as depression and anxiety. JO  12:17 So Chris and Kat, are your peers ever hesitant to add these therapies to their recovery plans? KATRINA  12:25 I know I wasn't. In talking with peers, we usually do touch on some of these possibilities. And there's usually enthusiasm at the idea. Oh yeah, I heard of that, or along those lines where they are willing to engage. CHRIS  12:43 I don't think there would be a hesitancy in general, if people were aware of what their various therapies are. There are many what I call, talk therapies that we can utilize today. Some have been mentioned, cognitive remediation, cognitive behavioral therapy, dialectical behavioral therapy, and acceptance commitment therapy, and family therapy. People in general, I think, have a fear of going into therapy because someone's going to try to fix me, and I have to expose them to, and I have to reveal all of my problematic thinking or what have you. So, I think the goal of these therapies have to be clearer for the patient or the client, and that is helping one to manage difficulty in the area of cognition and their thinking, helping them in their executive skills, helping them to improve their communication skills and relationships. So, the therapy has to be explained to people that it will be more than a supplement to the medication, where the medication is not able to address certain issues. Talk therapies have been demonstrated to promote the recovery process. JO  13:47 What are the biggest barriers to people not receiving the psychological support they need? CHRIS  13:53 Well number one, here in Canada, psychological support services are not covered by our health care system unless you're a patient in the hospital. But once you're out in the community, you have to shell it out of your own pocket, and most people can't afford psychological support therapies. And also, the lack of awareness about the role that trauma can play in psychosis and recovery. A lot of people don't know about that. And many service providers may not actually be trained in trauma informed care, due to the lack of trauma informed services. So all those things that I've just mentioned, can be great barriers to people receiving the appropriate psychological supports that they need. PHIL  14:32 I'll have to step in and agree with that. Access and availability is a big thing. The other thing to consider as a barrier. Families talk to me about this kind of at the beginning, when is psychotherapy going to start? And sometimes the barrier, of course, is the illness itself and that person to be able to engage and work within some of these therapies, they have to get to a certain cognitive level to be able to do that. And that's where sometimes we have to wait a little bit of time until we get some better control on some of those symptoms, so that people are then able to engage in some of the psychosocial and talk therapies that would be helpful. JO  15:08 What about creative therapies that use art, music, drama, and writing? KATRINA  15:14 Those, speaking from a person of lived experience and pure perspective, can be very, very useful for meditations and journaling, because really it helps somebody walk through and process thoughts, feelings, and experiences. And I personally think that can be very valuable, as it's really helped me in many ways. PHIL  15:40 I'd have to agree. We've been researching areas of this as well, and we published on this too in a number of different formats and looking at mindfulness-based support groups for families looking at self compassion, and mindfulness, in relation to depression and anxiety. And interestingly too, we've even published on claymation art therapy in our youth and young adult population and the benefits of that. One person may do well with claymation art therapy, and another person not interested at all. So, it helps to be able to investigate and to know that these types of therapies and creative therapies can be helpful. JO  16:14 In your stories and insights, I'm hearing that social support is also vital for people recovering from schizophrenia, this being available through peer support, self-help programs, and family education and support. Chris, what are the biggest barriers to people receiving the social support they need? CHRIS  16:35 Society in general and the media as well, they tend to think that it's just all about medication. You wouldn't believe how many times I've been asked this question through the over 1500 media interviews that I've done, in which I will be asked, "well, how do we make sure these people stay on their medication?" As if medication was the cure all? Again, education is needed that, quote, the treatment of mental illness, and particularly schizophrenia that we're talking about today, is very holistic, so a holistic approach. And that means, what do we do to help people when they're in the community, back at home, back in the community? What kinds of social supports do they need? Whether it's peer support, support groups, whether it's accommodations in pursuing education, accommodation and getting a job, adequate housing, decent income, all those factors. As a society, I think we get it with most other illnesses. These kinds of questions didn't come up when my wife was experiencing breast cancer. There was pure support, there was family engagement, there was family education. There was not just attempts but helping her to connect with various community agencies. One of the things that perhaps gets in the way, which we'll talk about later, is that this profound stigma and prejudice towards people who have a mental illness that live in our community, that affects our policies, that affects our funding. It's a great misconception out there that to address mental illnesses is just a matter of the medical. But as we've listened to Dr. Tibbo and Katrina, they've articulated well that psychological, social, the communal aspects involved in recovery are equally important. JO  18:35 Kat, can you share a story of how important social support is? KATRINA  18:40 The way I'll share it is actually to state that sometimes we hear feedback as peer support workers from our peers, as we're going through the process and discussing with them where they're at and where they're going, and what they're working on, and what they're trying to accomplish. And one of my peers sent back the message, for instance, that I made them feel comfortable, and that I connected with her, that I was nurturing, and calming, and helped that peer make their own decisions that were right for them. And that's, I think, an important piece, that connection to the recovery process and that non-aloneness. And I think that is something that peer support is demonstrating. What we're doing right now at the Mental Health Crisis Response Center is a pilot program. The feedback that we're getting is huge, phenomenal to positive that, yes, this is worth it. JO  19:41 I know you're researching the effectiveness of non-pharmaceutical treatment options like therapy and peer support. What have you learned so far? PHIL  19:52 Well, I think the high-level approach to this question is really important. And that we need to continue with our research in looking at non-pharmaceutical options, and the different types of therapy and peer support. Specifically finding out what we can use, what has the best effect, will be important for the population that we work with as well. We have researched peer support and we have found, yes definitely, it is needed and people, as Katrina mentioned, do benefit from it in many varieties of ways. JO  20:21 Chris as a recovery practitioner, you're very familiar with psychosocial rehabilitation, which I've learned among other things, includes case management, advocacy, structured living residences, and rehab centers, for example. Tell us more about that. And what are the biggest barriers to people receiving the rehabilitation they do need? CHRIS  20:46 We have here in Canada, what's called Psychosocial Rehabilitation Canada, an organization that promotes psychosocial rehabilitation of all mental health service providers. So it's not just limited, let's say, to social workers or mental health workers. So let me just define it. First of all, psychosocial rehabilitation, also sometimes called psychiatric rehabilitation, it promotes personal recovery, successful community integration, the satisfactory quality of life for persons who have a mental health problem or mental illness. Psychosocial rehabilitation services and supports, they're what we call collaborative, person directed, individualized, and we believe they're essential element of human service prospective. And so the goal of psychiatric rehabilitation, or psychosocial rehabilitation is focused on helping individuals develop skills, and access the resources needed to increase their capacity to be successful and satisfied, in what we would call living, working, learning, and social environments of their choice. And so you need a wide continuum of services and supports. The approaches, they are evidence based. And they are promising practices in key life domains of, let's say, employment, education, leisure, wellness, and basic living skills. And family involvement, family peer support, individual peer support are very important aspects of psychosocial rehabilitation. JO  22:18 Chris, what needs to be in place for this to happen? CHRIS  22:22 Truly integrated comprehensive mental health services in which the various sectors are endorsing and creating relationships with each other. So whether that's psychiatrists, social worker, a mental health worker, spiritual health care director. The team of support around the patient, they're not in competition with each other. They are to be working as a team when they have their meetings, and hopefully, with the patient there, listening to the patient. Again, that's that question. What do you feel would help you? What do you feel you need at this point? And as well as offering, what I want to say as wisdom through listening, offering a wisdom back to the patient in helping them to find the various supports and services in and outside of the hospital, that can promote the recovery experience. JO  23:15 Let's expand upon that and look at vocational rehabilitation, and or training that prepares people with schizophrenia for work that best meets their individual wants and needs. Chris, can you tell us more about that? CHRIS  23:31 So let me just tell you a story to illustrate this point about vocational training. This individual's true-life story who had schizophrenia and he had gone through four mental health workers. Well, what happened with the fourth mental health worker? Began to listen to the individual because he was always very persistent with his mental health workers, that he wanted to be an astronaut. They would just dismiss that, "There's no way you can do that, because you have schizophrenia." Well, the fourth mental health worker began to listen to him and ask him, let's just assume that his name is Joe, and said, "Joe, why would you like to be an astronaut?" And he had seen the first moon landing and other things, and he was very enchanted that he wanted to be an astronaut. So, she asked him then in the course of not just in one conversation, but as they developed their relationship. "Well Joe, what do you think would help you to be able to reach that goal?" And they talked about that, and perhaps hygiene could be a problem. Of course, they began to focus on education. "And so what school do you think there might be, and where would you like to go to school to learn more about this?" And so she encouraged him. "Well, why don't you try for one course?" And he took the course and guess what happened? He failed. But that's not the end of the story. She continued to encourage him about other options, and again, a true-life story. He eventually found work and began to work in a space aeronautics museum, welcoming guests and introducing them to the museum. So did he fulfill his goal and his dream? Yes, but it had to be adjusted. But she didn't give up hope on him in terms of his vocational desire. JO  25:06 What a great story. In my research, I continually came upon the term personalized medicine. Phil, what is personalized medicine? And how could it revolutionize diagnosis and treatment strategies for schizophrenia? PHIL  25:24 Personalized medicine, and sometimes people refer to it as precision medicine as well. So sometimes you hear those terms interchangeably. And really what it is, is the tailoring of the medical treatment to the individual, to the individual characteristics of each patient. It does rely on research, it does rely on an understanding of a person's own unique, molecular, and genetic profile as well, and how that can influence treatment. If you think about a personalized medicine, it is really what's going to be appropriate, what's going to work for you specifically based on who you are, both biologically and otherwise. And really, this sort of came out of the advent of trying to figure out from a genetic perspective, how can we use an individual's unique genetic makeup to guide treatment decision? We're not quite there yet, in that respect, but it allowed us to be able to step back, though, and still think about, okay, what is appropriate for this person that's sitting in front of me. And I think that's a little bit more of a holistic approach to our treatment, and that is truly personalized. Now, if we get to that stage where we can do a cheek swab, get a genetic makeup, and then say, okay, this particular treatment, either medication or otherwise, this is specific to you and will work the best. Obviously, that's a great outcome. Are we there yet? No. But research is going in that direction. JO  26:46 One topic I didn't come across in my research is the role of lifestyle choices in recovery. Healthy habits, like getting enough sleep, eating well, and exercising regularly. Kat, how important have lifestyle choices been in your recovery? And do you teach life skills as part of your work with peers? KATRINA  27:09 Lifestyle choices are very important in my recovery. It's something I pay very close attention to. As far as teaching life skills, we do workshops that do some form of teaching, but teaching as an agenda. It's more of an exploration type discussion. JO  27:30 Phil, what do you see in your research and hear from your patients about the importance of lifestyle choices? PHIL  27:36 Research obviously has shown that it's very important, these lifestyle choices. What are lifestyle choices? These could be anything from smoking, cannabis use, to sedentary lifestyle, activity, diet, a number of different choices. We know that individually each of those, and accumulatively each of those can have an effect on outcomes. And the research is pretty solid with respect to that. And so a lot of our focus, so once we get to some of the early sort of phases is, okay really, how can we improve lifestyle, what kind of healthy choices we can help people with lived experience make. We do things, we have a project where we got some funding currently from our Mental Health Foundation, where we're trying to target our rural population. So we got Fitbits. So that allows us to measure and monitor some things along the lines of sleep and steps and exercise. But to be able to send that to their clinicians and to be able to have those discussions, that's sort of great talking points about lifestyle. CHRIS  28:36 Let me combine that question about lifestyle choices and the previous one about personal medicine. Personal medicine, in terms of consumer movement or people who live with mental illnesses, it was really first introduced in early 2003 as a result of qualitative research conducted by Dr. Patricia Deegan. Now, Patricia Deegan is a psychologist, PhD, has lived experience of schizophrenia and experience of recovery. And so personal medicine along with what Dr. Tibbo said, is also about what we do that's medicinal for us in managing, let's say, my depression. What are those lifestyle choices that I know helped me in terms of managing all the stress associated with living with a mental illness? And stress can lead to relapse, we know. So it's not necessarily something prescribed by a doctor or nurse. It comes from within, and it's finding that right balance of what to do and what we take in our pathway to recovery. So that can be mindfulness, can be spirituality, it can be running and exercise. Those things that you know help you to manage your illness in terms of stress management, increasing your resiliency, and your mental health as well, because people with a mental illness can have positive mental health. We know that. And so that word as Patricia Deegan has written about it, personalized medicine has to do with those things that we know that are uniquely medicinal for us, and helping us move forward in our recovery. JO  30:16 Thanks Chris, great comments. Phil, is there any science to support the role of practices such as meditation in recovery? PHIL  30:26 Yes, there is research on this. It's not necessarily for everyone. But for people who can do mindfulness-based practices and meditation, it definitely has been shown to be quite helpful in a number of different ways. I don't say for individuals with lived experience, but we published actually on mindfulness-based techniques for family members, and definitely see the benefits within that group as well. JO  30:50 Advancing technology is another thing I'm hearing a lot about for diagnostic and treatment purposes. Phil, from your perspective and in your practice, can you bring us up to speed on that? PHIL  31:02 Our advances of technology, we're trying to utilize those as best as we can, as quickly as we can as well. And also moving from research to clinical applications, of course, is really quite important. Kind of alluded to this a little bit earlier. We have had advances in the various brain imaging techniques to help us with diagnosis. And there's a lot of different types of brain imaging techniques that are focused either on brain structure, but as well as brain function, and of course, the different parts of the brain, white matter and gray matter. And then other types of diagnostic technologies are there, treatments as well, such as rTMS. There's a lot of this that's happening. And I don't want to minimize that there's a lot of research that have gone into the development and use of smartphone apps as well, and their utility within helping people move forward with their lives and on their treatment to recovery goals. JO  31:56 Chris, what about that technology for social support services? CHRIS  32:01 Well, there are two things that COVID has surfaced for us. Number one has placed mental health definitely on the radar. Ninety-eight percent of Canadians are more concerned about the impact of mental health. Secondly, the use of virtual technology, and that will not go away after the pandemic. In fact, about a year and a half ago, I had my first FaceTime experience with my GP. I never thought that would happen. So use of Zoom and other technology to offer peer support individually, to offer support groups. Many of the schizophrenia societies across Canada are doing education with family members through virtual technology. So that's not going to go away after the pandemic. It is all in a state of development. I think Dr. Tibbo, when he and I've had discussions on this, we have to look at safety, confidentiality issues, privacy, and having good standards. And then, are the various apps that have been developed and ought to be developed, are they evidence based and effective? So I'm excited about where virtual technology can lead us, especially for people who live outside of urban areas. But the great challenge is that many people with mental illnesses, especially if they're on income security, they don't have access to internet, they can't afford a laptop or an iPhone. JO  33:24 Kat, how willing are your peers to take advantage of advancing technologies? KATRINA  33:30 It's hard to conjecture, because every peer is different. As Chris pointed out, even the ability of some might be limited. But from what I'm hearing as we compare notes, peers and I, now hey I have that app, this app that works really good for me. It comes up. So I think, for the most part, it's very favorable in that direction. JO  33:53 Chris mentioned COVID-19, and just a very quick question. Phil, how has COVID affected your patients with schizophrenia? PHIL  34:03 Keep in mind that for my particular patients that I see, it's mainly youth and young adults, and actually the resilience there is really quite high. And the adaptation to virtual technologies, such as Zoom and having meetings along those lines, they're actually fairly quick to adapt to. However, what is also interesting is that a lot of the youth and young adults that I see actually didn't want to have their meetings via Zoom. They'd rather be in person. So we've tried our best to work with that. We obviously want to make sure that nobody is going to have relapse or have any ill effects because of COVID. I think we did a pretty good job of pivoting and shifting service delivery and care to accommodate that. COVID-19 overall in the general population, there's a lot of research that has gone into that and we have seen an increase in, for example, substance use in this population. We've also studied acute care admissions to the inpatient units, and I've seen a shift during the height of COVID in states of emergency declarations, where the substances have played a role, a more significant role in admissions than they did before, as well as in a little bit older age group than what we would normally see in a non-COVID year. JO  35:15 Chris, what are you seeing with your peers and their families as a result of COVID? CHRIS  35:22 Each of my workdays, two to three hours now, have been devoted to taking phone calls and answering emails since the pandemic began, by individuals and family members who are looking for additional help. There is evidence that people with schizophrenia are more likely to develop the illness resulting from COVID-19, as opposed to the general population. I think fundamentally, what some recent reports have indicated is that it's become somewhat harder for people with pre-existing mental illnesses to consistently get not only psychiatric care, but also primary health care. JO  36:02 Kat has the pandemic been difficult for you? KATRINA  36:07 It's been challenging in ways for myself and for my peers. For instance, some describe that it slammed them when they were in healthy spaces. It actually slammed them right back into illness because it looked the same. Now, we were isolating, so they were isolated, again, or still. And that just took them back into it. Just as one example alone. For me, I have to admit riding buses to commute to and from work is a challenge because of what I see. And it causes me a little stress. The people that pull their masks down on the bus when they're supposed to have it up, and stuff like that. But for the most part, I think it's, we're just all hanging in there. JO  36:57 Before moving on to talk about stigma, I'd like to thank our major sponsors again, the Social Planning and Research Council of BC, Emil Anderson Construction, WorkSafeBC, and AECOM Engineering Canada. As a registered charity, we rely on support from sponsorships, grants, and donations. If you'd like to support our HEADS UP programming, please visit freshoutlookfoundation.org/donations. As I say on every podcast, you can't have a conversation about mental health, without talking about stigma. Phil, how does stigma affect people you've researched and treated biologically and psychologically? PHIL  37:40 Stigma can be a huge part of the illness. There are a number of elements to stigma as well. And I'm sure Chris and Katrina will elaborate on these as well, and some we've already alluded to as well within our discussion. Because stigma can affect people's entry into care. And that because of the stigma around the illness, or stigma actually even towards mental health, either themselves or even within their family members as well, can actually affect their pathways to care. And we've done some research on that and have been able to show that. And then when somebody is in care too, and we do have to work with what we sometimes call self stigma, people's perceptions and ideas of what a diagnosis of schizophrenia means and what it can mean. And so there's those elements as well. And of course, we're trying to be the best advocates that we can for patients and our families. And that's where we try to work with the stigma in other areas around society towards the illness, towards mental health, of course, in general. Being those advocates and supports towards vocational or educational pursuits as well. We've definitely gotten a lot better with respect to that over the last number of years, but there still exists some of that stigma out there. JO  38:54 Kat, how would you describe stigma from the perspective of a person with schizophrenia? KATRINA  38:59 I would describe it as a belittlement. And a discreditation is a way of writing somebody off to make them not count. It's even, now how many times do you see it on TV used in a court of law, theoretically, to discredit somebody so much that that witness doesn't even count. It's a write off, and that's not fair. JO  39:21 Chris, what about the impacts of social and vocational stigma on the people you're advocating for? CHRIS  39:28 Well, first of all, we need to understand that all stigmas are built on the same formula. And that is misconceptions and myths, plus lack of education multiplied by fear, results in prejudice, and none of us are immune from prejudice. We all as a human experience. And what we need to do is to be able to look at our attitudes, confront them, and be willing to grow up, to change. Because there is societal stigma, and then when an individual with a mental illness internalizes society's stigma, we call that self stigma. So they think, well, I must have a broken brain and I'm not deserving. And then there's structural stigma in terms of laws, and policies, and practices that result in unfair treatment of people with a mental illness. Now, what does it all result in? It's not just about hurt feelings. Stigma results in a reluctance to seek out treatment. It delays treatment, it increases morbidity and mortality, it results in social rejection, avoidance, and isolation. It results in worse psychological well-being for individuals living with a mental illness. There's poor understanding amongst friends and families. Stigma can lead to harassment, violence, and bullying, poor quality of life, increased socio-economic burden. That's above and beyond the shame and the self doubt that the individual may face. That is perhaps our greatest enemy in promoting comprehensive mental health services and recovery oriented mental health services. That's why we have to advocate as Martin Luther King did, as other leaders and various other movements did, to claim our voice and to identify injustices where they are, and what impedes our being able to see people with mental illnesses as our brothers and sisters, our neighbor, and the fact that we should love one another as we love ourselves. JO  41:33 Kat, you and Chris have both experienced the mental health care system. Just wondering what you've seen, as far as stigma goes within that system. CHRIS  41:43 Well, the Mental Health Commission did a study a number of years ago amongst mental health service providers, and it found that stigma is alive and well within our mental health system, and those who provide psychiatric supports and services. So that might be surprising to people. None of us are immune to stigma, it has to be addressed. And whether you're a doctor, a psychiatrist, a police officer, a correctional guard in one of our prisons, people have to receive supportive education, which helps them to identify their attitudes, which leads to actions of discrimination, or improper behavior, or working with clients, patients, prisoners, etc. So this is a huge issue. JO  42:36 So we're on the homestretch. Now, given what you've learned over the years, what would you say to give hope to people who are early in their recovery journeys? CHRIS  42:48 What I would say is, I want you to meet Katrina. Katrina has lived experience of psychosis. But she also has found ways to move forward and live beyond the limitations of mental illness. She's a peer support worker. And so Katrina, through her lived experience, she will listen. And she will give you realistic hope. Because the hope for recovery is possible. I know this is a difficult time for you right now. And the next couple of years, it may seem like you're not coming out of this deep, dark hole. So what I'm saying here is that I think introducing patients to a peer support worker as soon as possible, can help with the depression and the forlornness that a person may be experiencing by receiving a diagnosis of psychosis or schizophrenia. We need to be realistic, but also, we need to communicate hope that things can get better. And the person who can communicate that the best is a peer support worker who's been down that road and knows what helps and hinders recovery. JO  43:53 Kat, what have you learned about hope? KATRINA  43:56 I've learned that it is the most wondrous and beautiful thing in existence to have hope, and that life without hope, isn't life at all. JO  44:06 Chris, what would you say to family members who are confused, fearful, and frustrated? CHRIS  44:13 I would say that it's normal. It's very normal to be confused, and frustrated, and fearful, and to feel shame. It's normal. And that is not your fault. But that help is available. We know more than we've ever known before about schizophrenia, psychosis, treatment modalities, what helps in the recovery process. And so I would encourage the family who's new at all of this, that there are individuals known as family navigators, or family peer support workers, and that there's family education. There are support groups because the family is in recovery too. The individual with schizophrenia or psychosis, they're not the only one in recovery. But the family is also on a recovery journey, in terms of dealing with their stigma. Dealing with their fears and their frustration, learning communication skills with their loved one who has a mental illness, and that there's hope for the entire family. And things can get better, but not minimizing the barriers and the frustrations that are there. JO  45:17 Phil, what would you say to medical and mental health professionals to help them better understand schizophrenia, and to respond more compassionately? PHIL  45:26 A lot of it is that storytelling, and a lot of what we're doing here tonight too, as well, and just appreciate that a diagnosis of schizophrenia is not necessarily a negative diagnosis, and that people can have great outcomes. And its outcomes based on the individual and what they perceive that their own personal sense of well-being and psychological well-being. And so appreciating and having them appreciate the various outcomes that can exist within schizophrenia and psychosis. So it really comes down to still a lot of that education, that's important. It's not necessarily education, for example, from me from the medical community. It's also education for family members. It's education from people with lived experience, as well. And these are very important stories for the medical community to hear. JO  46:08 How would you pitch the need for wholesale change in mental health care to the people making those policy and funding decisions, Chris? CHRIS  46:18 Well, in terms of policymakers and politicians, I think that we not only point out to them, and most the time they know this already, that our current mental health system is not adequate. And it fails many people. And that most people struggling with a mental health problem or mental illness, are not getting the kinds of supports and services that we've talked about on this podcast today. But then I would move forward, promoting transformation of the mental health system through the recovery philosophy. Australia, New Zealand, Scotland, England, has moved towards recovery oriented mental health services. In fact, the fastest growing occupation in the mental health system in England is that of peer support workers, embedding peer support workers in the mental health system, which can help transform the mental health system. We have to educate those who make policy, in politicians. And we have to get to administrators and hospitals and other domains, and not just write recovery into policies, but develop toolkits to help practitioners to move towards a recovery environment. We have to be patient, but we have to be persistent. And we have to be consistent in our advocacy. And we have to speak with one voice. The best advocacy is collaborative advocacy. Unfortunately, there is still much debate within the mental health community about the medical model versus the recovery philosophy. But we have to persist, we have to be determined we can overcome. PHIL  47:57 So it's a great question. And I guess I kind of go back to some of a little bit what I mentioned earlier, it shouldn't be me doing this pitch for wholesale change. And sometimes I really think it needs to come from those individuals who are living it, both the individuals with lived experience, and their family members. And oftentimes, our major changes in either service delivery, or funding, or policy have come because of the advocacy of family and individuals with lived experience as well. We can be there in the medical community to help support, and give that research, and give the data, and look at cost analysis. But the pitch needs to be unified with all the important stakeholders. JO  48:38 And what would you say to those of us who may not know enough about schizophrenia, but who are willing to explore our ignorance and our conscious and or unconscious biases? CHRIS  48:50 Well, it's all about contact-based education. So what I would say to a person is get to know someone, get to know that relative who has schizophrenia, and get to know that neighbour who is experiencing psychosis the same way I had to do when I was a racist in the deep south. In the first part of my life, as a child, as a teenager and young adult, I had to confront my racism. And the way I did that was by moving out of my supposed circle of safety. And that was getting to know people different from me, people of colour. Eating with them, praying with them, interacting, listening to their hopes and dreams. And then you see a person. So we have to do the same thing in terms of going beyond our comfort zones, to learning the truth about the reality of people who live with psychosis or any mental illness. JO  49:44 Kat, any comments? KATRINA  49:46 To those who are willing to explore, you'll find a whole new world because you'll rediscover people that were there the whole time. JO  49:56 What I've discovered is a whole new world of potential. So, not only for people with schizophrenia, but for collaborative change. CHRIS  50:06 Exactly. You mentioned a wonderful word, their potential. In fact, that is the mission of the Schizophrenia Society of Canada. Build a Canada, where people living with psychosis and schizophrenia achieve their potential. And that's what recovery is all about. JO  50:26 So in closing, I have just one more question for each of you. Given what you've learned, personally and professionally, and what we're collectively learning through research and advancing technology, how do you envision the world of schizophrenia changing over the next 20 or 30 years? Kat, let's start with you. KATRINA  50:48 That there won't be the fear of the illness to stop people from finding out if they need help, how to do it. That there won't be this belittlement that can lead to the self stigma, which feels horrible. That there will be treatments that encompass the wholeness of who you are, working together in greater capacity than where we're at now. We have made some progress, but we're not there yet. JO  51:23 Chris, your vision? CHRIS  51:24 We will live in a society in which no one is left behind. Not because they have schizophrenia or psychosis. That stigma will basically be a thing of the past, and it will not be our big albatross. That in fact, that treatments will go beyond anti-psychotics and won't even have to use antipsychotics. And that the recovery philosophy will be fully ingrained within our mental health system. That's what I hope for. PHIL  51:56 I think we'll have a better understanding of the illness and understanding, for example, from the biological underpinnings of the illness. That will in itself help us to understand the best treatments for schizophrenia. So I think we'll see some advancement there within the biological treatments, but as well as the psychosocial or psychotherapy type of treatments, as well. And I think really what we're seeing as well, is just that better understanding and appreciation. I think in 20 or 30 years, we'll see some of the stigma being reduced as well. I think what will continue to happen is that understanding of illness, and it's really getting back to that early intervention piece. And people understanding that if things aren't really quite right, they should get it checked out. And I do make that analogy when I do some public speaking about skin cancer, and that we've had enough education at this point to realize, okay, if we have a funny looking mole, we should get it checked out. May not be anything, but it may be something that needs a little bit more attention. Hopefully, we will be in 20 or 30 years with mental health and wellness as well, is that enough education there to say, okay, if things aren't really quite right, then we should get it checked out. Again, maybe nothing, but it may be something that needs attention. The earlier that attention is there and the treatment than the better the outcomes. JO  53:10 Thanks so much to all of you for your profound insights, ideas, and passions for making the world a much better place for people with schizophrenia, their families and friends, their employers, and society at large. Phil, I so admire and applaud your attention to the ever-changing details of diagnosis, and both pharmaceutical and non-pharmaceutical treatment options. Your boundless curiosity will certainly make schizophrenia less mysterious, and perhaps one day even curable or preventable. PHIL  53:46 Thank you so much for that. And importantly, as these venues, these educational opportunities, these podcasts, are really going to help us to those eventual goals as well. Thank you very much for this opportunity. JO  53:58 Kat and Chris, your willingness to be vulnerable so that others might be helped, is truly inspiring. And I'm sure will help to inform and transform the evolving conversation around social support and advocacy. KATRINA  54:14 It's a pleasure to help. I know, if I would have had peer support years ago, things would have been different. And that's why I'm working so hard to be a peer support worker is to make that difference. JO  54:31 Chris? CHRIS  54:31 I hope that the listeners of this podcast will be inspired and motivated to take a different approach to seeing people who have a mental illness. And here's the statement, ask not what illness a person has, ask what person the illness has. See a person, not an illness. JO  54:53 Thank you both. This is one of the most robust and powerful discussions I've had. The three of you, what you bring to the conversation individually is astounding, but how well you blended your experiences and insights is really truly remarkable. This has been a wonderful, wonderful experience for me. That's a wrap on Part 2 of our podcast on schizophrenia. Be sure to catch Part 1, which focuses on stories, signs, myths, and recovery philosophy. Huge thanks again to our guests for sharing their amazing minds and spirits. To connect with Kat, Chris, or Phil, check out the episode show notes at freshoutlookfoundation.org/podcasts where you'll find contact info, complete bios, and a transcript. I'd appreciate you leaving a review as well. I'm also grateful for all you listeners and hope this information inspires and mobilizes you along the rapidly changing road to recovery. If you haven't already signed up for monthly HEADS UP e-blasts about new episodes, please visit freshoutlookfoundation.org. And for ongoing information, follow us on Facebook at FreshOutlookFoundation and Twitter at FreshOutlook. In closing, be healthy and let's connect again soon. Episode Reviews

