ANTIDEPRESSANTS??? MICHIGAN STATE UNIV PROFESSOR STRIPS NUDE IN CLASS AFTER BEGINNING TO RANT

o-MICHIGAN-STATE-PROF-NAKED-570[1]

Arrest of Math Professor at MSU

THIS CASE WILL LIKELY HELP US TO UNDERSTAND WHY WE SHOULD NEVER UNDER-ESTIMATE THE VAST POSSIBILITIES OF ANTIDEPRESSANT INDUCED MANIA!!! 

A Michigan State Math professor began cursing & ranting about computers (that is certainly understandable!) & ranting about how everything is just an act. He then began pacing up & down the hallway & screaming “There is no F-ing God!” Next he rapidly evacuated the entire classroom by coming back into the room & stipping nude, except for his socks, all the while continuing to swear a blue streak. (The cursing like a sailor is a common report we have had with antidepressant use from the beginning. Little old ladies report they began swearing which was shocking to them.)

“He made the weirdest analogies, the most notable being about beating his wife,” the student added.
Before stripping, the professor was “ranting about computers, Steve Jobs (pronounced Jobes), and how everything is just an act,” another student wrote.
The man is not being charged with a crime, but was taken to a local hospital, MSU said. Meanwhile, the school’s counseling center “has reached out to students who may have witnessed the incident to offer any support they need.”

Read more: http://www.nydailynews.com/news/national/professor-naked-class-article-1.1172584#ixzz28AnDiTaI

About the Author:  Ann Blake-Tracy is the author of PROZAC: PANACEA OR PANDORA?, and the director of the International Coalition For Drug Awareness [www.drugawareness.org]. She has testified before the FDA and testifies as an expert in legal cases involving serotonergic medications.

Ann Blake Tracy, Executive Director,

International Coalition for Drug Awareness
www.drugawareness.org & www.SSRIstories.com
Author: “Prozac: Panacea or Pandora? – Our Serotonin Nightmare – The Complete Truth of the Full Impact of Antidepressants Upon Us & Our World” & Safe Withdrawal CD “Help! I Can’t Get Off My Antidepressant!”

BOOK: Prozac: Panacea or Pandora? – Our Serotonin Nightmare! Anything you ever wanted to know about antidepressants is there along with everything drug companies hope you never find out about these drugs. SAFE WITHDRAWAL CD “Help! I Can’t Get Off My Antidepressant!” on how to safely withdraw from antidepressants & most psychiatric medications is saving lives! Available at www.drugawareness.org

BOOK TESTIMONIALS:

“VERY BOLD AND INFORMATIVE”

“PRICELESS INFORMATION THAT IS GIVING ME BACK TO ME”

“THE ABSOLUTE BEST REFERENCE FOR ANTIDEPRESSANT DRUGS”

“WELL DOCUMENTED & SCIENTIFICALLY RESEARCHED”

“I was stunned at the amount of research Ann Blake-Tracy has done on this subject. Few researchers go to as much trouble aggressively gathering information on the adverse reactions of Prozac, Zoloft and other SSRIs.”

WITHDRAWAL HELP CD TESTIMONIALS:

“Ann, I just wanted to let you know from the bottom of my heart how grateful I am God placed you in my life. I am now down to less than 2 mg on my Cymbalta and I have never felt better. I am finally getting my life back. I can feel again and colors have never been brighter. Thanks for all that you do!!” … Amber Weber

“Used your method of weaning off of SSRI’s and applied it to Ambien. Took 6 months but had been on 15 mg for years so what was another 6 months. I have been sleeping without it for 2 weeks and it is the first time I have been able to sleep drug free for 15 years. What a relief to be able to lay down and sleep when I need or want to. Ambien may be necessary for people at times but doctors giving a months worth of it at a time with unlimited refills is a prescription for disaster. It is so damn easy to become dependent on. Thanks for your council Ann.”… Mark Hill

“I’m so thankful for Ann Blake-Tracy and all her work. Also for taking the time out to talk to me and educate everyone! She has been a blessing to me during this awful time of antidepressant hell!” … Antoinette Beck

 

445 total views, no views today

ANTIDEPRESSANT??? Spanaway, WA Husband Confesses to Killing Wife & Daughter, Before Attempting to Kill Self

gLi3R.St

Dean Holmes in Spanaway, WA turned himself in this past Wednesday admitting that Tuesday night he had shot his wife multiple times while she slept. He then woke up his 11 year old daughter & her friend who was sleeping over. After dropping off the friend at her home, he then drove back toward his home while his daughter fell asleep in the back seat of the car. At that point he stopped the car, got out & through the back window shot his daughter multiple times. He then drove through a McDonalds for breakfast with his daughter’s body still in the back seat. After returning home he placed his daughter’s body next to her mother in bed & attempted to shoot himself. When he could not pull the trigger he drove to the police department & turned himself in.

