Monday, December 31, 2007

Elderly Suicide Increases with Age

Reviewed here.

Air Force Like Program at U of Illinois and at Cornell Reduces Suicide Rate by 40%

Referrals of students threatening suicide to just 4 sessions helped reduce the rate. Presumably, those with serious disorders stayed in treatment after the first mandatory four visits.

Here, and here.

Thursday, December 27, 2007

Another Suicider Kills First


$13 Million To Brothers of Woman Who Committed Suicide Day After Refused Treatment for Lack of Insurance

Mentioned in this article, toward the bottom. I don't know how treatment would have prevented a suicide the next day. Only long term treatment can prevent suicide. I would like to get more facts about the case.

Wednesday, December 26, 2007

Hunt for Suicide Gene

Suicidality likely gets transmitted independent of the transmission of depression.

Efforts to find this gene reviewed here.

Tuesday, December 25, 2007

FDA Warning Decreases the Diagnosis and Treatment of Pediatric Depression

The sole effective prevention of suicide is adequate, long term treatment. As a result of the irresponsible FDA warnings, diagnosis of depression in kids decreased by a third. The use of anti-depressants dropped by over 50%.

The Black Box Warning the FDA Failed to Put on all Anti-depressants

There is a valid black box warning to put on all anti-depressants. Naturally, the craven academics have failed to put it on. It supercedes their idiotic, PC, and cowardly warning about suicidality.

All anti-depressants, including the most sedative, amitriptylline, cause about 5% of patients to get agitated. This applies to dosage increases as well, even no agitation took place on lower doses.

This is a form of akathesia, from the inhibition of dopamine by increased serotonin tone in the first 24 hours.

All patients require this warning. It worsens over time, in the vast majority of people. If agitated the first or second day, stop the anti-depressant. Return to get another anti-depressant.

If someone is very depressed and suicidal, add very uncomfortable restlessness and agitation, some may injure themselves to seek relief.

A tiny number of patients, such as 1 in a 1000, reported an onset of suicidal ideas after a specific anti-depressants, long before this irresponsible warning. All in my practice, stopped the anti-depressant on their own, returned for an alternative.

Put a Black Box Warning on Families of Suicidal Youths

According to this study, youths have a greater and earlier chance to have a suicide event if members of the family were suicide attempters, had a greater parental incidence of being sex abuse victims. Earlier onset of suicidal behavior stemmed from having impulsive aggression and a baseline mood disorder.

Monday, December 24, 2007

Ideal Performance Wrongly Called Minimal

Reviewer criticizes long list of do's and dont's for suicide assessment and management as not minimal standard, but ideal standard, impossible to meet.

I would have added, garbage science, as worthless in the prevention of suicide.

Sunday, December 23, 2007

Suicide Attempts Timing and Anti-depressants

The highest rates were among psychiatry patients, lower in psychotherapy, lowest in primary care. Among all these three groups, attempts were highest prior to anti-depressant prescription, lower in the month after treatment, and declined thereafter. Reported here.

This finding supports the sole method to lower the suicide rate, long term treatment.

Again, I call for the entire FDA Psychopharmacology Committee and the FDA Commissioner to resign for their irresponsible black box warnings and caving in to political pressure. These PC, craven, academic traitors to clinical care caused an increased rate of suicide in pediatric patients, especially boys under 15. These incompetents no longer belong in any responsible position.

An interested reader submits this great YouTube video. It depicts the overheated bullying of the FDA Committee by scapegoating parents, left wing ideologues, and biased partisan hacks. It lacks any rebuttal of the effects of the Committee's craven, bonehead decision. No one mentions the hundreds of deaths the decision caused, by deterring the use of anti-depressants in adolescents.

Alleged Abuser of Suicider Sues Hospital for her Suicide

The judge in the case should be immediately impeached.

Celebrity Suicide increases Depressed Patient Attempts

Media coverage perhaps reminds depressed people of suicide as a coping skill.

Traumatic Brain Injury Associated with More Suicide Attempts

Especially if emotional distress is found.

Another Long Term Treatment Program Reduces Suicide

In an area of Hungary, training of family practitioners to use more anti-depressants reduced the suicide rate of women by 34%, compared with increases of 90% in comparison areas. Alcoholism was a factor in 75% of male suicides and 21% of female suicides. The program succeeded despite its not addressing nor affecting the rate of alcoholism.

John Edwards Won a Judgment for Suicide Malpractice

See Estate of Fuller v Mazzaglia for $2.3 million. A prominent suicide expert testified for the defense. If anyone knows who testified for the plaintiff or has deposition or trial transcripts, I would appreciate hearing about them.

Beyond Daubert or Frye to Reality

Daubert web site.

Let's stick to a standard of care testimony. The expert may properly cite studies. These are authored by academics, most often. Clinicians spread advances by word of mouth, and they get accepted or rejected within weeks. Strong remedies will become self-evident at the gut level. Weak or ineffective remedies will fail to impress and get dropped.

