Abnormal Behavior and Tamiflu Psychosis

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Just when AARP magazine, and so many other well respected and widely read  publications, are carrying articles about pandemic flu planning for personal  homes, more bad news.  This news is not for the publications, nor is it for  their readers, but for the authors who have tied their name to poorly researched  advice.  November 14, 2006 the U.S. Food and Drug Administration (FDA) and Roche  Laboratories, Inc., the manufacture of Tamiflu, announced that new labeling  would be provided for this highly publicized pandemic flu drug.  It turns out  that Tamiflu is just one more drug to be added to the long list of medication  recently implicated in “self-injury” (suicide) and other psychiatric side  effects.

While the data is not completely clear as to how much of the hallucination  and confusion associated with Tamiflu administration in the Far East is related  to influenza and how much is directly related to the drug, several things are  clear.

1. Those who received Tamiflu are far more likely to display “abnormal  behavior” and “self-injury” than those who have not received the drug.

2. The likelihood of having these side effects increases as the dose  increases and as the length of time the drug is taken increases.

Tamiflu is one of two drugs available for the treatment of pandemic  influenza.  Unfortunately, the pandemic strain currently being studied in Asia  (H5:N1) is already showing resistance to normal doses of Tamiflu.  In fact, in  recent cases the dose of Tamiflu has had to be doubled and the length of  treatment also doubled.  Further complicating this fact is the need in these  cases to add the second pandemic flu drug, also at double dose and double length  of treatment.

What does this mean for psychiatric side effects?  It means that these side  effects will increase if not arithmatically then lawrymathically.  In other  words, the side effects may not just double, but quadruple or more.

Article Source: http://EzineArticles.com/423702

Click here to read more.

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Published on Nov 13, 2012 by

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Uploaded by ksltube on Oct 23, 2009

You likely know someone by now who has or has had the H1N1 virus, and they may have taken the drug Tamiflu to treat their symptoms. But according to the CDC, most patients shouldn’t take that drug, and it can cause severe side effects.

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1999 Case of Adderall Induced Psychosis: “This is the most severe case that’s ever occurred.”

Posted by Maria Mangicaro

This was a press release from Sept. 22, 2000

“This is the most severe case that’s ever occurred.”

This statement was made by Stephan Antonsson, the Senior Vice-President of Shire Richwood, a British-owned corporation that makes the popular drug Adderall. The “case” that Antonsson was referring to involved Ryan Ehlis, one of Shire Richmond’s customers who had taken its drug, which is prescribed primarily for children with ADHD.

The other “cases” Antonsson referred to involved similar psychotic episodes experienced by patients as a result of taking Adderall. There had been at least ten, probably more. Most involved children, but some adults. This information was never given by Shire Richwood to the doctors and patients to whom it promoted its drug. No warning was given to Ryan Ehlis or his doctor.

Ryan Ehlis, a husband, father, and college student, was prescribed Adderall by his doctor because he was having problems with his calculus class. After taking the drug for ten days, Ryan––in an Adderall-induced psychosis (typified by hallucinations and delusions) –– took his shotgun into the bedroom of his sleeping five week-old daughter Tyra and shot her. He thought he was following God’s command to send her to Heaven. He then shot himself point-blank. Ryan survived. Tyra became Adderall’s “most severe case”.

Ryan was indicted for his daughter’s murder. But when two independent psychiatrists––one for the defense and one for the State of North Dakota ––agreed that the Adderall had produced a “drug-induced psychosis”, the prosecutor asked the Court to dismiss the case. Ryan’s selfimposed sentence of having to live with Tyra’s death for the rest of his life then began.

Ryan Ehlis and his wife Angie Moreno have filed suit against Shire Richwood in federal court in North Dakota. Incredibly, even after admitting that Tyra’s Adderall-induced murder was its “most severe case”, the manufacturer still refuses to warn the doctors. The litigation filed by the Ehlis Family might change that.

Click here to read the full complaint.

Misdiagnosis of schizophrenia in a patient with psychotic symptoms

Misdiagnosis of schizophrenia in a patient with psychotic symptoms.