Here is the comment I posted on this article in response to a friend of the family who had stated she could not understand because Dean appeared to love his wife & daughter so much.:

“Washington state is loaded to the gills with antidepressants! Do you know what these drugs do? They cause you to act out your worst nightmare & that is called a REM Sleep Behavior Disorder (RBD). Of those being diagnosed with RBD 86% are taking an antidepressant. And of those suffering RBD 80% hurt themselves or someone else. If Dean seemed to really love his wife & daughter this would have been his worst nightmare. Someone had better start asking about meds! (By the way I was the expert in comedian Phil Hartman’s murder/suicide & their wrongful death suit has been settled by the makers of Zoloft.)”

Read the article here: http://www.thenewstribune.com/2012/08/30/2274355/spanaway-man-charged-with-first.html#storylink=misearch#storylink=cpy

Ann Blake-Tracy, Executive Director,

International Coalition for Drug Awareness
www.drugawareness.org & www.SSRIstories.com
Author: “Prozac: Panacea or Pandora? – Our Serotonin Nightmare – The Complete Truth of the Full Impact of Antidepressants Upon Us & Our World” & Safe Withdrawal CD “Help! I Can’t Get Off My Antidepressant!”

 

BOOK:  Prozac: Panacea or Pandora? – Our Serotonin Nightmare! Anything you ever wanted to know about antidepressants is there along with everything drug companies hope you never find out about these drugs. Find the book & the CD “Help! I Can’t Get Off My Antidepressant!” on how to safely withdraw from antidepressants & most psychiatric medications. Available at www.drugawareness.org

BOOK TESTIMONIALS:

“VERY BOLD AND INFORMATIVE”

“PRICELESS INFORMATION THAT IS GIVING ME BACK TO ME”

“THE ABSOLUTE BEST REFERENCE FOR ANTIDEPRESSANT DRUGS”

“WELL DOCUMENTED & SCIENTIFICALLY RESEARCHED”

“I was stunned at the amount of research Ann Blake- Tracy has done on this subject. Few researchers go to as much trouble aggressively gathering information on the adverse reactions of Prozac, Zoloft and other SSRIs.”

WITHDRAWAL HELP CD TESTIMONIALS:

“Ann, I just wanted to let you know from the bottom of my heart how grateful I am God placed you in my life. I am now down to less than 2 mg on my Cymbalta and I have never felt better. I am finally getting my life back. I can feel again and colors have never been brighter. Thanks for all that you do!!” … Amber Weber

“Used your method of weaning off of SSRI’s and applied it to Ambian. Took 6 months but had been on 15 mg for years so what was another 6 months. I have been sleeping without it for 2 weeks and it is the first time I have been able to sleep drug free for 15 years. What a relief to be able to lay down and sleep when I need or want to. Ambien may be necessary for people at times but doctors giving a months worth of it at a time with unlimited refills is a prescription for disaster. It is so damn easy to become dependent on. Thanks for your council Ann.”… Mark Hill

“I’m so thankful for Ann Blake-Tracy and all her work. Also for taking the time out to talk to me and educate everyone! She has been a blessing to me during this awful time of antidepressant hell!” … Antoinette Beck
Tags: 

349 total views, 1 views today

ANTIDEPRESSANT: SIX DEAD: DAMIAN RZESZOWSKI NOT GUILTY IN MASS MURDER CASE

N0439001344860140469A[1]

This beautiful little girl is Kinga Rzeszowski (5) who was stabbed to death along with her mother, younger brother, maternal grandfather, friend & her friend’s mother by her father who then stabbed himself 40 times even to the point of collapsing one of his lungs, then slashed his throat & wrists another 20 times! A jury in the UK has just found him not guilty of murder, but guilt of the lesser charge of manslaughter. A day or two before the murder he had overdosed on antidepressants. Few realize that as the serotonin rises you have an LSD or PCP reaction because the body reacts to LSD or PCP as a rush of serotonin. They mimic serotonin. There is little difference when antidepressants force the serotonin level too high! Would anyone have been surprised by his actions had he been taking PCP? Of course not! But they remain CLUELESS when it comes to this similar effect with antidepressants!!! So clueless that he continues taking a cocktail of drugs in prison – a common theme in these antidepressant-induced tragedies.