My name is Whitney Dafoe. I have had ME/CFS since 2004, when I was 21. In 2008 I went to India and wound up going from mild ME/CFS to severe ME/CFS overnight. It was up and down for a few years after that, but in 2013 I plummeted back into extremely severe ME/CFS. For the next 7 years I was completely bedridden, unable to speak, unable to eat or drink a crumb of food or a drop of water and most of the time unable to move even a muscle without crashing. In 2020 I started Abilify and it gave me a modest improvement that allowed me to use my computer, phone, type and think more clearly. But I am still bedridden, unable to speak, fed by a Jtube feeding tube and get all fluids through a Hickman Port in my chest. Since improving from Abilify I have since been writing Facebook and blog posts about ME/CFS and photographing my life on an Instagram account.  This manuscript is my story and an attempt to describe as clearly as possible what it is like to live with extremely severe ME/CFS. It is significant because it is a peer reviewed published manuscript along with research papers. Doctors, healthcare workers, caregivers, supporters and patients will be able to read it and better understand the experience of severe ME/CFS. You can read more about me on my website and ME/CFS blog here:  www.whitneydafoe.com/mecfs You can follow me on Facebook here: www.facebook.com/whitneydafoe You can follow my photographs documenting life with severe ME/CFS on Instagram here: www.instagram.com/whitneydafoe