Source

Department of Psychiatry, University of Pennsylvania, Philadelphia 19104, USA.

Abstract

OBJECTIVE:

A case is presented of a 37-year-old black woman with a 5-year history of a chronic psychotic illness, diagnosed as schizophrenia, who presented to the emergency room complaining of a severe headache, while appearing confused and experiencing visual and auditory hallucinations. The purpose of this case study is to illustrate the way in which the appellation of schizophrenia can be misapplied in a patient with a complicated medical history and poor follow-up evaluation and treatment.

BACKGROUND:

Patients with active psychosis are frequently unable to provide a coherent or comprehensive medical history. In the absence of obvious indications to the contrary, a diagnosis of a primary psychiatric illness is often assumed, especially if this label has been applied in the past. However, the differential diagnosis of psychosis is extensive.

METHODS:

This patient was given a complete psychiatric and neurologic evaluation, and aspects of the history that had been lost or ignored were uncovered and reevaluated.

RESULTS:

A diagnosis other than schizophrenia was made and another treatment, other than antipsychotic drugs, was initiated. The patient responded rapidly with improved cognitive function and resolution of her psychotic symptoms.

CONCLUSIONS:

This case serves to illustrate how the absence of a careful clinical assessment and historical case review, in patients who have been previously labeled as schizophrenic, can perpetuate misdiagnoses and inappropriate treatments. It highlights the importance, especially in patients with an incomplete medical history, of ruling out all organic causes of psychosis to avoid inappropriately labeling someone as having a psychiatric illness.

Former Washington Post Reporter Pete Earley talks about his book “Crazy: A Father’s search through America’s Mental Health Care Madness”

Uploaded by on Jan 29, 2010

Program Description:
Pete Earley will use his personal story to illustrate how difficult it is to get a loved one with a severe mental illness meaningful help. He will specifically focus on how and why persons, such as his son, often end up in our criminal justice system and why that is wrong. In addition to telling his sons story, he will describe the results of a nine month investigation that he conducted as a journalist inside the Miami Dade County jail where he followed persons with severe mental illnesses through the criminal justice system and out into the community to observe what services were available to them. The goal of his presentation is to explain why jails and prisons have become our new asylums, why this is wrong, why it wastes money, and how communities can better serve persons with mental illnesses by focusing on a variety of successful programs that help people recover rather than punish them for being ill.

Program Presenter:
In a *Washingtonian Magazine* cover story entitled, Top Journalists: Washingtons Media Elite, Pete Earley was described as one of a handful of journalists in America who have the power to introduce new ideas and give them currency. A former reporter for *The Washington Post*, he is the author of nine nonfiction books and three novels. His first book, *Family of Spies: Inside the John Walker Spy Ring*, was a New York Times bestseller and was made into a five hour miniseries shown on CBS television. For his book, The *Hot House: Life Inside Leavenworth Prison*, Earley spent a full year as a reporter inside a maximum security prison. His book, *Circumstantial Evidence* helped lead to the release of a black man from death row after he had been wrongly convicted of murdering a white teenager in Alabama. His book, *CRAZY: A Fathers Search Through Americas Mental Health Madness, *tells two stories. It describes his attempts to help is college age son, Mike, after he becomes ill with bipolar disorder and is arrested. It also describes a year that Earley spent at the Miami Dade County Jail where he followed persons with mental disorders, who had been in jail, out into the community to see what sort of services they received. His book was one of two finalists for the Pulitzer Prize in 2007 and has won awards from Mental Health America, National Alliance on Mental Illness, and the American Psychiatric Association.

Anti-N-methyl-D-aspartate receptor encephalitis presenting with acute psychosis in a preteenage girl: a case report

Abstract

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare, newly defined autoimmune clinical entity that presents with atypical clinical manifestations. Most patients with anti-N-methyl-D-aspartate receptor encephalitis develop a progressive illness from psychosis into a state of unresponsiveness, with catatonic features often associated with abnormal movements and autonomic instability. This is the first report of anti-N-methyl-D-aspartate receptor encephalitis in a Greek pediatric hospital.