After two decades of testifying & consulting in these antidepressant-induced violent murders & suicides it amazes me how absolutely ignorant the entire world remains, including the court system, to the connection & true cause of such incomprehensible violence!!! I have worked Columbine & MANY other US school shootings, comedian Phil Hartman & his wife’s murder/suicide & MANY more murder/suicides wiping out entire families, Andrea Yates’ case & MANY other mothers who have killed their children over the past 20+ years. Yet the courts & everyone else seem to continue to remain ignorant of the fact that antidepressants cause you to act out your worst nightmare in a sleep state called a REM Sleep Behavior Disorder (RBD). Of those being diagnosed with RBD 80% hurt themselves or someone else & 86% of those diagnosed with RBD were found to be taking an antidepressant. It antidepressant is the single most common denominator in these cases, yet it seems the whole world is failing the simple math in this case!

How do the pharmaceutical companies keep these cases suppressed the way they do?! They have LONG known their drugs cause these tragedies. The large numbers of secret settlements remain hidden from the public so you are not aware how often they happen. Goggle ssristories to see a database of just a few all too similar cases. (Especailly note the Donald Schell case in Wyoming) So WHO is guilty of premeditation in this case? Do you really think Damian Rzeszowski was warned that taking an antidepressant could possibly cause this? NO! And few other patients have ever been warned either!

You can continue to cry for vengeance upon this man or any of the others instead of looking at the true guilty parties in this horrific tragedy, but mark my words … in doing so the cost may be your life or the life of a loved one someday soon.! This is a serious public safety issue! When is someone near you on an antidepressant going to slip into a toxic nightmare (literal nightmare of RBD) & include you in that nightmare?

Look how many times this man stabbed himself! even to the point of collapsing his lung! That cannot happen without this frenzied drug state! He had just overdosed on these drugs. Tragically, few are aware that the brain goes dead before the body in an overdose with antidepressants. Why was he released from the hospital before the full toxic effect of the rising serotonin hit him to cause this psychotic reaction?

WARNING: If you are taking an antidepressant you must know that it is more likely that this violent sleep disorder, RBD, is more common in withdrawal .So, weaning off an antidepressant MUST be VERY, VERY gradual (months or years, rather than days or weeks) so as to avoid this serious toxic reaction.

http://www.ssristories.drugawareness.org/show.php?item=5087

http://www.independent.ie/world-news/europe/video-husband-guilty-of-killing-six-in-barbecue-rampage-3209635.html

http://ssristories.drugawareness.org/archive/show.php?item=240

Ann Blake-Tracy, Executive Director,
International Coalition for Drug Awareness

www.drugawareness.org & www.ssristories.drugawareness.org
Author: *”Prozac: Panacea or Pandora? – Our Serotonin Nightmare –
The Complete Truth of the Full Impact of Antidepressants Upon Us &
Our World”* & Withdrawal CD *”Help! I Can’t Get Off My Antidepressant!”

598 total views, 2 views today

PROZAC: 15 Yr Old Girl Kills 9 Yr Old Neighbor “To See What It Felt Like”

NOTE FROM Ann Blake-Tracy:

This case helps you see clearly first hand what
the term “homicidal ideation” really means! This is a side effect of
antidepressants that goes hand in hand with “suicidal ideation”. It is a
fixation on murder – an obsessive compulsive type of adverse reaction to the
medication.
____________________________
Paragraph four reads:  “Bustamante dug two shallow
graves before killing Olten. Bustamante had a record of trying to commit suicide
and
was on the antidepressant known
as
prozac.

http://www.postchronicle.com/news/original/article_212268807.shtml

15-Year-Old Girl Indicted For Murder (Photo) Meet Alyssa
Bustamante
by Mitch
Marconi

A 15-year-old girl named Alyssa Bustamante
has been arrested and is going to court over killing a 9-year-old named
Elizabeth Olten ‘to see how it feltto kill someone.

Bustamante is to be
tried as an adult according to reports after lawmakers found out the viciousness
of her attack.