My name is Whitney Dafoe. I have had ME/CFS since 2004, when I was 21. In 2008 I went to India and wound up going from mild ME/CFS to severe ME/CFS overnight. It was up and down for a few years after that, but in 2013 I plummeted back into extremely severe ME/CFS. For the next 7 years I was completely bedridden, unable to speak, unable to eat or drink a crumb of food or a drop of water and most of the time unable to move even a muscle without crashing. In 2020 I started Abilify and it gave me a modest improvement that allowed me to use my computer, phone, type and think more clearly. But I am still bedridden, unable to speak, fed by a Jtube feeding tube and get all fluids through a Hickman Port in my chest. Since improving from Abilify I have since been writing Facebook and blog posts about ME/CFS and photographing my life on an Instagram account.  This manuscript is my story and an attempt to describe as clearly as possible what it is like to live with extremely severe ME/CFS. It is significant because it is a peer reviewed published manuscript along with research papers. Doctors, healthcare workers, caregivers, supporters and patients will be able to read it and better understand the experience of severe ME/CFS. You can read more about me on my website and ME/CFS blog here:  www.whitneydafoe.com/mecfs You can follow me on Facebook here: www.facebook.com/whitneydafoe You can follow my photographs documenting life with severe ME/CFS on Instagram here: www.instagram.com/whitneydafoe

Abilify has been a long-time staple of my medication regimen.  However, to help solve my incessant drowsiness, I have begun tapering it with the approval and supervision of my psychiatrist.  Here is a brief explanation of my experience with Abilify.

Robert shares his incredible successful healing journey of resolving over thirty years of schizophrenia and safely withdrawing from his medications. In 2010, Robert and Dr. Lee began using both functional and energy medicine to support his miraculous recovery. What happened to help him succeed? Listen to our conversation to hear the true story of a hero's journey.For more about Dr. Lee, please visit: Website: www.holisticpsychiatrist.comYouTube: The Holistic PsychiatristClick on the Holistic Updates Sign up for weekly stories and insights: Holistic UpdatesTo schedule consultations or appointments, call her office at 240-437-7600The content provided by this podcast is for informational purposes only and has not been approved by the U.S. FDA. This podcast is not intended to provide personal medical advice, which should be obtained from a medical professional.

Find the Memorizing Pharmacology book here: https://adbl.co/3wAZEmN The body system we continue to cover is gastrointestinal and omeprazole, esomeprazole, lansoprazole, pantoprazole are all proton pump inhibitors PPIs.  TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd Suffixes Omeprazole (Prilosec) with the -prazole suffix, p-r-a-z-o-l-e suffix is a true proton pump inhibitor, abbreviated PPI. We want to watch out for aripiprazole (Abilify) and brexpiprazole (Rexulti) which are antipsychotics, not PPIs but have the -piprazole ending, p-i-p-r-a-z-o-l-e. Also, some drug cards say the ending is -azole, but that is not an actual suffix, that is a chemical group, using that ending might have you confuse antifungals like fluconazole (Diflucan) for PPIs, so again, the PPI suffix is -prazole. You will notice that omeprazole (Prilosec) and esomeprazole (Nexium) are very similar and it's that omeprazole contains two molecules, a left and right mirror image and esomeprazole only contains the left-handed image. In Latin, left is sinister, so the “es, e-s” represents that only left-handed side. Why does that matter? That left-handed molecule is the active molecule. Mechanism of Action (MOA) PPIs or “prazoles” work by blocking your stomach's parietal cells which normally release hydrogen ions contributing to the stomachs' acidity. This, without the proton pump inhibitor, could lead to heartburn or possible GI ulceration. The proton pump inhibitor blocks the hydrogen/potassium ATPase pump preventing protons from going in the stomach. This raises the pH, making it more basic, and removes the excessive acid. Indications We then use proton pump inhibitors to manage heartburn, gastroesophageal reflux disease (GERD), peptic ulcer disease, and Barrett's esophagus. Barrett's esophagus is a condition where the acid reflux damages the esophagus causes it to redden. Many times patients who are on chronic NSAIDs or anticoagulants have a higher GI bleed risk and a proton pump inhibitor is for prophylaxis rather than active treatment. Dosing Traditional dosing is to give the PPI 30 to 60 minutes before breakfast. A concern comes when the medication does not seem to work, but it is not the medication, rather, the patient is taking with or even after breakfast. Make sure you know which is which. Also, H2 blockers work a bit more quickly, so the patient might expect a similar timetable with a PPI, let them know that it will take a bit longer. Clinical Considerations Acute use for a few weeks, especially with over-the-counter lengths of time, usually 2 weeks, tends to cause few side effects. Long term, however, we have concerns of B-12 deficiency, increased fracture risk, C. Diff, an opportunistic infection. Again, B-12 deficiency comes because the now less acidic stomach does not do as good a job at absorbing B-12. Before we start this section, here's a reminder contrasting enzyme inhibition and enzyme induction. A drug that inhibits and enzyme blocks the enzyme somewhat increasing drug levels making the patient toxic. A drug that induces and enzyme, makes the enzyme work better reducing drug levels and making the patient subtherapeutic. CYP2C19 inhibition can happen with citalopram (Celexa) and escitalopram (Lexapro), so in this case the antidepressant drug levels can go up leading to QTc prolongation. That's why we have dosing maximums on citalopram of 20 milligrams daily with someone on omeprazole. CYP2C19 induction with omeprazole and clopidogrel (Plavix) is one class example as clopidogrel is a pro-drug and by inducing the enzyme to break down more clopidogrel, the enzyme lowers clopidogrel levels. A pro-drug is one that is not quite the drug yet, the liver may have to metabolize it into a drug. Clopidogrel itself is an antiplatelet drug, so reducing the effectiveness of an antiplatelet drug while trying to prevent myocardial infarction (heart attacks) and strokes.   Note, prescribers can use cilostazol (Pletal) for intermittent claudication, a problem with blood flow in the legs where they might be in pain for short distances and the drug allows them to walk further is also a concern. Using lansoprazole or a similar PPI might create a favorable effect. Some drugs need an acidic environment for absorption like iron supplements and lowering the acidity runs counter to the best situation for iron. Adding ascorbic acid, vitamin C can help. Cefuroxime (Ceftin) is a second-generation cephalosporin antibiotic with good gram-positive coverage, but one might change to another antibiotic if they see omeprazole in the chart. Mesalamine (Pentasa) for ulcerative colitis and itraconazole (Sporanox) and antifungal both both benefit from an acidic stomach.    

Children are often put on medications without an initial trial on natural supplements that support their innate ability to heal. This podcast explores the advantages of using a holistic approach for the treatment of depression, anxiety, and ADHD in a 9-year-old girl, who had been prescribed an antipsychotic medication called Abilify by a conventional psychiatrist. Her mother shares her story of what happened during treatment: lessons learned, mistakes made, and finally, withdrawal completed.For more about Dr. Lee, please visit: Website: www.holisticpsychiatrist.comYouTube: The Holistic PsychiatristClick on the Holistic Updates Sign up for weekly stories and insights: Holistic UpdatesTo schedule consultations or appointments, call her office at 240-437-7600The content provided by this podcast is for informational purposes only and has not been approved by the U.S. FDA. This podcast is not intended to provide personal medical advice, which should be obtained from a medical professional.

I forgot to take my abilify and thankfully found some on accident. I'm studying for an interview so that made it difficult. Venting --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

In this episode I interview Attorney Michael Mosher who has 30 years of experience. Mr. Mosher has an extensive background in pharmacokinetics, the adverse reactions of various drugs as well as the proper administration of each psychotropic drug including anxiolytics (eg. Xanax, Ativan, Klonopin), hypnotics (Halcion, Dalmane, Restoril), stimulants (eg. Ritalin, dexedrine, Adderall), anticonvulsants (eg. Tegretol, Depakote, Neurontin), antidepressants (eg. all the SSRIs, Effexor and the tricyclic antidepressants), and neuroleptics, (eg. Zyprexa, Risperdal, Seroquil, Abilify). Mr. Mosher has also settled numerous cases against doctors and drug companies involving illnesses and damage due to addiction/dependence via the use of Xanax, Klonopin and other benzodiazepines as well as injuries resulting from SSRIs.

A new track by DJ Habett from the album "Les forces de l'esprit" (2021-02-17). Tags: Ambient, Triphop, Median, Hope, Medication, List, Moods, Coaxial, Epic, Theme, Groove, Dark, Guitar, Synthesizer CC(by)

Aripiprazole is an atypical second generation antipsychotic agent. It commonly goes by the brand name Abilify. It is a quinolinone derivative which looks similar to but different from quinolones (antibiotic class). There are many indications for Abilify such as in the treatment of schizophrenia and bipolar disorder but can also be used to treat the irritability often seen in autistic disorder. Dosing initiation is often titrated. For example, when initiating dosing for adults with bipolar disorder initiation begins with 10-15mg po qd with 5-10mg dose increases weekly with the max dose of 30mg/day. Common side effects are dizziness, lightheadedness, drowsiness and weight gain. There is a black box warning for increased mortality in elderly patients with dementia related psychosis and for suicidality and antidepressant drugs. Abilify should not be used to treat dementia related psychosis in elderly. Patients should be monitored for worsening or emergence of suicidal thoughts and behaviors. Go to DrugCardsDaily.com for episode show notes which consist of the drug summary, quiz, and link to the drug card for FREE! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. The main goal is to go over the Top 200 Drugs with the occasional drug of interest. Also, if you'd like to say hello, suggest a drug, or leave some feedback I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on twitter @drugcardsdaily --- Send in a voice message: https://anchor.fm/drugcardsdaily/message

Aripiprazole, an antipsychotic medication marketed as Abilify, eases aggressive behavior in autistic children, but questions remain about its side effects. The post Spectrum reporting prompts new review of common drug appeared first on Spectrum | Autism Research News.

Aripiprazole, an antipsychotic medication marketed as Abilify, eases aggressive behavior in autistic children, but questions remain about its side effects.

I haven't recorded an episode in 1.5 months because of fatigue.  Today I talk about my experience with fatigue caused primarily by a dosage of Abilify that was too strong.  Other topics include self care, basic needs, and routine.

In this epi, Emily walks us through her history of depression and various treatment options she has tried. Emily discusses AA, DBT, Running, Meditation, and pillz. Learn about Marsha Linehan's "Wise Mind" (and other DBT principles) here: https://www.mindfulnessmuse.com/dialectical-behavior-therapy/what-is-wise-mind --- Send in a voice message: https://anchor.fm/liza-chapa/message Support this podcast: https://anchor.fm/liza-chapa/support

1. What is off-label drug use? a. Off-label drug use is when doctors prescribe medications for unapproved uses b. FDA cannot control how doctors prescribe c. 20% of Rx in US are fore off-label uses 2. Why use a drug for off-label purposes? a. Tried all other options without success b. Literature to support drug’s use, even if limited c. Different dosage form d. Dosage for which there is evidence that a higher dose may be effective e. Drug is generic so there is no financial benefit for a manufacturer to obtain approvals 3. What are the risks? a. Balance between effectiveness and risk is tilted toward risk b. Investigational studies with close monitoring of safety 4. Approvals a. Experimental b. Benefit unknown c. Risks unknown d. Plan must pay for all consequences 5. Examples a. Gabapentin for anxiety b. High dose/strength opiates for pain c. Stimulants for weight loss d. Anti-epileptic medications for mood disorders/bipolar disease e. Examples of atypical antipsychotics include Seroquel, Zyprexa and Abilify. They are being used to treat an array of conditions off-label, including anxiety, attention-deficit disorder, sleep problems, behavioral problems in toddlers and dementia. f. Antipsychotics to treat dementia g. Cancer treatment – estimated 50% are off-label _____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