Case presentation

An 11-year-old Greek girl presented with clinical manifestations of acute psychosis. The differential diagnosis included viral encephalitis. The presence of a tumor usually an ovarian teratoma, a common clinical finding in many patients, was excluded. Early diagnosis and prompt immunotherapy resulted in full recovery up to one year after the initial diagnosis.

Conclusion

Acute psychosis is a rare psychiatric presentation in children, diagnosed only after possible organic syndromes that mimic acute psychosis are excluded, including anti-N-methyl-D-aspartate receptor receptor encephalitis. Pediatricians, neurologists and psychiatrists should consider this rare clinical syndrome, in order to make an early diagnosis and instigate appropriate treatment to maximize neurological recovery.

Keywords: NMDAR, Encephalitis, Psychosis, Children
Click here to read full article.

A Multidisciplinary Approach to the Treatment of Anti-NMDA-Receptor Antibody Encephalitis: A Case and Review of the Literature

The Journal of Neuropsychiatry and Clinical Neurosciences, VOL. 24, No. 2

Abstract

Anti-NMDAR (N-methyl-d-aspartate receptor) encephalitis is a novel autoimmune and paraneoplastic disease often presenting as acute psychosis. Few studies exist in the psychiatric literature on neuroimmunity and behavioral management. This article reviews the epidemiology, diagnosis, pathophysiology, and management of this disease from a neuropsychiatric perspective. Patients have potential for near-complete recovery with early diagnosis and intervention. In addition to immune-suppression and tumor removal, electroconvulsive therapy may be an important tool in treatment of the underlying process in cases developing life-threatening catatonia. Psychiatrists should be familiar with treatment options, since they may be consulted within the context of a multispecialty team.

Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse.

Acta Psychiatr Scand. 2006 Jul;114(1):3-13.

Source

Department of Mental Health Science, University College London, London, UK. j.moncrieff@ucl.ac.uk

Abstract

OBJECTIVE:

To examine the evidence that discontinuation of long-term antipsychotic medication, including clozapine, may provoke a psychotic episode.

METHOD:

Databases were searched and citations scrutinised.

RESULTS:

Evidence for a rapid onset psychosis (supersensitivity psychosis) following clozapine withdrawal was found and weaker evidence that this might occur with some other antipsychotic drugs. Some cases were reported in people without a psychiatric history. It appears that the psychosis may be a feature of drug withdrawal rather than the re-emergence of an underlying illness, at least in some patients. Meta-analyses of withdrawal studies have suggested that antipsychotic discontinuation may also increase the risk of relapse over and above the risk because of the underlying disorder, but not all individual studies show this effect. Mechanisms may relate to brain adaptations to long-term drug use but data are sparse.

CONCLUSION:

These effects require further urgent research. Interventions to reduce morbidity after drug withdrawal need to be developed.

Neuropsychological aspects of Wilson’s disease.

Int J Neurosci. 1996 Apr;85(3-4):221-9.

Rathbun JK. SourceUniversity of Michigan, Department of Psychology, Ann Arbor 48103, USA.

Abstract: A consecutive series of 34 patients with confirmed diagnoses of Wilson’s disease (WD) was administered complete neuropsychological examinations upon admission to a university medical center for routine laboratory tests.

Twenty-five patients with neurological and/or hepatic symptoms (symptomatics) revealed frequent and severe motor deficits and infrequent and mild cognitive deficits in contrast to nine patients with genetic findings of Wilson’s disease but no symptomatic findings (asymptomatics). Somato-sensory tests were normal in all.

One of the most intriguing findings was the absence of a significant correlation between the level of copper toxicity and the degree, nature, and frequency of associated neurological deficits in both symptomatic and asymptomatic patients.

Fifty per cent of the present sample received psychiatric treatment, including hospitalization, for schizophrenia, depression, anxiety, and related disorders prior to confirmed diagnosis of WD.

The present findings provide additional evidence that patients with the initial presenting psychological symptoms may be easily misdiagnosed and mistreated if the possibilities of Wilson’s disease are not ruled out first. PMID: 8734560

[PubMed – indexed for MEDLINE]

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