Bustamante stabbed, strangled, and cut the throat of the

9-year-old girl named Elizabeth Olten. When police asked why she killed the girl
she said she “wanted to know what it felt liketo kill someone.
Here is a
photo of young Elizabeth, who life was ended on a whim.

Bustamante dug
two shallow graves before killing Olten. Bustamante had a record of trying to

commit suicide and was on the antidepressant known as prozac.

There is
now a fight on whether or not to be her in an adult jail or possibly even a
mental institution.

Her lawyer is desperately fighting to keep her out of
jail. It‘s hard to believe that is the face of a killer. (c) tPC

544 total views, 1 views today

ANTIDEPRESSANTS & PAINKILLERS: Soldier Dies in his Sleep: Virginia

NOTE FROM Ann Blake-Tracy:

The first four paragraphs of this article reads like a classic
recipe for antidepressant adverse reactions, listing all of the most common and
then the reference to them being the signs of PTSD even though he was never in
combat. What is interesting is that the family understood enough to relate
it all to the drugs. And then to know that the drugs did kill him.
What they did not understand though is how much of a part of
the sexual assault the drugs might have played.
First of all false accusations of sexual assault is so
commonly reported by someone on antidepressants that for two decades I have
generally asked who the patient believes has sexually assaulted them if they
have been on these drugs more than a couple of years. The extremely vivid
drug-induced nightmares are often sexual in nature leading patients to believe
these attacks were real because they were so vivid and because the
patient can no longer detect dreams from reality while on these
drugs.
But the second component is the widespread use of these drugs
in the military and their potential to produce sexual compulsions which would
produce more sexual attacks as well as the potential of antidepressants to
produce homosexual reactions in those previously heterosexual.
So if this young man really was attacked and it was not a
delusion, the attacker may have been on an antidepressant and experiencing
the adverse reaction of mania – in particular, nymphomania-a pathological
compulsion for sex:
_____________________________________
“For years after the parachute accident that ended his Army
service, Cody Openshaw spiraled downward.

He entered college but couldn’t
keep up with his studies. He had trouble holding a job. He drank too much. He
had trouble sleeping, and when he did sleep, he had nightmares. He got married
and divorced in less than a year. He had flashbacks. He isolated himself from
his friends and drank more.

His anxiety level was out of this world,” his father said. “This was a young man who got straight A’s in high school, and
now he couldn’t function.”

Openshaw had the classic symptoms of
post-traumatic stress disorder, even though he had never been in combat. His
parents attributed the trauma to the accident and the heavy medications he was
taking for the continuing pain.

Paragraphs 61 through 64 read:  “He was still heavily
medicated, however –
with narcotics for the lingering
pain from his parachute accident and antidepressants for his
post-traumatic stress disorder.”

His first night at home,
he went to bed and never woke up.”

“The
cause of death was respiratory arrest from prescription drug
toxicity.
He was 25.”

” ‘These medications that he was on, they
build up in your bloodstream to the point of toxicity,’  his father
said.  ‘And that’s what we’re assuming happened’.”

http://hamptonroads.com/2009/10/military-men-are-silent-victims-sexual-assault

Military men are silent victims of sexual assault

By Bill
Sizemore

The Virginian-Pilot
© October 4, 2009

For years after
the parachute accident that ended his Army service, Cody Openshaw spiraled
downward.

He entered college but couldn’t keep up with his studies. He
had trouble holding a job. He drank too much. He had trouble sleeping, and when
he did sleep, he had nightmares. He got married and divorced in less than a
year. He had flashbacks. He isolated himself from his friends and drank
more.

His anxiety level was out of this world,” his father said. “This
was a young man who got straight A’s in high school, and now he couldn’t
function.”

Openshaw had the classic symptoms of post-traumatic stress
disorder, even though he had never been in combat. His parents attributed the
trauma to the accident and the heavy medications he was taking for the
continuing pain.

But there was more.

Finally, he broke down and
told his father.

A few months after his accident, as he was awaiting his

medical discharge from the Army, he had been sexually assaulted.

The
attack left him physically injured and emotionally shattered. Inhibited by
shame, embarrassment, sexual confusion and fear, it took him five years to come
forward with the full story.

What truly sets this story apart, however,
is not the details of the case, horrific as they are, but the gender of the
victim.

There is a widespread presumption that most victims of sexual
assault in the military services are women. That presumption, however, is
false.