Dr. Walter Kaye is a Professor in the Department of Psychiatry and the Founder & Executive Director of the Eating Disorders Program at the Eating Disorders Center for Treatment and Research at UC San Diego. Dr Kay is a leading expert in Eating Disorders and is a co-editor in the Clinical Handbook of Complex and Atypical Eating Disorders and the Behavioral Neurobiology of Eating Disorders. Dr. Kaye’s current research is focused on exploring the relationship between brain and behavior using brain imaging and genetics and developing and applying new treatments for anorexia and bulimia nervosa. Eating Disorders are severe disturbances in eating behaviors, thoughts and emotions. Many who suffer with eating disorders are preoccupied with both food and their weight. They can have severe body image dissatisfaction and a need for perfection. Even though eating disorders are grouped together in the DSM-5, they are distinct illnesses. Anorexia Nervosa symptoms include a distorted body image and a belief in being overweight despite being dangerously underweight. There are two types of anorexia nervosa, one restrictive and one binge-purge type. Bulimia Nervosa is characterized by eating excessive amounts of food in short period of time, and then purging the food using compensatory behaviors like vomiting and laxatives. Binge Eating Disorder is engaging in episodes of excessive eating, but unlike bulimia, there is not purging of the food or calories. Eating disorders affect people from all racial and ethnic backgrounds on many psychosocial levels. They can cause serious medical problems, and a multidisciplinary approach to care is needed.   Transcript Dr. Bridget Nash (2s): Hello, my name is Dr. Bridget Nash and I'd like to welcome you to the Therapy Show, a podcast series that seeks to demystify mental health treatment. Today I am honored to welcome Dr. Walter Kaye who is a Professor in the Department of Psychiatry and the founder and Executive Director of the Eating Disorders Program at the Eating Disorders Center for Treatment and Research at UC San Diego. Dr Kaye is a co-editor of the Clinical Handbook of Complex and Atypical Eating Disorders and Behavioral Neurobiology of Eating Disorders. He is a leading expert in eating disorders, and it's here to discuss some of the new research in the field of Treatment. Dr. Kaye welcome to the Therapy Show! Dr. Walter Kaye (42s): Oh, thank you very much. Dr. Bridget Nash (45s): Can you start by telling us a little bit about your personal background and professional development that led to your research in the field of eating disorders? Dr. Walter Kaye (53s): Yeah, certainly. I first trained as a neurologist and then trained in Psychiatry a number of years ago, and I've always been interested in doing research. I didn't particularly have an interest in eating disorders, but I got a fellowship at the National Institute of Mental Health, and when I went there I was asked to take over a study on Anorexia, and actually in my training I had never met anybody with Anorexia and at the time, I was particularly interested in trying to understand how behavior was encoded in the brain. Dr. Walter Kaye (1m 24s): And so, I was thinking about studying some disorders like Parkinson's that have certain changes in behavior, and we know that that's due to the neurologic disturbances in treating people with Anorexia. I was really struggling how, what we call it a stereotypic their behavior is, that it is people with Anorexia resemble each other much more so than probably any other psychiatric disorders in terms of people resembling each other. For example, if you have schizophrenia, people have all kinds of different symptoms. But people with Anorexia tend to have the same, relatively the same symptoms, and you know, that it can make you think that there is something in the brain that's causing this a, so that is actually been what got me interested in in studying brain and biology and Anorexia. I was at NIMH for about seven years, and then I went to the University of Pittsburg for 20 years, and now I'm here at a University of California, San Diego, where I do research and also, I oversee the treatment program for Anorexia and Bulimia.  Dr. Bridget Nash (2m 27s): So how would you briefly explain Eating disorders to a non-professional? Dr. Walter Kaye (2m 31s): This is a number of ways to explain it to it. I think that's what's really confuses people because people with the Anorexia often, but not all the time, they see themselves as being too fat and they go on a relentless pursuit of the thinness. And initially the other disorder that we treated very often is Bulimia Nervosa, which is where people are kind of alternate between restricted eating, overeating and then sometimes purging and people also have a body image distortion, but these are disorders that are often also associated with things like anxiety in obsessionality. Dr. Walter Kaye (3m 5s): And people have a certain time pattern of temperament traits. These tend to be perfectionistic, sometimes obsessive, anxious people. And so this has been very, very puzzling because the eating disorders, you know, tend to start mostly in females around early teenage or mid teenage years and so the prevailing notion is that this is a disorder of this caused by culture or society and people are dieting to achieve some kind of desired look. Dr. Walter Kaye (3m 39s): But the reality is that people with Anorexia diet to a weight that, they can be 50, 60 pounds, and and nobody would consider that to be fashionably slim. In fact, people with Anorexia, when they get to that weight, they still see themselves often as being too fat, and they want to pursue a lower weight. And the other thing that's really noticeable about Anorexia is that, it's very hard for people to diet or lose weight. The recidivism rate in obesity is very high and to be able to eat a few hundred calories a day, every day for years at a time is not something that most people can’t do. Dr. Walter Kaye (4m 21s): We've really been very interested in the question of whether it is really an underlying biology that explains a lot of these puzzling symptoms that you see in the Anorexia and Bulimia. Dr. Bridget Nash (4m 31s): Can you talk about what's happening in the brain and the body when a person has an eating disorder? Dr. Walter Kaye (4m 36s): Well, there's two levels of it. One is the question of whether there is some underlying biology that causes an eating disorder. And then the second part is, “gee what happens when you starve yourself and what effects does that have on their brain and the body.” Let's talk mostly about Anorexia cause that's really where I do most of my research. People with Anorexia go on this, this is kind of relentless diet and they may be 12, 14 and 15 years old when they start it. Dr. Walter Kaye (5m 7s): But if you ask somebody with Anorexia what they were like is a child before they ever developed the eating disorder, what most of the time they'll tell you is they have a certain pattern of temperament and personality traits. These tend to be as children they're very achievement oriented, or they want to get all A's. They tend to be often kind of perfectionistic. They may be anxious and worried about what might happen, concerned about risk, inhibited, sometimes very obsessional, and organized, sometimes kind of inflexible, but these are, for the most part, this isn't the problem for them. Dr. Walter Kaye (5m 44s): Their parents there pretty compliant kids. They do well in school. They are, but something happens when they start to get into these teenage years and often, they have exaggerated anxiety. And what they'll often tell you is, there something about food, or wanting to eat food that makes them very anxious, and something about not eating that either makes ... doesn't increase the anxiety or it actually feels kind of empowering. And so, they get into this, because food is so uncomfortable for them, that they get into this escalating downwards spiral where the more weight they lose, the more weight they want to lose, and they can literally starve themselves to death. Dr. Walter Kaye (6m 25s): In fact, this disorder has the highest death rate of any behavioral disorder. It's thought that somewhere between five or ten percent, maybe even more, people with Anorexia will die from the Anorexia. And so once you start to starve yourself and lose weight like this, there is a whole host of secondary changes that occur in the body as your body is trying to a conserve energy and live with very few calories and it effects nearly every organ system in the body as you lose weight. Dr. Walter Kaye (6m 56s): So, it's been very hard to tease apart what's the cause and what's the consequence of Anorexia. Now, over the course of this disorder, what we find is that a group of people recover and somewhere probably around about 50% of the people eventually recover and may do very well in life. But it's not unusual that people may be ill with Anorexia for two or five or even ten years before they get better. And about maybe about 30% or so have a partial recovery, and then you have a group of people that have very chronic disorder or die from it. Dr. Walter Kaye (7m 34s): And the thing that's really the most concerning thing to recognize is we don't really have very powerful treatments for Anorexia. There's no medication that's been proven to work. We have some treatments that seem to work more effectively in adolescents and children with the Anorexia, it's a, it's called Family Based Treatment or Maudsley, we can go back and talk a little bit more about that. But even with that treatment, it's very hard to change this anxious behavior that happens when people eat. Dr. Walter Kaye (8m 6s): And so it's very important to really understand the biology and the mechanisms underlying this behavior in order to come up with more effective kinds of therapy both to keep people from being ill for many, many years before they get better or to prevent them from becoming chronically ill or dying from this illness Dr. Bridget Nash (8m 28s): For Bulimia, can you talk a little bit about the body image symptoms? And also, is there a secondary gain that somebody might experience from binging and purging? Dr. Walter Kaye (8m 37s): Human behavior is complicated and, as similar as people with Anorexia are to each other, everybody's an individual, and there's probably always a mixture of different kinds of environmental and biologic factors that contribute to anybody developing a disorder like this. People was Bulimia -- why do people binge and purge --well people with Bulimia often tell you that when they're stressed or upset or anxious, have a fight with their mother or something like that, there is something about bingeing and purging behavior that actually is kind of comforting and may make the uncomfortable feelings go away, at least temporarily, even though in the long run they return and they may feel worse. So, they're, just like with Anorexia, there there's some beneficial response to extremes of food intake or extremes of not eating food, and now that we're beginning to understand more about the brain, some of the biology about this, begins to make sense. And with some people with Bulimia, because people with Bulimia often stay around the more normal weight, the body image issues that may be part of what's is also driving their desire to, to lose weight and to, to remain at a certain, what they consider ideal body weight. Dr. Walter Kaye (9m 58s): So, it's complicated, but again, most people with Bulimia don't get to the extremes of weight loss that you see with Anorexia. Then, of course, there's actually a third disorder here, which are people that have both a mixture of Anorexia and Bulimia and they lose a lot of weight, but they also binge and purge. Dr. Bridget Nash (10m 18s): Eating disorder behaviors are very secretive. Are there any signs or symptoms that a family can look for in the early stages of illness that can help them? Dr. Walter Kaye (10m 27s): You see two different kinds of patterns here. In people with Bulimia that don't lose an extreme amount of weight, they often tell you they're ashamed and a distressed about binging and purging. And they tend to be the most secretive. They're the people that nobody in the family will know that they're bingeing and purging, they're doing this at night, or they're hiding, or they're any number of things that people do to keep it a secret from their family. This may go on for years and sometimes it’s very hard to discover and the family begins to notice that there's large amounts of foods missing or that is a toilet has gotten clogged up by vomitus. Dr. Walter Kaye (10m 59s): You know one of the things that happens when people binge or purge to an extreme, it may affect their menstrual periods then they stop having a menstrual period or they may be very irregular. We see in a very different pattern in Anorexia and people with Anorexia don't usually try and hide it, they have more of a, a denial so that they don't see themselves as well being too thin. And in fact, even though they may lose 30, 40 pounds, they'll look at it their arm, you know, hold their arm out to say... Dr. Walter Kaye (11m 30s): "Can't you see how fat I am." And they're not really very motivated to get into treatment and there's a lot of denial and a lot of resistance to being in therapy and sometimes frank hostility to try to get them into treatment. And that's of course, one of the problems with Anorexia because it says it can be a life threatening illness. Yet this is a group of people that don't feel that they're at any risk. Dr. Bridget Nash (11m 56s): Why is the early intervention critical for people suffering with eating disorders? Dr. Walter Kaye (12m 0s): This goes back to a couple of different reasons. 1) There is there is some evidence that the earlier you get somebody into treatment, the better they might do. So, the most effective treatment we have, particularly for Anorexia, is called Family Based Treatment or Maudsley. And because this can be a very chronic disorder, and people get into treatment or are forced into treatment and forced to gain weight, but they leave treatment and they lose that weight all over again. Dr. Walter Kaye (12m 30s): And they may go through repeated cycles. So, because most families are unable to keep their child in a treatment program for a long period of time, and because this is a chronic disorder, this therapy has been effective because it makes parents an ally. Instead of saying to parents, you are bad people, you've caused this. There is really no evidence that families cause eating disorders or that bad parenting causes eating disorders. You want to bring them in as an ally and try to explain to them reasons why your child is acting this way, and more importantly make the parents part of the treatment team so once your child goes home, the parents have strategies and knows how to most effectively get them to eat and maintain their weight. And that treatment has really been a game changer in that there's a number of studies that have shown that is a more effective treatments for many people, especially if they’re younger than older treatments as usual. But say that there's a large proportion of people that don't really respond very well to Family Based Treatment and go on to have a chronic disorder. Dr. Walter Kaye (13m 33s): And so that's one of the reasons we need to learn more about the biology so that we come up with more effective approaches here. But what happens to people when they get malnourished? Well, there are certain systems in the body that growth during the teenage years is a very important, and so one of those is bone strength. And actually, your bones continue to develop and get stronger during your teenage years and your bone growth becomes peak in your late teens, early twenties, and then its, then you slowly lose strength as you get older. Dr. Walter Kaye (14m 11s): If you miss that are critical period of bone growth, you're gonna, your likely to have weak bones all your life. You cannot make up for it later with better nutrition when you're in their twenties and thirties. And it is not unusual that we see people who have had a period of Anorexia and now are fully recovered, but they suffer, they're very susceptible to fractures as they get into their thirties and forties that other people might not have just because their bones are so weak. And they're certain other patterns, similar kind of patterns of growth that occur in parts of the brain during your teenage years as you're are getting into your twenties. Dr. Walter Kaye (14m 48s): And now we're beginning to wonder whether there may be permanent changes to some parts of the brain if people remain malnourished for many years. There are long term consequences that can happen. And even people that have Bulimia Nervosa that don't lose a lot of weight can also show some of these more chronic permanent changes. Dr. Bridget Nash (15m 10s): I liked the way you talk about the family as part of the treatment team. And I think that a multidisciplinary approach is key to treating someone with an eating disorder, even including like when we think about it, the medical, the dental, the psychiatric in the psychotherapy piece, I think they're all critical don't you think? Dr. Walter Kaye (15m 30s): It takes the team to treat somebody with Anorexia. A dietician, a various kind of therapy, sometimes medication. Family is just maybe the most critical element of that whole team. Dr. Bridget Nash (15m 43s): What are some of the most common obstacles that prevent people from achieving a full recovery? Dr. Walter Kaye (15m 49s): I don't think we really know that. And that's where you start to get into biology. One of the questions that we've really struggle with, and typically are doing research on his, this question about eating behavior. Let me ask you, how, how do you feel when you go without eating for a day or two? Dr. Bridget Nash (16m 7s): Angry! Dr. Walter Kaye (16m 7s): Yeah. Most people will say there's something unpleasant about it. It's irritable. It's uncomfortable. It just doesn't feel good and what people will find, if you go without eating for a day or two, you you get hungry, that first bite of food really is more pleasurable. It will still be pleasurable. But when you are really hungry, food tastes better doesn't it? Dr. Bridget Nash (16m 28s): Yes. Dr. Walter Kaye (16m 30s): Okay. So, if you ask somebody with Anorexia, what do they feel like when they have to eat or they think about food, you know, what they almost always tell you is there's something about that that makes them anxious and uncomfortable. And when they don't eat, they feel the anxiety isn't increased, or sometimes they feel even better, empowered. So, just from that standpoint, it makes you think that there's something that is wired very differently in people's brain with Anorexia because the primary job of animals is to find food and feed themselves every day. Dr. Walter Kaye (17m 4s): And we know from animals’ studies there is very powerful systems that are built into the brain to do that. So, what happens is, when animals go without eating for a while, their body says to sense that they need energy stores, their energy stores are diminished, their gas tank is less full. And that, there's a number of different pathways from the brain that send the messages signals to the, to the brain that say "Gosh, you need more energy." And what that does is that really, you know, in humans that is interpreted as an uncomfortable feeling like: “Hey, there's something wrong, you got to go out and eat.” And in animals, what that particularly does is that works on a part of the brain that is very important for reward and motivation, and it actually sends a signal to that part of their brain that motivates you to go out and search for food. So, we know a lot about that part of their brain. It's very deep in the brain and is shared with animals. It's actually below our consciousness. It's a part of the brain that sits on top of the brainstem, but under the cortex and is called the striatum or the basal ganglia. Dr. Walter Kaye (18m 9s): And it’s very important for motivating all kinds of behavior, whether it's food or drugs or sex or anything that people or animals are motivated to do. And you can do brain imaging studies now that, at least, ask the question of – “What happens in that part of the brain, there's the activity in that part of the brain, that's important for motivation get turned on when you are hungry.” And so, we did a study in, and this is just published a couple of months ago in the American Journal of Psychiatry, where we had people with Anorexia come into a laboratory that we have on campus, building a setting. Dr. Walter Kaye (18m 45s): And they lived there for three days. One day we had them go without eating for 16 hours. On the other day we had to meet normally. And what we wanted to do is measure the activity in this motivational part of the brain. And so, we had them come in. Then after that the, they came into an imaging center and we imaged to their brain and we had them, we put a little plastic tube in their mouth we had them taste, repeat a taste of sugar water, which we know kind of turns on this system. And what we found is that, in the control women, the women that didn't have Anorexia, we found exactly what others have found. Dr. Walter Kaye (19m 20s): On the day that they were hungry, there was much more activity in this motivational center of the brain then there was on the day they were full. No surprise. And we did the same thing in people with anorexia, you know, what we found is that, on the day that if they were fed, they look just like the controls. On the day they were hungry, it was decreased activity in the motivation center. So. this makes perfect sense. It what is really saying is that people with Anorexia, the reason they can starve themselves is that they're just not getting a signal that's compelling them to go out and eat food. Dr. Walter Kaye (19m 59s): Does that kind of makes sense? Dr. Bridget Nash (20m 2s): It does. Now are they motivated to do anything else? Like to do other things like compulsive behaviors? Dr. Walter Kaye (20m 6s): We have looked at other kinds of motivation, which is things like response to money, and they had the same diminished signal in that part of the brain. So, you know, people with Anorexia like to save money, they don't spend money. And so, they are not really motivated to for any kind of reward, and that actually we think as part of the problem with treatment is that they really have a hard time sensing the reward of it. You know, parents try to motivate their kid's all the time to eat and maintain their weight by a promising "I'll buy you a new Porsche." Dr. Walter Kaye (20m 39s): Because treatment is so expensive, it's probably cheaper to buy them a Porsche and it doesn't work because the people with Anorexia tend to be very insensitive to reward. But the converse side of it is there over-sensitive to things going wrong, to what we call punishment or some kind of aversive risk state. In fact, it, the other thing that we found in this study is that the more anxious than people with... Anorexia were, the more activity they showed in this part of their brain that's very sensitive to things going wrong and inhibit behavior. Dr. Walter Kaye (21m 15s): And actually what we think is going on is that if you're an animal out there in the wild, you're a rabbit, your living out there in their field, you are living here in your little hole on the ground, is relatively safe, you start to get hungry, that hunger is going to motivate you to go out and look for food, right? But animals have to have a system built into their brain that inhibits that behavior if there's something dangerous going on like a predator that might eat it. And so even though that rabbit is very hungry, that rabbit has to inhibit that hunger and motivation to eat and run away if there's some kind of risk going on, some kind of danger. Dr. Walter Kaye (21m 54s): And what I think is going on with the people with Anorexia is they are getting kind of a biased signal here. They're over sensitive to things going wrong, danger, anxiety, adversity, change, uncertainty. All those things that give you a signal there's some kind of risk, and they're actually getting a signal in their brain. They're somehow miscoding food and their miscoding food is being dangerous and risky. And that doesn't exist for the rest of us because nobody is wired that way, but there's something very different about the brain that people with Anorexia. Dr. Walter Kaye (22m 28s): Does that kind of make sense. Dr. Bridget Nash (22m 31s): It makes a lot of sense. I just wonder what the cause is. Do you have any theories of the cause of where that began? Dr. Walter Kaye (22m 38s): Well, now that we're beginning to understand what system is involved in the brain, we think that there's something wrong in this mechanism that balances reward and punishment, and people with Anorexia tend to be very sensitive to punishment and risk and things like that. So, then what exactly is it a chemical mechanism of that is still a mystery, but I think we've started to understand were to look now. Dr. Bridget Nash (22m 60s): That's really hopeful and promising. So, is there anything that improves treatment outcomes? Dr. Walter Kaye (23m 6s): We're finding that some people, and there have been some articles now in the literature, part of this system, it relies on a chemical called dopamine, which actually, people think of it as a reward chemical, but it’s actually a very important for this balance between reward and punishment. And that there's some studies suggesting at at least some people with Anorexia, may respond to some drugs that work on the dopamine system. It was a paper on American Journal last year is showing that Zyprexa also called Olanzapine showed improved weight gain to some extent in people with Anorexia. Dr. Walter Kaye (23m 42s): And there's been several other studies showing that a drug called Abilify which kind of has a similar mechanism or Aripiprazole also might work on some people, it doesn't work in everybody, it's not a magic bullet, but it may be helpful to some people. We really need to do now more controlled studies of that. But at least it’s starting to open the door to ask questions about mechanisms, Oh, by the way, I wanted to mention one other thing. The thing that's really important about this study I just told you about is we studied people who had recovered from Anorexia and not people that were ill. Dr. Walter Kaye (24m 16s): And the reason that we did that is this problem with teasing apart cause and effect. If you study people are ill or malnourished with Anorexia, it wouldn't be surprising you'd get altered signals in his system, and we wanted to look at people that are normal weight, not on a medication, normal menstrual function, doing really well in life and we found that they still had a disturbance in this system and suggesting that this may be the trait that leads to Anorexia in the first place. Dr. Bridget Nash (24m 48s): Are there other mental disorders that often co-occur with eating disorders? Dr. Walter Kaye (24m 52s): Sure. One of the, it seems to be the most common is anxiety or Obsessive Compulsive Disorder, but people also have depression and they may have a number of other disorders too. Dr. Bridget Nash (25m 5s): So, do people with eating disorders have a higher rate of suicide? Dr. Walter Kaye (25m 8s): Unfortunately, they do. I mean that's part of the increase death rate and mortality rate in Anorexia is some people starve themselves to death, but some people commit suicide and another reason why we need more effective treatments. Dr. Bridget Nash (25m 24s): Why is it important that clinicians who are treating people with eating disorders are trained in the most up-to-date research and treatments? Dr. Walter Kaye (25m 32s): Just because of the difficulty of treating this disorder and the difficulty of even getting people to participate and engaged in treatment. The more we learned about the Anorexia and the symptoms that people have, I think the better we can speak peoples, the language in the way, you know, understand the way people are thinking and reach out to them and get them to be motivated and engage in treatment, and I think one of the problems that we've had with Anorexia and often psychiatric disorders, is that, do you try, and there's theories about behavior... Dr. Walter Kaye (26m 7s): and maybe they make a lot of sense, but maybe they don't, and if you try and use a theory, that really has no particular, it doesn't fit or explain why somebody has a disorder, it is less likely to result in any kind of effective therapy. So, for example, now that we understand this altered balance between reward and punishment, we can work with families on that strategy, and we explain this to families and say: "Look, rewarding your child isn't going to be that effective." But there are these are kids that worry about consequences and don't want to do things wrong or make mistakes or... Dr. Walter Kaye (26m 44s): and we can help families develop strategies to use consequences. Now we're not trying to punish their kids, it's just that, ya know, sometimes they pay much more attention to that and to realize that, if they don't eat and maintain their weight, there is going to be consequences they consider even worse, then it becomes very individualized cause you want to figure out what consequences bother that child the most. What we are finding that can be somewhat a more successful kind of strategy. Dr. Bridget Nash (27m 13s): That's incredible. So, to use consequences to get the attention and to sort of start the conversation with the young person or whoever you're treating, that's excellent. Dr. Walter Kaye (27m 23s): For example, kids with Anorexia, you know, they really don't want to go back into treatment, they don't want to go into the hospital, they don't want to go into, you know, a residential program and sometimes that's the only leverage that you have. Not great, but you have to work with what you got it. Dr. Bridget Nash (27m 38s): And I think if you're not trained in understanding eating disorders, I want to ask you to explain to our audience, eating disorders are different. They're almost like distinct disorders, like Bulimia is a distinct disorder and Anorexia nervosa are distinct disorders, I mean we call them all feeding disorders, but their complex and they're different. Dr. Walter Kaye (27m 57s): They're both very different and they actually, sometimes have some similarities and one of the puzzling things is that both the Anorexia and Bulimia run in families, so one person can have Anorexia and another can have Bulimia you know, I don't think we really, you understand this. Dr. Bridget Nash (28m 14s): And if you're a clinician who's working in the field, who's been certified and I think you also understand that some people need multiple treatment, multiple treatment center or multiple residential treatment... Dr. Walter Kaye (28m 25s): Yeah. Dr. Bridget Nash (28m 26s): ... to get better. Whereas the person who's not experienced might see that as they're failing or they're not getting it the first time. Can you speak to that a little bit? Dr. Walter Kaye (28m 35s): Yeah. Well, you know, one of the things that's very important is that when people get malnourished, they actually, their symptoms tend to get worse and they spiral out of control and they have difficulty. The brain gets starved. They have difficulty learning things or using therapy, and, and so for both mental as well as physical reasons, they need to get back to a healthy body weight and that can really be an enormous challenge for people with Anorexia, and so being an a, you know, they often end up a higher level of care because it’s just so, if you don't get them until a more healthy nutritional state, they may die from their Anorexia. Dr. Walter Kaye (29m 13s): And also, the other thing that's going on here is that some people with Anorexia get very energy inefficient. And by that, I mean there's been studies showing, for example, people with obesity, have a hard time losing weight and they seem to have an easy time gaining the weight back after they lose weight. The opposite tends to seem to occur with a lot of people with Anorexia. They lose weight very easily, and it's hard for them to gain weight. Dr. Walter Kaye (29m 43s): And sometimes they need thousands of calories a day to gain that weight back. And if you're somebody with Anorexia and you want to eat 500 calories a day and you need three or four thousand to gain weight, you know, two, three pounds a week, food is making you anxious, what's the chance they're going to be able to do that at home? Not great. And they may have to eat that amount of food for two, three, four months to get back to a healthy body weight. Dr. Walter Kaye (30m 13s): So sometimes higher levels of care are just so critical to save their life. Dr. Bridget Nash (30m 19s): Exactly. Now aren't people with Anorexia nervosa interested in food? I mean, I think there's a misconception that they're not interested in food, but do you think that they might have a preoccupation with food perhaps? Dr. Walter Kaye (30m 32s): Absolutely. I mean, they collect calories. They cook for others. They window shop for food. They work in food industries. And I think this has been one of the puzzling parts. So, this network, you can have a brain circuit that is very important for recognizing you're hungry and driving the motivation to eat. And there's a series of kind of steps along the way that do that. And it's possible that you could have a blockage in one part of that which is... Dr. Walter Kaye (31m 2s): So, people with Anorexia seem to recognize that they're hungry, they're getting the signal, they can't turn that signal into motivation to eat, to initiate eating. But they're still, their part of their brain is still recognizing they're hungry. And this is a strange signal that nobody else has, and I suspect that really explains why they're obsessed with food and they cook for others, yet they can't eat. Dr. Bridget Nash (31m 31s): And can you speak a little bit about Binge Eating Disorder. It's a new disorder in the DSM-5, but I think it's one that has a lot of medical consequences. Dr. Walter Kaye (31m 39s): Yeah. Binge Eating Disorder tends to occur more frequently in males. It's a somewhat later age of onset and people have, they tend to often have mood and anxiety disturbances and respond somewhat differently to treatment and other treatments compared to Anorexia, but ideologically they're really not the same disorder whereas you see, Bulimia nervosa and Anorexia nervosa kind of run together in families, you don't really see that; Binge Eating Disorder has a separate kind of family and inheritance structure. Dr. Walter Kaye (32m 13s): There's one other disorder that we've recognized now that it's ARFID, or Avoided Restricted Food Eating Disorder, which is very extreme, picky. It tends to occur in children, that's something that we treat a lot also. And these are kids, there is a whole host of different symptoms they have. Some have pain in their stomach and can't eat because it causes pain and some are very anxious, some have obsession, they only can eat four different white foods, some disturbed by certain textures and tastes of food. Dr. Walter Kaye (32m 43s): So, it's not just one symptom complex - it's something that we've more recently kind of recognized, and some of these children really have a hard time eating and lose a lot of weight and so it's one of the disorders that we treat. And there's some from these children who end up developing Anorexia and some just have an ARFID disorder, so it's things that we're learning about, but it's also a disorder where Family Based Treatment is often very useful. Dr. Bridget Nash (33m 10s): And early intervention as well. Dr. Walter Kaye (33m 12s): Yeah. Yeah, exactly. Yeah. Dr. Bridget Nash (33m 14s): What are you most excited about mental health treatment today? Dr. Walter Kaye (33m 18s): Well, you know, I think we're finally becoming a science. The progress that's been made in the last 10, 20 years has just been enormous. And of course, the reason was that the brain is encased in your skull there, as opposed to having diabetes or heart disease where you can measure things. We haven't been able to measure what's going on in the brain and it's only been the last decade or so we've had powerful brain imaging and genetics kinds of studies that are allowing us to really look inside the brain and begin to understand brain circuits and pathways and mechanisms of behavior and how behavior is encoded in the brain... Dr. Walter Kaye (33m 54s): that have just made a difference. I am just kind of astounded how far we've gotten in my professional career, where you can begin to look at these behaviors and go like "Oh, well I think this part of the brain is involved and now I understand the mechanism, and I can predict what we are going to find and we can replicate those kinds of findings." And that's starting to lead to more effective treatments as we begin to translate that science into therapy. Dr. Bridget Nash (34m 18s): Effective and targeted treatments as well. Dr. Walter Kaye (34m 24s): Yeah. And that's one of the things that we do here. I like to look at our program not only as a, a treatment program, but also a laboratory for developing treatments. So we've very interested in this whole question of temperament in people with Anorexia and you know, these temperaments don't go away, but people with Anorexia when they recover, tend to do really well in life and they learn to use some of these temperaments in really kind of advantageous ways. This is a group of people who were very achievement oriented. Dr. Walter Kaye (34m 53s): They self-discipline, they pay attention to detail. They work hard. They wanted to do the right thing and they often have not just great but have actually spectacular careers. And so, this actually turns out to be a benefit to having some of these traits once people learn to use them in advantageous constructive ways. So, we think that that may be actually an important insight into developing more effective treatment approaches. Dr. Bridget Nash (35m 25s): That is very exciting. If you had a magic wand and could improve one thing about mental health treatment today, what would it be? Dr. Walter Kaye (35m 31s): Being able to understand each person's unique vulnerabilities and mechanisms because when you really come down to it, people are pretty complicated and everybody has probably in some ways unique mechanisms that are causing, and environmental influences and so that starts to explain why, whatever treatment we have works for some people, but not others. And so, if we could better understand, you know, it's called precision medicine. If you can better understand each person's unique with a series of factors, you could really more precisely prescribe treatment. Dr. Walter Kaye (36m 6s): We're not there yet. It's going to be a while. Yeah. We'll probably get there. Dr. Bridget Nash (36m 12s): No, we're going to get there because people are going to be asking for it now. Like when we hear from you and hear all of these exciting targeted treatments, it's going to kind of create a demand. Do you think? Dr. Walter Kaye (36m 25s): Yeah, yeah, absolutely. Dr. Bridget Nash (36m 28s): Dr. Kaye on behalf of myself, my listeners, and all of the people that you've helped through your work. I want to thank you for your contributions to mental health treatment and for taking the time out of your busy schedule to help me and my audience better understand the field of eating disorders. And to my listeners, be sure to check out my website TherapyShow.com, which has many resources about mental health. There, you will also find how to submit questions, stories, or insights that you have about the mental health system or suggestions about who else I interview can and how I can improve the show. Dr. Bridget Nash (37m 1s): I'd like to close by reminding our listeners to please subscribe, share, and review this podcast. So you, someone you love, and people around the world can gain more benefit for therapy. There is no need to suffer in silence. Get the help that you need to create the life that you want.

