The FDA has approved armodafinil, a non-amphetamine wake-promoting agent, to treat excessive sleepiness associated with:
• narcolepsy
• shift work sleep disorder
• or obstructive sleep apnea/hypopnea syndrome (as an adjunct to treatment for the underlying obstruction).
Armodafinil, a longer-acting formulation of the sleep-regulating stimulant modafinil, has shown efficacy against excessive sleepiness in randomized clinical trials. A spokeswoman for armodafinil's manufacturer, Cephalon, says the agent should reach the market in 2010 after Cephalon gathers more clinical data.
Cephalon will also evaluate armodafinil’s efficacy in bipolar depression, cognition associated with schizophrenia, excessive sleepiness in medical conditions such as Parkinson's disease, and fatigue resulting from cancer treatment, the spokeswoman said.
Cephalon manufactures armodafinil and modafinil under the brand names Nuvigil and Provigil, respectively.
Read more about armodafinil in a future issue of CURRENT PSYCHIATRY.
Law firm advertisements that invite product liability litigation involving antipsychotics might be scaring patients with schizophrenia or bipolar disorder into stopping the medications and increasing their risk of relapse, new findings suggest.
Among the 402 psychiatrists who responded:
• 97% reported that one or more patients stopped taking antipsychotics or reduced their dosage—mostly without consulting the psychiatrist. Of that number, 52% believe their patients were influenced by law firm advertisements.
• 94% said their patients relapsed after stopping or cutting antipsychotics. Most common consequences of relapse were symptom recurrence (cited by 93% of psychiatrists who reported relapse), hospitalization (75%), loss of an important relationship (40%), and attempted suicide (26%).
The National Council for Community Behavioral Healthcare and Eli Lilly and Company commissioned the survey.
Men who serve or have served in the U.S. armed forces are twice as likely to commit suicide as non-veterans in the general population, new findings suggest.
Researchers led by Mark Kaplan, PhD (Portland [OR] State University) reviewed death certificate and U.S. National Health Interview Survey database information on 320,890 adult men. Among the findings:
• Veterans represented 15.7% of the national survey sample but accounted for 31.1% of the suicides.
• Just over half of veterans who committed suicide had limitations associated with mental or physical illness compared with 23% of non-veterans (P<0.05).
The authors acknowledged several study limitations, including reliance on death certificates to obtain suicide data and lack of specific information on psychiatric comorbidities. The findings were published in the July Journal of Epidemiology and Community Health.
The FDA is conducting a 6-month “priority review” on whether to approve the second-generation antipsychotic aripiprazole to treat schizophrenia in youths ages 13 to 17.
Aripiprazole’s manufacturers are seeking the indication based on data from a 6-week, double-blind, randomized study. Adolescents ages 13 to 17 with schizophrenia who received aripiprazole, 10 or 30 mg/d, showed significant improvement compared with placebo, as measured by Positive and Negative Syndrome Scale total scores.1
Aripiprazole, marketed as Abilify, is indicated for schizophrenia and type I bipolar disorder in adults.
Reference 1. Robb AS, Findling RL, Nyilas M, et al. Efficacy of aripiprazole in the treatment of adolescents with schizophrenia. Poster presented at: Annual Meeting of the American Psychiatric Association; May 19-24, 2007; San Diego.
Many clinicians are hesitant to diagnose depression, findings from a newly published Epocrates survey suggest.
Of the 300 physicians, 100 nurse practitioners and 100 physician assistants who answered the survey, more than half said they are reluctant to diagnose depression. Among the reasons cited:
• resistance from patients (cited by 63% of respondents)
• uncertainty of diagnosis (51%)
• clinicians place higher priority on physical symptoms (51%)
• concerns about subjecting patients to social stigma (51%)
• inability to follow up on treatment (31%)
• clinicians do not view depression as a disease/disorder (17%)
• time-consuming diagnosis (10%)
• symptoms vary by gender and ethnicity.
Also, 48% of respondents said they have not discussed depression treatment options in 40% or more of patients who show depression symptoms. When clinicians do address a patient’s depressive symptoms, 96% recommend pharmacotherapy and roughly 60% suggest psychotherapy or health-related lifestyle change.
Information on the respondents’ practice specialties was not available.