In a 2006 survey of active-duty troops, 6.8 percent of women and
1.8 percent of men said they had experienced unwanted sexual contact in the
previous 12 months. Since there are far more men than women in the services,
that translates into roughly 22,000 men and 14,000 women.

Among women,
the number of victims who report their assaults is small. Among men, it is
infinitesimal. Last year the services received 2,530 reports of sexual assault
involving female victims – and 220 involving male victims.

One of them
was Pfc. Cody Openshaw.

Now his family has made the difficult decision to
go public with his story in the hope that it will prompt the military services
to confront the reality of male sexual assault.

As Openshaw’s father put
it in an interview, “Now that they know, what are they going to do about it.”

Openshaw grew up in a large Mormon family in Utah, the fifth of
nine children. He was a mild-tempered child, an Eagle Scout who dreamed of
becoming a brain surgeon.

He was an athlete, a tireless hockey player and
a lover of the outdoors. He was prone to take off on a moment’s notice to go
hiking or camping – sometimes with a friend, often just him and his tent – among
Utah’s rugged canyons and brown scrub-covered mountains.

He had a
sensitive side, too: He was a published poet.

He looked big and menacing
but he was really a teddy bear, one of his brothers said.

When he walked
into a room, a sister said, everyone would light up.

He also had a
mischievous streak. Once after joining the Army in 2001, he went home on leave
unannounced for his mother’s birthday. He had himself wrapped up in a big
cardboard box and delivered to the front porch. When his mother opened the box,
he popped out.

Openshaw volunteered for the 82nd Airborne Division, based
at Fort Bragg, N.C., where he excelled as a paralegal and paratrooper. But his

military career came to an untimely end shortly after the Sept. 11, 2001,
terrorist attacks.

As his unit was training to invade Afghanistan, a
parachute malfunction sent Openshaw plummeting 60 feet to the ground, causing
severe stress fractures in his spine and both legs.

For months as he
awaited his medical discharge, he was plagued by chronic pain. The medications
prescribed by the Army doctors only helped so much, and alcohol became a kind of
self-medication.

After a night on the town with a fellow soldier, his

father learned later, Openshaw returned to the barracks and encountered a
solicitous platoon sergeant.

His legs were hurting, and the sergeant
said, “Let me rub your legs.” Then the contact became violently sexual. Openshaw
– drunk, disabled and outranked – was in no position to resist.

The next
day the sergeant told him, “Just remember, accidents happen. They can happen to
you and to your family. You know, people show up missing.”

The story came
out in tortured bits and pieces.

Openshaw confided in his older sister
the next day in an agonized phone call but swore her to secrecy. He took his

assailant’s warning as a death threat.

“He was worried about me and the
rest of the family,” his sister said. “He said ‘We need to keep it quiet.’

Because of the reported threat to Openshaw’s family, their names and
locations have been omitted from this story.

He finally told his
therapist at the Department of Veterans Affairs hospital in Salt Lake City, who
referred him to a VA sexual assault treatment center in Bay Pines, Fla. As part
of his therapy there, Openshaw shared more of the traumatic episode in a letter
to his father.

“He wanted to get better,” his brother said. ” He decided,
‘I’m going to beat this. I’m tired of five years of depression. I want to feel
alive again.’ ”

A longtime friend thinks guilt was a factor in Openshaw’s
reluctance to come forward with his story.

“I think he blamed himself
because he was drinking,” the friend said. “When the assault happened, he said
he remembered laying there and he was so drunk that he couldn’t do anything
about it.

“It really affected him. He struggled even with asking a girl
out on a date. He felt unworthy.”

Trauma from sexual assault has
become so commonplace in the military that it now has its own designation: MST,
for military sexual trauma.

The VA was first authorized to provide sexual
assault outreach and counseling to female veterans after a series of
congressional hearings in 1992. As the realization dawned that this was not just
a women’s issue, those services were extended to male veterans.

According
to a 2007 study by a team of VA researchers, a nationwide screening of veterans
seeking VA services turned up more than 60,000 with sexual trauma. More than
half of those – nearly 32,000 – were men.

Those numbers almost certainly
understate the problem, the researchers wrote, concluding that the population of
sexually traumatized men and women under the treatment of the VA is “alarmingly
large.”

Sexual trauma, the researchers found, poses a risk for developing
post-traumatic stress disorder “as high as or higher than combat
exposure.”