Aripiprazole, marketed as Abilify, is widely thought to be safer than risperidone, the only other drug approved for use in autistic children. A decade’s worth of data suggests that is not true.

Aripiprazole, marketed as Abilify, is widely thought to be safer than risperidone, the only other drug approved for use in autistic children. A decade’s worth of data suggests that is not true.

This week's guest, Kelsey, opens up about her struggles with anxiety, depression, and manic episodes. She also discusses her large family made up of herself and multiple half siblings and how that dynamic changed her role as a child. Facebook and Instagram: @FriendRequestPod Twitter: @FriendRequestJL

EPISODE #327 Anti-Depressants and Mass Shootings Pt. 2 Richard welcomes an expert in serotonergic medications to talk about the possible violent side effects of anti-depressant medications. GUEST: Dr. Ann Blake Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. She has testified since 1992 as an expert witness in Prozac and other SSRI related court cases around the world. Her first book on the issue was published in 1991. During the last twenty years she has participated in innumerable radio, television, newspaper and magazine interviews on this subject. She is the author of Prozac: Panacea or Pandora?   PLEASE SUPPORT OUR SPONSORS!! C60EVO.COMThe Secret is out about this powerful anti-oxidant. The Purest C60 available is ESS60.  Buy Direct from the SourceUse the Code RS1SPEC for special discount. Ancient Life Oil Organic, Non GMO CBD Oil.  Big Relief in a Little Bottle! The Ferrari of CBD products. Strange Planet's Fullscript Dispensary - an online service offering hundreds of professional supplement brands, personal care items, essential oils, pet care products and much more. Nature Grade, Science Made!   Life Change and Formula 13 Teas  All Organic, No Caffeine, Non GMO!  More Energy!  Order now, use the code 'unlimited' and your first purchase ships for free.