If the expert proposes some standard of care, e.g. heart decelerations this many times require C-Sections, should we settle for academic studies? Shouldn't we demand the expert provide his own records on the management of similarly situated patients? If the expert can only provide 3 such records, does he qualify as an expert? Can one be expert after 3 repetitions of decision making? If he can provide a dozen such records, are they the totality of the records of similar patients, and not cherry picked records agreeing with testimony? One should demand all the records of the expert, and sample them. If a record is found that contradicts the testimony, a mistrial should be called, and the legal costs of both sides should be obtained from the lying expert's personal assets.

And, yes, experts should feel intimidated. With the absurd arrogance to dictate practices to the doctors of the entire state at the point of a gun, they should take the consequences of their lying prostitution to the land pirate.

Saturday, December 15, 2007

Low Risk of Medmal in Psychiatry

Reviewed here.

This program has Lilly as a sponsor. They make Zyprexa. Perhaps, sales have dropped from fear of litigation. Lilly would be interested in getting this message out.

I have been sued several times. In every case, I had given superior care, and achieved the aim of treatment.

I made mistakes that injured patients. I would have settled in those cases had I been sued. Never sued for any real mistakes.

This lawyer is not making the obvious point. The vast majority of cases are weak or frivolous. She would go out of the legal defense business if someone were to deter the land pirates, or made them do their job properly.

Jail and Prison Suicide Rates Decline

The graph is here.

Friday, December 14, 2007

Alcoholism in Bipolar Disorder with Suicidality

Elevated risk of substance abuse and suicidality in bipolar disorder with alcohol abuse reviewed here.

Tuesday, December 11, 2007

Clueless FDA at it Again

This time they are going after a smoking cessation medication for causing a small number of users to experience agitation and passing suicidal ideas. By deterring family doctors again from its use, they will kill 10's of 1000's of patients by the consequences of smoking.

Prison Suicide Reviewed in a Series in this Left Wing, Biased Newspaper

The left wing view sympathizes with the criminal.

Wednesday, December 5, 2007

Mass Murder by Suicider, Robert Hawkins, On the Loose Thanks to the Criminal Lover Lawyer

Here, here, here , here. Some history here. This mass murdering suicider broke up with girlfriend, and lost a job, recently. Thank a lawyer for having this unstable, repeat offender, criminal, mass murderer on the loose. These needless, tragic deaths are the fruit of Supreme Court takeover of psychiatric decisions for the sole aim of lawyer job generation and rent seeking. The lawyer has no competence to make psychiatric treatment decisions. The Supreme Court requires a trial to get someone in treatment involuntarily. The patient must commit a dangerous act to qualify. Now, Hawkins qualifies for involuntary treatment. More here. The video pic and note. He is certainly correct about himself. The criminal has the total protection of the criminal lover lawyer. One day, the criminal lover lawyer will be neutralized and removed from the control of the three branches of government. Those with antisocial personality should then be affirmatively strongly encouraged to commit suicide to prevent the massive costs they generate by their devastating aggressiveness.

A pro-criminal judge set this drug user, mass murdering suicider loose to kill. This judge should immediately resign, or be impeached. It is not expected that a judge will predict the future behavior of a disturbed person. It is that the judge has no competence to make psychiatric decisions about the management of present mental disorder. What is the name of the judge who set this mass murderer suicider loose on the public?

Naturally, this judge who caused this mass murder, has criminal lover, self-dealt, legal immunity. I bet 10 cents, the mall and store will get sued for premises security liability. The innocent victim of this mass murder has to pay ruinous settlements, the guilty party, the criminal lover lawyer gets off free.

I strongly urge cross claims by any defendant against each of the parties that set this violent criminal drug user loose to do what he did. I strongly urge a claim against the most responsible party, that criminal lover judge. His immunity is unconscionable, and violates the defendant's procedural due process rights. On policy grounds, piercing this horrible immunity would deter other criminal lover lawyers from endangering the public by setting loose their good pals, the violent criminals.

Monday, December 3, 2007

No Criminal Charges for Suicide After Cyberbullying

Reported here. Social consequences of cyber bullying reviewed here.

The defense should demand all electronic communications to review them for cyber-bullying. The defendant should file a cross claim against any cyber-bully and any enabler. The insurance company lawyer may refuse to attack back. The private lawyer might have to defend the rights of the defendant when the insurance defense lawyer refuses.

Sunday, December 2, 2007

Long Term Use of Anti-Depressant Reduces the Suicide Rate by Two Thirds

As we have been arguing, only long term treatment reduces the risk of suicide. Arch Suic Res 11:163-175, 2007.

This doctor argues the risk of untreated depression for suicide dwarfs any risk for suicidal ideas from anti-depressants. NEJM

The irresponsible, dangerous members of the FDA Psychopharmacology Committee must resign immediately. The FDA Commissioner should be fired for failing to supervise these dangerous peddlers of garbage science, and enemies to clinical care.