Among active-duty personnel, the Defense Department has
embarked on what it says is an unprecedented effort to wipe out sexual assault

in the ranks.

Key to that effort, the department says, is encouraging a
climate in which victims feel free to report the crime without fear of
retribution, stigma or harm to their careers.

In 2005, Congress
authorized the creation of the Defense Task Force on Sexual Assault in the
Military Services to examine how well the services are carrying out that
mission. Its final report is being prepared now.

The task force fanned
out across the world, hearing stories from dozens of service members who had
been victimized by sexual predators. In April, at a public meeting in Norfolk,
the group saw a slide presentation prepared by Cody Openshaw’s father.

As
the story unfolded, the hotel conference room fell silent. By the end, the
staffer who presented it – a crusty retired general – was close to
tears.

It was a rare event: Of 58 stories collected by the task force
over a year of meetings and interviews, only seven involved male
victims.

If the crime is seldom reported, it follows that it is seldom
prosecuted. According to Army court-martial records, 65 sexual assault cases
involving male victims have been prosecuted worldwide in the past five years.
There were almost 10 times that many cases, 621, involving female
victims.

The Air Force, Navy and Marines were unable to provide a
breakdown of sexual assault cases by gender.

Jim Hopper, a psychology
instructor at Harvard Medical School who has studied male sexual abuse, said
victims’ reluctance to come forward is rooted in biology and gender
socialization.

Males are biologically wired to be more emotionally
reactive and expressive than females, Hopper said, but they are socialized to
suppress their emotions.

“Boys are not supposed to be vulnerable, sad,
helpless, ashamed, afraid, submissive – anything like that is totally taboo for
boys,” he said. “The messages come from everywhere. Right from the start, a
fundamental aspect of their being is labeled as not OK.”

Military
training reinforces that socialization, Hopper said. “It conditions men to
accept physical wounds, death and killing while leaving them unprepared for
emotional wounds that assault their male identity.

“When they get
assaulted, they’re unprepared to deal with their vulnerable emotions. They
resist seeking help. They believe that their hard-earned soldier-based
masculinity has been shattered. They’re going to feel betrayed, alienated,
isolated, unworthy. They feel like they’re a fake, a fraud, not a real man,”
Hopper said.

Openshaw’s father, a marriage and family therapist, fears
that the plight of male victims will continue to get short shrift.

“The
military should take a more proactive role in understanding male sexual
assault,” he said. “They need to set up some way that these young men can get
some services without feeling so humiliated. They don ‘t have to be so macho.”

When Openshaw returned home from treatment in Florida in April
2008, his family and friends were buoyed by hope that he had turned a
corner.

The two months of treatment “did a world of good,” one friend
said.

“He texted me and said, ‘I’ve learned so many things. I’ve learned
that bad things can happen to good people, and it’s not their fault.’

“He was so excited to come home,” a sister said. “He was planning a big
party. He wanted everybody to see he was better.”

He was still heavily
medicated, however – with narcotics for the lingering pain from his parachute
accident and antidepressants for his post-traumatic stress disorder.

His

first night at home, he went to bed and never woke up.

The cause of death
was respiratory arrest from prescription drug toxicity. He was 25.

“These
medications that he was on, they build up in your bloodstream to the point of
toxicity,” his father said. “And that’s what we’re assuming happened.”

He
does not think his son committed suicide.

“I have nine children,
including Cody, and 15 grandchildren,” he said. “Cody had made arrangements for
them all to come over the next day. There was absolutely nothing in his affect
or demeanor that would suggest that he would kill himself.”

He is buried
beside a pine tree on a flat, grassy hilltop in the shadow of his beloved
mountains. His gravestone is adorned by U.S. flags, flowers and cartoon bird
figures recalling his whimsical streak.

A year later, his death remains
an open wound for the family. One younger brother is “very angry with God,” his

father said. He refuses to visit the grave.

Openshaw’s young nieces and
nephews still talk about him and ask when he’s coming over to play.

“Kids
loved him to pieces,” his mother said. “He affected everybody he
met.”

She, like her husband, hopes her son’s story will prompt the
military services to take male sexual assault more seriously: “Something needs
to be done so other service members and their families don’t have to go through
this.”

The Army Criminal Investigation Command investigated the case, but
with the victim dead and no eyewitnesses, the initial conclusion was that there
was insufficient evidence to prosecute.