EPISODE #325 Anti-Depressants and Mass Shootings Richard welcomes an expert in serotonergic medications to talk about the possible violent side effects of anti-depressant medications. GUEST: Dr. Ann Blake Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. She has testified since 1992 as an expert witness in Prozac and other SSRI related court cases around the world. Her first book on the issue was published in 1991. During the last twenty years she has participated in innumerable radio, television, newspaper and magazine interviews on this subject. She is the author of Prozac: Panacea or Pandora? WEBSITES:   PLEASE SUPPORT OUR SPONSORS!! Ancient Life Oil Organic, Non GMO CBD Oil.  Big Relief in a Little Bottle! The Ferrari of CBD products. C60EVO.COM The Secret is out about this powerful anti-oxidant. The Purest C60 available is ESS60.  Buy Direct from the SourceUse the Code RS1SPEC for special discount. Strange Planet's Fullscript Dispensary - an online service offering hundreds of professional supplement brands, personal care items, essential oils, pet care products and much more. Nature Grade, Science Made!   Life Change and Formula 13 Teas  All Organic, No Caffeine, Non GMO!  More Energy!  Order now, use the code 'unlimited' and your first purchase ships for free.

1. Quality of prescription drugs a. Health Canada responsible for efficacy and safety of drugs marketed in Canada b. Health Canada operates under the Food and Drugs Act and regulatory mandate under the Food and Drug Regulations c. Most drugs are not manufactured in Canada d. There is no parity between drugs available without a prescription in US vs. Canada 2. Availability of prescription drugs a. US Rx received in Canadian pharmacy must be approved by a Canadian physician prior to it being filled – cosigning b. Canada Health Act – drugs administered in Canadian hospitals are approved at no cost to patients c. Employers cover many Canadians and their families d. Drug Shortages Canada – i. Website for reporting drug shortages and discontinuations in Canada ii. Drug sellers must report that they cannot meet demand 3. Cost considerations a. Canada i. Most prescription drugs are imported ii. Government places price ceilings on Brand name medications imported into Canada b. Canadian internet pharmacies are suspect c. Bricks and mortar pharmacies are same as US 4. Opportunity Savings a. HIS Markit study – Abilify costs 87% less and Xarelto costs 60% less b. Concerns that manufacturers will increase prices for drugs in US and Canada 5. State Plans a. Florida b. Vermont 6. Trump’s Plan a. States, individual pharmacies, wholesalers can write proposals and submit for federal approval b. Exclusions – biologics, medications created from living organisms c. FDA would work with manufacturers to bring drugs made in foreign factories to the US (e.g., insulin) 7. Arguments Against – PhRMA a. Counterfeit, dangerous medications b. Canada drug market too small c. Canada doesn’t have an unlimited supply of medications ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks YouTube: https://www.youtube.com/user/ProPharmaEducation

Tony Altar, PhD, Senior Scientific Fellow and Advisor of Verge Genomics, delivers a thorough overview of new mechanisms and treatments for brain illnesses.    Altar is helping to guide Verge forward with his 35+ years of experience helming CNS drug discovery and development teams, from initial concept to commercial productivity and success. Altar is the former Global Head of Neuroscience at Otsuka. During Altar's tenure he led his team in the discovery and FDA approval of aripiprazole (Abilify™) for multiple uses in bipolar disease, depression, as well as schizophrenia. Altar was also the Chief Scientific Officer at Assurex Health, CSO of Psychiatric Genomics, and he co-founded the Regeneron vision program, and led teams at Genentech.    Altar discusses his background and how he became interested in the brain and the potential problems that can develop. He talks about his time as a high school student when there was a lot of use of psychedelic drugs in the community. As a curious high school scientist in the making, Altar's scientific mind wondered… if a single molecule could create temporary psychosis and states of euphoria, etc. then could the mechanism of psychiatric illnesses perhaps share the same features? Completing his high school studies in advance, Altar began a volunteer position at the Neurobiochemistry Lab at the Brentwood Veteran's Administration, which accelerated his interest in disease and brain issues.    As Altar explains there are 20,000 genes, approximately, in the human body and the brain expresses almost half of those. And fortunately, it is now possible to study all 20,000 of them to understand the coding of proteins and measure mRNA in diseased tissue. The mRNA is ‘messenger RNA,' a subtype of RNA. The mRNA are molecules that carry a portion of the DNA code to other parts of a cell for processing.   Altar discusses cell types and neurons and how various brain diseases impact them. He explains how some neurons are more vulnerable and thereby more susceptible to succumb to disease. He talks about the various methods and companies that are working toward solutions to treat schizophrenia and other mental health issues. Altar explains the mechanisms of Parkinson's Disease and how changes can be very subtle. He explains the loss of dopamine neurons and the impact that has, and he details some of the protective mechanisms and explains why cells die.   Altar talks extensively about enzymes, and brain injection therapies that are utilized for better results due to the fact that the brain is not easy to access, and intravenous solutions may or may not get to the brain.    Verge was founded by some of the industry's best machine learning experts and neuroscience drug developers. And Altar and his fellow Verge contemporaries are excited about the amazing advances in computational genomics and new insights into neuroscience that are creating great progress in drug discoveries, that can help combat neurodegenerative diseases.

L'aripiprazolo è il capostipite di una nuova classe di farmaci psico attivi definita "neurolettici di terza generazione". Quali caratteristiche molecolari possiede l'aripiprazolo? Quali indicazioni ha questo farmaco? Che effetti collaterali ci si possono aspettare dall'aripiprazolo?#aripiprazolo #psicofarmacologiaVi interessano la Psichiatria e le Neuroscienze? Bene, allora iscrivetevi a questo podcast, al mio canale YouTube e seguitemi sul web tramite il mio blog https://www.valeriorosso.comInoltre andate su Amazon a dare un’occhiata ai miei libri:“Psicobiotica” - Un nuovo modo di intendere il rapporto tra la Mente ed il Corpo….andate su: https://amzn.to/2IZwjhm“Psichiatria Rock” - 50 pensieri off line dal mio blog….andate su: https://amzn.to/2IVKKmJ

L'aripiprazolo è il capostipite di una nuova classe di farmaci psico attivi definita "neurolettici di terza generazione". Quali caratteristiche molecolari possiede l'aripiprazolo? Quali indicazioni ha questo farmaco? Che effetti collaterali ci si possono aspettare dall'aripiprazolo?#aripiprazolo #psicofarmacologiaVi interessano la Psichiatria e le Neuroscienze? Bene, allora iscrivetevi a questo podcast, al mio canale YouTube e seguitemi sul web tramite il mio blog https://www.valeriorosso.comInoltre andate su Amazon a dare un’occhiata ai miei libri:“Psicobiotica” - Un nuovo modo di intendere il rapporto tra la Mente ed il Corpo….andate su: https://amzn.to/2IZwjhm“Psichiatria Rock” - 50 pensieri off line dal mio blog….andate su: https://amzn.to/2IVKKmJ

"Coming up with the best solution for the visual problem is always going to be your best bet and if you lose the job…you lost it because the other company thought through the solution in a much different way." – Carolyn Hill As President at Carolyn Reps, Carolyn and her team are the expert at solving tough problems to win top projects for production companies and studios. Since 2001, her clients have been awarded well over $100 MM in projects including campaigns for United Airlines / Olympics, Dunkin’ Donuts, Abilify, the Nasonex “Bee,” Spiriva “Rosie the Elephant,” Carrabba’s, and many more. Carolyn has represented such notable production companies and studios as Bark Bark, Blind, Curious Pictures, Derby Content, Noble Animation, Pogo Pictures, Production Service Network (PSN), Saville Productions, and Sound Lounge. Love what Carolyn has to say? LISTEN ALL THE WAY THROUGH THE END. Carolyn and I brainstorm and let me know if you would like to join Carolyn — and me — for a one-day event to learn all of her sales mojo! — What does a rep do… really? — How has the rep business model evolved over the past decade? — Why does every studio or production company owner think “We need a rep!” — Why is that usually a bad idea? — What are the top sales best practices that every studio / prodco ought to know? — What’s next for you?

Friends with Benefactors (Classic) – Ep. 10 – Adult Kiddie Litter™ http://www.friendswithbenefactors.com/wp-content/uploads/2018/11/Friends-With-Benefactors-Adult-Kiddie-Litter™.mp3 In this episode the friends celebrate Mother’s day, and discuss what’s bugging them, American Girl Dolls, Abilify, Donald Trump’s VP choice, precocious children, transgenders in bathrooms, Talk Sex with Sue, lady Ghostbusters and much more. This week’s Beer Reviews is Two Roads – Conntucky … Continue reading "Adult Kiddie Litter™"

Tales of good and bad experiences with psychiatric medication, Lithium, Lamotrigine, Pregabalin, Abilify, Latuda, Risperidone,...

Richard speaks with a court expert witness about the frightening connection between mass shootings and anti-depressant drugs.  In virtually all mass-shootings, the shooters were taking some type of anti-depressant or anti-psychotic medication. GUEST: Ann Blake-Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. Her first book on the issue, Prozac: Panacea or Pandora? was published in 1991

This week, we interview Laura Delano. Laura is Co-Founder and Executive Director of the Inner Compass Initiative and The Withdrawal Project, which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs.  The passion she feels for the mission and vision of ICI arises from the fourteen years she spent lost in the mental health system and the journey that she’s been on since 2010, when she chose to leave behind a “mentally ill” identity and the various treatments that came with it, and gradually began to rediscover and reconnect with who she really was and what it means to suffer, struggle, and be human in this world.  Since becoming an “ex-patient”, Laura has been writing and speaking about her personal experiences and about the broader social and political issues sitting at the heart of “mental illness” and “mental health”. Since 2011, she has worked both within and beyond the mental health system. In the Boston area, she worked for nearly two years for a large community mental health organization, providing support to and advocating for the rights of individuals in emergency rooms, psychiatric hospitals, and institutional “group home” settings. After leaving the “inside” of the mental health system, she began consulting with individuals and families seeking help during the psychiatric drug withdrawal process. Laura has also given talks and workshops in Europe and across North America, facilitated mutual-aid groups for people in withdrawal, and organized various conferences and public events such as the Mad in America International Film Festival.  In this interview, we got time to talk about Laura’s personal experiences of the mental health system and what led her to co-found the Inner Compass Initiative and The Withdrawal Project. In this episode we discuss: Laura’s experiences as a patient in the mental health system, starting treatment aged thirteen and leaving the system behind aged 27. How she spent much of that time as a compliant patient, taking the medications and following the advice of her doctors. That, by 2010, she was on 5 medications (Lithium, Abilify, Lamictal, Effexor and Ativan) and had spent the last decade becoming worse and unable to properly engage with life. How she came to read Anatomy of an Epidemic by Robert Whitaker and that it was a profound moment of realisation. That Laura decided to take control of her life and became determined to get off the drugs as quickly as possible. How traumatic it was to come to the realisation that almost everything she had been told during treatment was overly simplistic or incorrect. That Laura did experience feelings of being a victim of psychiatry, but realised that this increased her emotional dependency on psychiatry and that it was necessary to move beyond that to feel free. That these experiences made Laura passionate about her own process of healing and rediscovering herself and helping others to find their way back to themselves after being psychiatrized. That as she healed she moved into a space of acceptance and gratitude and felt that the period around three years off the drugs was when she came to feel really alive and motivated again. That Laura feels that if we are going to move beyond the mental health system, it is about helping people to realise they don't need the mainstream system and point them to alternatives at a local level and creating physical spaces where people can come together. How Laura came to co-found The Inner Compass Initiative and The Withdrawal Project which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs. That The Withdrawal Project was highlighted in a recent New York Times article discussing antidepressant withdrawal. How ICI and TWP present information on many aspects of psychiatric drugs and withdrawal to help guide and inform people who do want to start the journey off their psychiatric drugs and away from the mental health system. That TWP connect is a free peer to peer networking platform that allows people to connect one on one with others who have similar experiences. How a similar peer to peer system is available on ICI to enable conversations about moving beyond the mental health system. That Laura wants to encourage people not to give up because we do heal from psychiatric drugs and that we need to spread that message far and wide. The need to both learn and unlearn when approaching how we take back our power and control of our lives after psychiatric treatment. How important it is to properly prepare before starting to taper from psychiatric drugs and how the Withdrawal Project can enable that preparation. The ‘speed paradox’ when coming off psychiatric drugs. How people can find out more about The Inner Compass Initiative and The Withdrawal Project. That Laura is keen to support local community initiatives to get underway. Relevant links: The Inner Compass Initiative The Withdrawal Project TWP Connect Learn about psychiatric drug withdrawal Inner Compass Initiative’s The Withdrawal Project Gets Mention in The New York Times—Is the Tide Finally Turning? The New York Times - Many People Taking Antidepressants Discover They Cannot Quit Read more about Laura’s journey into and out of the mental health system Laura’s presentation in Alaska, 2015 Anatomy of an epidemic by Robert Whitaker

Everyone knows medical care in the US is expensive even with insurance and prohibitively expensive without it. I have a lot of patients who are uninsured, or who bounce on and off insurance, or who have trouble affording their co-pays. This is a collection of tricks I’ve learned (mostly from them) to help deal with these situations. They are US-based and may not apply to other countries. Within the US, they are a combination of legal and probably-legal; I’ve tried to mark which is which but I am not a lawyer and can’t make promises. None of this is medical advice; use at your own risk. This is intended for people who already know they do not qualify for government assistance. If you’re not sure, check HealthCare.gov and look into the particular patchwork of assistance programs in your state and county. I. Prescription Medication This section is about ways to get prescription medication for cheaper. If even after all this your prescription medication is too expensive, please talk to your doctor about whether it can be replaced with a less expensive medication. Often doctors don’t think about this and will be happy to work with you if they know you need it. They may also have other ways to help you save money, like giving you the free sample boxes they get from drug reps. 1. Sites like GoodRx.com. This is first because it’s probably the most important thing most people can do to save money on health care. For example, one month of Abilify 5 mg usually costs $930 at Safeway, but only $30 with a GoodRx coupon. There is no catch. Insurances and pharmacies play a weird game where insurances say they’ll only pay one-tenth the sticker price for drugs, and pharmacies respond by dectupling the price of everything. If you have insurance, it all (mostly) cancels out in the end; if you don’t, you end up paying inflated prices with no relation to reality. GoodRx negotiates discounts so that individual consumers can get drugs for the same discounted price as insurances (or better); they also list the prices at each pharmacy so you know where to shop. This is not only important in and of itself, but its price comparison feature is also important to figure out how best to apply the other features in this category. Even if you have insurance, GoodRx prices are sometimes lower than your copay. 2. Get and split bigger pills. Remember how a month of Abilify 5 mg cost $30 with the coupon? Well, a month of Abilify 30 mg also costs $30. Cut each 30 mg pill into sixths, and now you have six months’ worth of Abilify 5 mg, for a total cost of $5 per month. You’ll need a cooperative doctor willing to prescribe you the higher dose. Note that some pills cannot be divided in this way – cutting XR pills screws up the extended release mechanism. Others like seizure medication are a bad idea to split in case you end up taking slightly different doses each time. Ask your doctor whether this is safe for whatever medication you use. Do not ask the pharma companies or trust their literature – they will always say it’s unsafe, for self-interested reasons. Contrary to some doctors’ concerns, this is not insurance fraud if you’re not buying it with insurance, and AFAIK there’s no such thing as defrauding a pharmacy.