The suspect has been questioned
but remains on active duty. He has been recently deployed in Iraq.

If the
case is not prosecuted, the suspect may be subject to administrative
sanctions.

Louis Iasiello, a retired rear admiral and chief of Navy
chaplains who co-chairs the sexual assault task force, said that when commanding
officers take the crime seriously, victims – whether male or female – are more
likely to come forward.

“The command really does set the tone,” he said.
In places where the command set a positive tone and also set a zero tolerance
toward this crime, it was very obvious that people felt more comfortable coming
forward and reporting an incident and getting the help they needed to begin the
healing process.”

In the Openshaw case, that clearly didn’t happen, said
Thomas Cuthbert, the task force staffer who presented the story in

Norfolk.

At the time of his attack, Openshaw was in a holding unit at
Fort Bragg for soldiers awaiting medical discharge.

“Instead of
protecting him while he was being treated, he was left alone and subject to a
predator,” said Cuthbert, a retired brigadier general.

“The kid was not
in a position where he was fully capable of defending himself, and he got hurt
by some hoodlum wearing a uniform. Any Army officer worth his salt, looking at
those facts, would get angry.

“He needed help, and instead he received
abuse of the worst kind. Leadership can’t prevent all crime. But when someone in

authority takes advantage of a subordinate, leadership should be held
accountable.”

If the services are serious about coming to grips with male
sexual assault, Cuthbert said, there is still much work to be done.

If it
can happen to a talented, promising soldier in the 82nd Airborne, he said,
plenty of others who aren’t as independent or as capable of taking care of
themselves also are at risk.

“Nobody in uniform is very happy talking
about this issue. They don’t want to publicly admit it’s there, although we all
know it’s there.”

Bill Sizemore, (757) 446-2276,
bill.sizemore@pilotonline.com

546 total views, 1 views today

ANTIDEPRESSANTS & THEIR CONNECTION TO FALSE MEMORIES OF SEXUAL ABUSE

NOTE BY Ann Blake-Tracy (www.drugawareness.org): Mackenzie Phillips has accused her deceased famous father Papa John of the Mamas and the Papas of sexually abusing her when they were high on drugs. Now if they were both high on drugs it could be possible, but I don’t buy it because it is SO EXTREMELY COMMON for those on antidepressants to make false accusations of sexual abuse!

Her step mother said she does not believe these accusations of abuse. She was obviously far closer to the situation that any of us and perhaps when she mentions Mackenzie’s “mental illness” we should pay attention to the MIND ALTERING DRUGS they are giving her.

Antidepressants produce horrifying nightmares, often sexual in nature, that are so vivid patients often begin to believe they are “remembering” something that happened to them when it is nothing more than the elevated serotonin levels producing the nightmares.

Of course their doctors as usual did not warn them to watch for that adverse reaction and yet another family is destroyed or another father’s or mother’s memory destroyed. Wake up to the real nightmare of these drugs and their impact upon our world! www.drugawareness.org

A man that I admired my entire life for his great contributions to the world in many areas and had great respect for was accused the same way by his own daughter who ALSO went on The Oprah show to discuss her new book on what her father supposedly did to her.

It did not matter at all that the entire family told everyone this woman was nuts and had no grasp on reality. Why should that stop Oprah?

So the woman was allowed to shatter this incredible man’s last few months of life by going public with her antidepressant-induced accusations. She even kidnapped her ailing father to force him to publicly confess what he had done to her. (Her father was so busy doing so much for the world that he would not have had a minute to do what she had accused him of anyway!!)

How absolutely ironically tragic is that years before I had given this man the very first copy of my book when it came out which has an entire chapter explaining this adverse reaction of False Memory Syndrome – a term never heard before the introduction of Prozac on the market.

Ann Blake Tracy, Executive Director,
International Coalition for Drug Awareness
www.drugawareness.org & www.ssristories.NET
Author: ”Prozac: Panacea or Pandora? – Our Serotonin Nightmare – The Complete Truth of the Full Impact of Antidepressants Upon Us & Our World” & Withdrawal CD “Help! I Can’t Get Off My Antidepressant!”

WITHDRAWAL HELP: You can find the hour and a half long CD on safe and effective withdrawal helps here: http://store.drugawareness.org/ And if you need additional consultations with Ann Blake-Tracy, you can book one at www.drugawareness.org or sign up for one of the memberships for the International Coalition for Drug Awareness which includes free consultations as one of the benefits of that particular membership plan.