Medicine loves guidelines. But everywhere else, guidelines are still underappreciated. Consider a recommendation, like “Try Lexapro!” Even if Lexapro is a good medication, it might not be a good medication for your situation. And even if it’s a good medication for your situation, it might fail for unpredictable reasons involving genetics and individual variability. So medicine uses guidelines – algorithms that eventually result in a recommendation. A typical guideline for treating depression might look like this (this is a very over-simplified version for an example only, NOT MEDICAL ADVICE): 1. Ask the patient if they have symptoms of bipolar disorder. If so, ignore everything else on here and move to the bipolar guideline. 2. If the depression seems more anxious, try Lexapro. Or if the depression seems more anergic, try Wellbutrin. 3. Wait one month. If it works perfectly, declare victory. If it works a little but not enough, increase the dose. If it doesn’t work at all, stop it and move on to the next step. 4. Try Zoloft, Remeron, or Effexor. Repeat Step 3. 5. Cycle through steps 3 and 4 until you either find something that works, or you and your patient agree that you don’t have enough time and patience to continue cycling through this tier of options and you want to try another tier with more risks in exchange for more potential benefits. 6. If the depression seems more melancholic, try Anafranil. Or if the depression seems more atypical, try Nardil. Or if your patient is on an earlier-tier medication that almost but not quite works, try augmenting with Abilify. Repeat Step 3. 7. Try electroconvulsive therapy. The end result might be the recommendation “try Lexapro!”, but you know where to go if that doesn’t work. A psychiatrist armed with this guideline can do much better work than one who just happens to know that Lexapro is the best antidepressant, even if Lexapro really is the best antidepressant. Whenever I’m hopelessly confused about what to do with a difficult patient, I find it really reassuring that I can go back to a guideline like this, put together by top psychiatrists working off the best evidence available. This makes it even more infuriating that there’s nothing like this for other areas I care about.

Last month Otsuka Pharmaceutical and Proteus Digital Health won U.S. Food and Drug Administration approval for what's being hailed as the first digital pill. Abilify Mycite, a drug-device combination that marries Otsuka's Abilify, used to treat schizophrenia, with Proteus' ingestible sensor, wearable sensor, and smartphone app intended to monitor and improve compliance. We spoke to George Savage, chief medical officer of Proteus, about the technology, other potential uses, and how it may help address the quality and cost of healthcare.

Ty and Sky talk about Abilify, a pill that tracks if you have taken it!   Follow us on Facebook Help fund us on Patreon! Check our new website www.tyandskyshealthpub.com Contact us and submit suggestions - healthpubpodcast@healthypublic.media

[YouTube Video Version: https://youtu.be/Jwxt8eZIkR8] A machine that's capable of inducing hallucinations? Sounds like something out of a science-fiction movie, or as if it's Steven Spielberg's upcoming film "Ready Player One". Well as strange as it may sound, researchers at Sussex University's Sackler Centre for Consciousness Science have chosen a safer option, instead of dosing up volunteers with hallucinogenics, they're trying a method that puts out more reliable data - a virtual reality headset designed to hallucinate in the same way that the human brain does. That's right: A headset that induces hallucinations. Seems silly right? What happens when the headset becomes an implantable device which alters your behavior? Ameet Sarpatwari, an instructor in medicine at #Harvard Medical School, said the digital pill “has the potential to improve public health,” especially for patients who want to take their medication but forget. Patients who agree to take the digital medication, a version of the anti-psychotic Abilify, can sign consent forms allowing their doctors and up to four other people, including family members, to receive electronic data showing the date and time pills are ingested. My point is this: They're using new and alternative forms of medicine to further disassociate us from reality. Become An EXCLUSIVE Member: https://www.patreon.com/FreedomFaction Website: http://factionsoffreedom.jimdo.com/ Email: FreedomsFaction@Gmail.com Instagram: @Freedom_Faction, @Freedoms_Faction FaceBook: https://www.facebook.com/factionsoffreedom/ Twitter: @FreedomsFaction, @NoizceEra Donate: https://www.paypal.me/noizceera The Battalion’s Bazaar: https://factionsoffreedom.jimdo.com/the-battalion-s-bazaar/ Operation Dunamis: https://www.gofundme.com/operation-dunamis

In this week’s episode: I lost a friend this week to stroke. In News: there’s a new type of Abilify that knows when you take it.   Some tips on dealing with grief some honorable mentions not in the episode: https://themighty.com/2017/11/army-policy-mental-illnesses-waiver/   and   https://www.psychologytoday.com/blog/fulfillment-any-age/201711/borderline-personality-disorder-and-ability-read-emotions The interview this week is with Elle, who is diagnosed with Bipolar and Borderine Personality. Thanks for listening and … Continue reading "Episode 8 – Elle"

In the decade between 2004 and 2013, the number of seniors taking at least threepsychiatric meds more than doubled. And for those who live in rural parts of the country, it tripled! I'm talking about drugs such as opioids like Percocet and Demerol, antidepressants such as Prozac and Paxil, antipsychotics including the dementia med Abilify, and tranquilizers like . So why are seniors taking so many of these drugs? And -- perhaps more importantly -- why are their doctors prescribing them at this rate? It seems you can't turn on your TV or computer without a daily story about the dangers of opioids or others on this long list -- yet they're still flying off the Rx pad. Dr. Ron is a board certified physician and a Diplomate. He also is a licensed Acupuncturist. He has over 50 years of medical experience and with Dr Gerry and Dr Dan brings you a weekly program on up to the minute topics and the real story behind the headlines. The 3 doctors comprise over 150 years of experience. Check out ICNR.com for Dr Gerry Smiths new e book on Advances in Chronic Pain Treatment   Email at docronradio@gmail.com and Facebook page Dr Ron Unfiltered Uncensored.

On this weeks show, and amazing turnaround in the fortunes of the MaRS West Tower, CQDM and Brain Canada team up once again, and a significant step in the fight against cancer. We have all this and more on this week’s Biotechnology Focus Radio Show Podcast. Welcome to another episode of Biotechnology Focus Podcast. I’m your host Shawn Lawrence, here to give you a rundown of this week’s top stories on the Canadian biotech scene,   Story CQDM and Brain Canada are join forces again in the funding of two new research projects to address unmet needs in brain research. Together, the two organizations are awarding a total of $3 million to the projects which will oversee the development  cutting-edge tools, technologies and platforms designed to accelerate the discovery of new drugs for brain and nervous system disorders. The two distinguished research teams will unite nine researchers from seven public and private organizations across Canada. The first project is led by Edward Fon at the Montreal Neurological Institute and Hospital (MNI) joined by multi-provincial collaborators from McGill University, Université Laval and University of British Columbia. The second project led by Jean-Martin Beaulieu at University of Toronto is a public-private collaboration with the Research Institute of the McGill University Health Centre and ImStar Therapeutics in Vancouver. Additionally, these researchers will benefit from CQDM’s unique mentoring program. They will have the opportunity to collaborate with influential senior scientists from the pharmaceutical industry who bring expertise and support to the projects, to help better align research with the needs of industry and patients. The Brain Canada funds are provided through a partnership with Health Canada, known as the Canada Brain Research Fund. Story Princess Margaret Cancer Centre scientists have discovered a distinct cell population in tumours that inhibits the body’s immune response to fight cancer. According to principal investigator Pamela Ohashi, director, Tumour Immunotherapy Program at the cancer centre, University Health Network. Dr. Ohashi holds a Canada Research chair in Autoimmunity and Tumour Immunity, the findings, published online in Nature Medicine, are critical to understanding more about why patients will or will not respond to immune therapies.  Specifically, Dr. Ohashi and her team uncovered a potential new approach to modulate the immune response to cancer. She adds that by looking at tumour biology from this different perspective, researchers will have a better understanding of the barriers that prevent a strong immune response. This can help advance drug development to target these barriers. Dr. Ohashi discusses her team’s discovery of a new population of cells that regulate immune response in the following audio clip. https://www.youtube.com/watch?v=l-vbE-DRTdY Dr. Ohashi’s research team along with international collaborators analyzed more than 100 patient samples from ovarian and other cancer types to discover a distinct population of cells found in some tumours. This population of cells suppresses the growth of cancer-fighting immune cells, thereby limiting the ability of the immune system to fight off cancer. For patients, down the road Dr. Ohashi envisions a new era of combined therapies to simultaneously target and kill these suppressive cells while augmenting the immune response against cancer.  The team’s next avenue of research will be focused on identifying a “biomarker” that can identify this distinct suppressive cell elsewhere in the body – for example, in blood or other samples – as a potential predictive clinical tool to determine when these cells are present in patients, which currently cannot be done. Dr. Ohashi’s research was funded by the Canadian Institutes of Health Research and The Princess Margaret Cancer Foundation. Story Aequus Pharmaceuticals has landed $100,000 in federal funding through the National Research Council’s Industrial Research Assistance Program. The company plans to use funds towards an ongoing proof-of-concept clinical study for its lead product candidate, AQS1301, a once-weekly transdermal aripiprazole patch. Aripiprazole is an atypical antipsychotic and the active ingredient in Abilify®, a leading medication in the U.S. used for the treatment of a number of psychiatric disorders including bipolar I disorder, schizophrenia, major depressive disorder and irritability associated with autistic disorder. Aripiprazole is currently available in once-daily oral tablets and a once-monthly injectable form, however, medication adherence continues to be a significant challenge for patients. Offering the medication in a patch form potentially could make it more convenient to use, and improve patient adherence says Anne Stevens, COO and director of Aequus Pharmaceuticals . The product is currently in clinical development, butAequus expects to confirm its regulatory development plan in a pre-Investigational New Drug (pre-IND) meeting with the US Food and Drug Administration (FDA) in the second half of 2017. Aequus anticipates results of the current repeat dose, 28-day study in the first quarter of 2017. The results will be used to inform the final design of the patch to be advanced into the regulatory phase of its clinical trials. Story Genome British Columbia is making an investment into Augurex Life Sciences through its Industry Innovation (I²) funding program. The company was founded on an invention shared between the University of Alberta and the University of British Columbia in 2006. The funding is repayable and is allocated to promising technologies (products, processes or services) at the early stages of commercial development, and aims to provide risk capital that is concurrently matched by other public or private funding sources. The investment will go towards helping the company launch several blood test products from its pipeline and advance its overall therapeutic program. With a focus on autoimmune diseases affecting joints such as rheumatoid arthritis (RA), Augurex has already developed its first blood test, called JOINTstat™, which measures the 14-3-3η(eta) protein in blood for early RA diagnosis, joint damage risk monitoring, and also predicts RA development in people with joint pain. Since this is a very early contributor to disease and correlates with joint damage prognosis, it facilitates the identification of patients for early RA intervention and tighter control of treatment so that clinical and remission targets can be reached; the highest priorities in rheumatology care. Additionally, a portfolio of 14-3-3η-centric biomarkers has emerged from Augurex’s work, with demonstrated applications in multiple autoimmune diseases with joint involvement. As an aside, JOINTstat has since been studied in over 4,000 patients, and is Health Canada approved. It was launched in Canada by LifeLabs and has been in clinical use since late 2013 in the U.S. Recently, the test was also CE marked and TGA approved making it certified for clinical use in Europe and Australia.  Story California Capital Equity, LLC, has increased its equity position in Laval, QC’s ProMetic Life Sciences, exercising 44,791,488 share purchase warrants at a price of $0.47 per share for total proceeds of $21,051,999.36. The venture capital firm  based in LosAngeles, CA, specializes in providing growth and development capital to start-up through mezzanine stages. The firm’s equity and debt investments are typically in small and medium sized companies. It first invested in ProMetic in 2008. Dr. Patrick Soon-Shiong, CEO of California Capital Equity cited the company’s robust proprietary therapeutic platforms and promising growth potential as key factors behind the firm’s latest investment.  Story Our final story this week, In an amazing turnaround for what once was a struggling center for innovation and entrepreneurship, that once upon a time event required the government of Ontario to step in and offer bridge financing to keep it afloat, MaRS Discovery District now reports that it has completed a significant private financing of its West Tower, with proceeds of this transaction to be used to repay most of the Ontario government's interest-bearing loans to MaRS. The caveat, is the repayment comes almost three years ahead of schedule.  Taking part in the private financing are Manulife, Sun Life Financial and iA Financial Group, who together led the $290-million transaction by investing in 19-year bonds issued by Phase II Investment Trust. According to Ilse Treurnicht, CEO of MaRS, the West Tower is now fully leased, and could soon generate the operating income required to be entirely self-sustaining, putting MaRS on stable footing. Last year we featured two of the more noteworthy tenants at the building, Johnson & Johnson’s JLABS @ Toronto, and the Bridge@CCRM in our June/July issue of Biotechnology Focus. And now, offering over 1.5 million square feet of state-of-the-art lab and office space in the heart of Toronto's Discovery District, the MaRS Centre is now home to more than 140 research labs and companies spanning the entire innovation ecosystem, including Multinational medical firms such as Johnson & Johnson's JLABS @ Toronto, which itself houses over 40 biotech and health startups, Merck, growing  life science firms such as Synaptive Medical, Deep Genomics, Interface Biologics, Highland Therapeutics, and Triphase Accelerator; and life science incubators like Blueline Bioscience. Leading research groups from the University of Toronto (which owns a 20% stake in the West Tower), University Health Network (including Princess Margaret Cancer Centre), Ryerson University and the Ontario Institute for Cancer Research also call the West tower home. The facility has even attracted other major tenants like Autodesk, Facebook, Merck, PayPal, Etsy, Airbnb, IBM, CIBC and RBC. In all, ventures within the MaRS network raised $2.6 billion in capital and generated $1.3 billion in revenue between 2008 and 2015, and today employs more than 5,200 people. Well that wraps up another episode of the Biotechnology Focus Podcast. We hope you enjoyed it. Be sure to let us know what you think, and we’re also always looking for story ideas and suggestions for future shows, and of course we’d love to hear from you as well, simply reach out to us via twitter @biotechfocus, or by email at the following email address  press@promotivemedia.ca. And remember, you can also listen to past episodes online via our podcast portal at www.biotechnologyfocus.ca . For all of us here at Biotechnology Focus, thanks for listening.

On this weeks show, Accelerating precision medicine for cancer patients, Avivagen partners with NRC to tackle antibiotic resistance in humans, and Knight buys in on an Israeli biotech, We have all this and more on this week’s Biotechnology Focus Radio Show Podcast. Welcome to another episode of Biotechnology Focus Podcast. I’m your host Shawn Lawrence, here to give you a rundown of this week’s top stories on the Canadian biotech scene, Story Montreal’s Knight Therapeutics-a specialty pharma company reports it is taking a small stake in an Israeli-based company, Protalix BioTherapeutics, through the acquisition of 6,200,000 common shares of the company at an average price of US$0.57 per share. With the purchase, Knight now owns approximately five per cent of the outstanding common shares of Protalix. The shares were purchased by Abir Therapeutics Ltd., Knight’s wholly-owned Israeli headquartered subsidiary, which owns 28.3 per cent of Medison Pharma (Medison), Israel’s third largest pharmaceutical company ranked by revenues. It is anticipated that Medison will provide selected services to Abir in order to launch innovative pharmaceuticals in Israel.  Protalix, a publicly traded biopharmaceutical company is focused on the development and commercialization of recombinant therapeutic proteins expressed through its proprietary plant cell-based expression system, ProCellEx®. Protalix’s first product manufactured by ProCellEx, taliglucerase alfa, was approved for marketing by the U.S. FDA. Story In VICTORIA, BC, Aurinia Pharmaceuticals Inc. reports it has selected Worldwide Clinical Trials as its Clinical Research Organization (CRO) for the company’s AURORA Phase 3 study of volcosporin for the treatment of active lupus nephritis (LN). Voclosporin, an investigational drug, is calcineurin inhibitor and immunosuppressant. According to the company, by inhibiting calcineurin, voclosporin blocks IL-2 expression and T-cell mediated immune responses. It is made by a modification of a single amino acid of the cyclosporine molecule which has shown a more predictable pharmacokinetic and pharmacodynamic relationship, an increase in potency, an altered metabolic profile, and potential for flat dosing.  Lupus Nephritis (LN) in an inflammation of the kidney caused by Systemic Lupus Erythematosus (SLE) and represents a serious progression of SLE. SLE is a chronic, complex and often disabling disorder and affects more than 500,000 people in the United States (mostly women). With the selection of Worldwide, Aurinia will now proceed with conducting a randomized, placebo-controlled, double-blind global 52-week trial in approximately 320 patients. The primary endpoint as in the Phase 2b AURA trial is renal response (complete remission), at 24 weeks. In addition to the assessment of renal response, a key marker of clinical benefit in this population is the duration of proteinuria improvement. Therefore, secondary endpoints will include the duration of renal response at 52 weeks (48 weeks in AURA), an efficacy measure which delineates durability of renal response (remission), an important parameter in evaluating long-term outcomes for the treatment of LN. Story On the business front, Mississauga’s Aralez Pharmaceuticals announced last week that it is opening new offices in Dublin, Ireland. The company, which focuses on cardiovascular, pain and other specialty areas, says it plans to add more highly skilled jobs in Dublin by the end of 2017, and use these offices as a launching pad for expansion into the broader European Union market. The Dublin offices are Aralez's first permanent business premises outside of North America.   Story New findings published in Nature are highlighting the potential of a new messenger RNA vaccine to protect against Zika virus. Acuitas Therapeutics Inc., a private biotechnology company based in Vancouver published the data demonstrating that single low dose immunization with a messenger RNA delivered in an Acuitas LNP carrier has the potential to protect against infection by Zika virus. The company is developing a lipid nanoparticle (LNP) delivery technology for the messenger RNA (mRNA).  In the Nature paper, Acuitas Therapeutics scientists and academic researchers including Dr. Drew Weissman, a professor of Infectious Diseases in the Perelman School of Medicine at the University of Pennsylvania showed that single low-dose immunization with mRNA-LNP encoding the pre-membrane and envelope (prM-E) glycoproteins of a Zika virus strain responsible for the 2013 outbreak elicited potent, durable and protective neutralizing antibody responses in animals. The company in collaboration with Dr. Weissman say they hope to further advance this exciting new therapeutic modality. Story In Ottawa, ON, Avivagen Inc., a life sciences company commercializing products intended to replace the antibiotics added to livestock feeds, with the help of the National Research Council of Canada (NRC) has launched a new project to establish proof-of-concept for a first human health application of its OxC-beta™ Technology. The technology is derived from Avivagen discoveries about carotenoids, compounds that give certain fruits and vegetables their bright colors and is a non-antibiotic means of maintaining optimal health and growth. OxC-beta™ Livestock is a proprietary product shown to be effective and economic in replacing the antibiotics commonly added to livestock feeds.  Specifically, the project will evaluate the efficacy of OxC-beta™ Technology (“OxC-beta”) in an established research model of an infectious disease of humans. Work will be conducted by NRC experts at its facilities based upon a jointly developed protocol and is expected to be completed in 2017. Dr. James (Jamie) Nickerson, Avivagen’s director of product validation, commented on the project and its objectives, saying the company is pleased to be working with NRC. He adds that OxC-beta has demonstrated safety and effectiveness across more than a dozen livestock trials and those results suggest it could also prove to be important to human health and well-being. Neither the NRC or Avivagen have disclosed the specific disease target at this time, in the hopes of ensuring the patentability of this potential new application for OxC-beta™ technology. What is known is that the disease target is one of the top 18 urgent, serious or concerning drug-resistance threats listed by the United States Centers for Disease Control (the “CDC”). Story Vancouver’s Aequus Pharmaceuticals has landed $100,000 in funding from the National Research Council of Canada Industrial Research Assistance Program to support the ongoing Proof of Concept clinical study of its lead product candidate, AQS1301, a once-weekly transdermal aripiprazole patch. Aripiprazole is an atypical antipsychotic and the active ingredient in Abilify®, a leading medication in the US used for the treatment of a number of psychiatric disorders including bipolar I disorder, schizophrenia, major depressive disorder and irritability associated with autistic disorder. Aripiprazole is currently available in once-daily oral tablets and a once-monthly injectable form, however, medication adherence continues to be a significant challenge for patients. In terms of the clinical study, Aequus anticipates results of this repeat dose, 28-day study in the first quarter of 2017. The results will be used to inform the final design of the patch to be advanced into the regulatory phase of its clinical trials. Aequus expects to confirm its regulatory development plan in a pre-Investigational New Drug (pre-IND) meeting with the US Food and Drug Administration (FDA) in the second half of 2017. Story In Toronto, Trillium Therapeutics Inc, a clinical-stage immuno-oncology company developing innovative therapies for the treatment of cancer, has initiated dosing in its second Phase 1 clinical trial with TTI-621 in patients with relapsed or refractory percutaneously-accessible solid tumors and mycosis fungoides. Trillium is developing TTI-621 as a novel checkpoint inhibitor of the innate immune system, and the drug is currently being evaluated in an ongoing 10-cohort Phase 1b study in patients with relapsed or refractory hematologic malignancies. The two-part clinical trial is designed as a multi-center, open-label Phase 1a/1b trial, with TTI-621 being evaluated as a single-agent in patients. The escalation phase will include single or multiple doses of TTI-621 delivered by intratumoral injections, which will be followed by an expansion phase during which one or more selected dose levels of TTI-621 will be tested. Story Wrapping things up this week, in a national first,t he Terry Fox Research Institute and two leading cancer centres in Canada -- the Princess Margaret Cancer Centre in Toronto and the BC Cancer Agency in Vancouver – are partnering on an innovative pilot project to accelerate precision medicine for their cancer patients. The initiative comes at a time when other developed countries are investing heavily in strategies to improve survival from cancer through precision medicine and increased collaboration. The pilot will provide much-needed evidence on how best to roll out a broader vision for data sharing and collaborative translational and clinical research to enable precision medicine for cancer patients.  The pilot is the first phase for developing and implementing a national program that will link high-performing comprehensive cancer research centres, hospitals and universities and their clinical and laboratory programs across Canada through the Terry Fox Designated Canadian Comprehensive Cancer Centres Network. Through the pilot project, each organization will provide complementary analyses of specimens (e.g. tumour biopsies and blood samples), identify and determine ways to harmonize their research processes, set up an IT infrastructure for data sharing, and develop resources required to conduct multi-centre precision medicine clinical trials.  The initial focus will be on colorectal, ovarian, and prostate cancers, with the goal of improving the health outcomes of patients through treatment by precision medicine. Each organization is contributing $4 million over the next two years for a $12-million total investment that will see multidisciplinary teams focus on four specific research thrusts that are institutional priorities: genomics, immunotherapy, molecular imaging and data sharing. That concludes another episode of the Biotechnology Focus Podcast. If you like our show, let us know via a twitter, you can We’re also always looking for your feedback, story ideas and suggestions so we’d love to hear from you.  You can also listen to past episodes online via our podcast portal at www.biotechnologyfocus.ca . For all of us here at Biotechnology Focus, thanks for listening.

Ep. 111: May 5, 2016On Today's Show:The Dog House beat boxing. Everybody hates Robert-LOL! Things we stole. Natasha's 2 white hairs. Elvis the snitch and a big bad apartment brawl. Elvis flirts with buzzed Selena. Prince death investigated by DEA. Elvis on snapchat & Natasha finally snapchatting. Abilify leads to urges of sex, gambling, binge eating, and more . You have Zachary. What is considered old? Associate producer Crystal on Tinder??

FDA Drug Safety Podcast: FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Maintena, Aristada)

Ep. 111: May 5, 2016 On Today's Show: The Dog House beat boxing. Everybody hates Robert-LOL! Things we stole. Natasha's 2 white hairs. Elvis the snitch and a big bad apartment brawl. Elvis flirts with buzzed Selena. Prince death investigated by DEA. Elvis on snapchat & Natasha finally snapchatting. Abilify leads to urges of sex, gambling, binge eating, and more . You have Zachary. What is considered old? Associate producer Crystal on Tinder??

Today in FirstWord:

Read the full story with photos at: https://www.otsuka.co.jp/en/company/globalnews/2014/0829_01.html Taiwan's Minister of Health and Welfare, Dr. Wen-ta Chiu, kicked off Otsuka Taiwan Pharmaceutical’s 40th Anniversary celebration with a message of congratulations. He gave an overview of the company’s contribution to the history of medical therapies in Taiwan since it was first established in 1974. Dr. Chiu also mentioned of the development of Taita solutions, therapeutic agents launched since the 1980s such as Meptin and Mikelan, and then Pletaal, Abilify and Samsca, and PIC/S GMP certification of the Chungli factory in 2010. The event held at Regent Taipei Hotel was attended by a total of 85 guests, including Mr. Ichiro Otsuka, Vice Chairman of Otsuka Holdings and representatives from Taiwan's Ministry of Health and Welfare, Otsuka group companies, Taiwanese corporations, Taiwanese shareholders and former Taiwan Otsuka management. Taiwan Otsuka Pharmaceutical was established as a pioneer in the Asian market on August 30 1974 during Japan’s oil crisis, at a time when the world was also in the grip of recession. At the time, significant growth was forecast for the Asian market. The factory started production in 1976, and the business went into full swing in July. The Taiwanese market environment has seen remarkable change, both stable and ongoing. The sales division currently has specialist medical representatives in the three areas of therapeutic drugs, CNS drugs and parenteral nutrition, and the company has expanded to employ 180 staff, including factory employees. Taiwan Otsuka Pharmaceutical, by providing innovative drugs and information, has made an ongoing contribution to the health and medical treatment of people in Taiwan. All employees are making a collective effort to use this 40th anniversary as a springboard to the future, striving for even greater development.

Read the full story with photos at: https://www.otsuka.co.jp/en/company/globalnews/2013/1101_01.html Otsuka made its first international expansion in 1973, establishing Thai Otsuka Pharmaceutical (TOP). During that era, most Japanese pharmaceutical companies were focused on drug development in Western countries. However, Otsuka looked to its neighbors in the east and in 1981 became the first Japanese pharmaceutical company to establish a joint venture in China, China Otsuka Pharmaceutical Co., Ltd. Later, Otsuka headed westward to Europe and the US, offering its highly original products in the areas of pharmaceuticals, medical devices, nutraceuticals and cosmedics. Today, Otsuka Pharmaceutical has over 20 affiliated research institutes and 139 production sites around the world. Otsuka employees are encouraged to take on creative challenges wherever they work, whether researching and developing products that promote health or supplying local markets. Our pharmaceutical and nutraceutical products are sold in over 80 countries. For example, our central nervous system drug ABILIFY offers patients an excellent efficacy and side effect profile in disorders including schizophrenia and depression. ABILIFY is sold in 60 countries, is the seventh ranked prescription drug in global sales*1 and the number one ranked prescription drug in the United States.*2 Otsuka’s iconic beverage POCARI SWEAT, which replenishes critical electrolytes lost when sweating, is sold in 17 countries and regions and sales outside of Japan exceed domestic sales. Overall, as the average Japanese pharmaceutical companies generate 35% of revenues internationally, Otsuka Pharmaceutical and its affiliates generate 62% and will continue to expand. And on November 1st, 2013 Thai Otsuka Pharmaceutical (TOP) celebrated its 40th year of operation in a gala ceremony held at the Plaza Athenee Bangkok. The event brought together 220 of the company’s key stakeholders, local dignitaries and high-profile Otsuka delegates, while serving as an opportunity to renew its commitment as a leading pharmaceutical brand in Thailand. The list of attendees included Japanese Ambassador to Thailand Shigekazu Sato; CEO Boonsithi Chokwatana from SAHA group; OPF Representative Director Tetsuji Iwamoto; OIAA’s Senior Operating Officer Eom Dae-sik and a number of previous TOP presidents. Mr. Thanan Suntayodom, chairman, conveyed his overwhelming pride in having worked as a member of Thai Otsuka over the past 40 years and shared with the audience how Otsuka began its first step to overseas expansion. “In 1965, Otsuka Pharmaceutical Co., Ltd. Japan had appointed Mr. Sakakibara (from the foreign trade department) to be the representative to bring I.V. solution products and find a distributing agency in Thai market and that was when he met my father, Charoen Suntayodom. Right after that, Charoen Bhaesaj Group started to import products from Otsuka. The product was well accepted by our customers for its high quality and for its good treatment. As the sales volume grew rapidly, my father and Mr. Suwan Sirivikul flew and met Mr. Masahito Otsuka in 1971 to explain it was necessary to have a factory in the Thai market. After it was approved, a factory was established in Samut Sakorn province (about 50km from Bangkok) in 1973.” In his congratulatory remarks, Japan Ambassador Sato expressed his sincere gratitude toward Thai Otsuka’s community service during Thailand’s worst flooding in 2011. Also, TOP President Motoyuki Sakiyama expressed his heart-felt gratitude toward its local employees, past and present, “We will become the best partner for our patients and clients in Thailand for another 40 prosperous years. Thai Otsuka is built upon Otsuka’s corporate philosophy which values innovative ideas, firm commitment to implementation as well as harmony with local culture.”

In its debut podcast, PEERS focuses on one of the most covered stories of the summer, the Casey Anthony trial. Three years after the death of two-year-old Caylee, a jury found the 25-year-old Florida woman not guilty of the murder of her daughter. Shortly after the verdict was announced, those still in disbelief of Anthony's innocence struggled with how and why a mother could allegedly kill her child. Many trying to make sense of the terrible act were quick to question the subject's mental state. Noticing the prevalence of the term "bipolar" in online forums about Casey Anthony around the globe, mental health advocate and writer Andy Behrman decided to write about the issue in the About.com article, "The Casey Anthony Trial Adds to Misunderstanding Mental Illness." Responding to others' questions about whether he thought Anthony had bipolar disorder, Behrman writes about the stigmatization of the condition. In the very first PEERS podcast with host Jenee Darden, Behrman discusses his thoughts on the Anthony issue and his perspective on the high use of psychiatric medication in the U.S., including why he quit acting as a spokesman for the drug Abilify. Behrman authored a memoir about his early journey through bipolar disorder called Electroboy: A Memoir of Mania, and is currently working on a second book that exposes how major pharmaceutical companies operate. 

Liberal and humorous views of politics and the world by two beautiful women. Guaranteed to make Republicans fume. Topics this episode include monkey legislation, tent cities, Limburger Limbaugh, Coultergeist, Abilify suicide pill, lunatic fringe, alligator sex rumor, Bush National Mood Ring and more.