WITHDRAWAL WARNING: In sharing this information about adverse reactions to antidepressants I always recommend that you also give reference to my CD on safe withdrawal, Help! I Can’t Get Off My Antidepressant!, so that we do not have more people dropping off these drugs too quickly – a move which I have warned from the beginning can be even more dangerous than staying on the drugs!

ORIGINAL ARTICLE: http://www.spinner.com/2009/09/24/radio-stations-wrestle-with-playing-john-phillips
Radio Stations Wrestle With Playing John Phillips

Posted on Sep 24th 2009 5:15PM by James Sullivan
Comments (164)
Print | Email More
Oldies radio stations around the country are debating whether to continue playing the music of one of the quintessential ’60s groups, the Mamas and the Papas, in the wake of Mackenzie Phillips’ allegations that she had an incestuous relationship with her father, group founder John Phillips.

“I just had a long discussion with our morning show team,” said Jay Beau Jones, program director of Boston’s WODS, “Oldies 103.3,” a long-running CBS Radio affiliate. On Friday morning, disc jockeys Chris Zito and Karen Blake will invite their audience to call in and talk about Phillips and his musical legacy. “Obviously, this is a horrific, car-crash type of story,” says Jones. “If the station plays ‘California Dreamin” or ‘Monday, Monday,’ my concern is the audience will have a negative reaction and turn off the radio.”

In contrast, Dan Allen, creator of Clear Channel’s “Real Oldies” format, says he doesn’t anticipate any lasting boycott of the band’s music. “If we stop playing them, who are we going to hurt?” he says. “I don’t think we can punish John Phillips,” who died in 2001.

If true, Allen adds, Mackenzie Phillips’ claims are “abhorrent. I have two daughters myself. But I don’t think it’s going to cause a backlash.”

After giving PEOPLE magazine excerpts from her new memoir, ‘High on Arrival,’ Mackenzie Phillips appeared on ‘Oprah’ and ‘Today’ this week, repeating her claim that her father raped her while both were under the influence of drugs, and that the two had intermittent sexual relations during the next 10 years.

“My father abused me, but he wasn’t a monster,” she writes. “He was a tortured man who led a tortured existence.”

John Phillips, the son of a hard-drinking ex-Marine, grew up in Alexandria, Va., breaking into music on the folk scene of New York’s Greenwich Village in the early 1960s. With two fellow folk veterans, Canadian Denny Doherty and Baltimore product “Mama” Cass Elliot, and a young Californian named Michelle Gilliam — who would become his second wife — he started the Mamas and the Papas. The folk-rock quartet’s combination of exuberant group vocals, saloon-style piano and lush arrangements by some of the West Coast’s best session musicians, led by drummer Hal Blaine, made the group a key part of California’s emergence at the center of the pop world.

Phillips was instrumental, along with producer Lou Adler, in the creation of the Monterey Pop Festival in 1967, which introduced the Who, Jimi Hendrix and Janis Joplin to the American mainstream. He wrote and produced the Summer of Love anthem ‘San Francisco (Be Sure to Wear Flowers in Your Hair),’ recorded by his colleague Scott McKenzie (the inspiration for Mackenzie Phillips’ name), with whom he would co-write another huge hit, the Beach Boys’ ‘Kokomo,’ in 1988.

Scoring 10 Top 40 hits in two years, the Mamas and the Papas had a notoriously rocky relationship behind the scenes. Phillips wrote one of the group’s biggest hits, ‘I Saw Her Again,’ in response to Michelle’s affair with Doherty (which, curiously, Doherty sang lead on).

After decades of heavy drug use — Phillips once claimed he injected himself with cocaine and heroin every 15 minutes for two years — “Papa John,” as he titled his autobiography, had a liver transplant in 1992. He died at age 65 in March, 2001.

Sainthood is not exactly a prerequisite for election to the Rock and Roll Hall of Fame, as the Mamas and the Papas were inducted in 1998.

“We don’t have any problem playing music by other people who have done heinous things,” says Clear Channel’s Allen. “Rockers ‘n’ rollers aren’t always good boys.”

Even so, few rock ‘n’ roll images have been tarnished quite as badly as John Phillips’ this week.

Michelle Phillips, the bandleader’s second of four wives, said this week that she does not believe her stepdaughter’s allegations.

“Mackenzie has a lot of mental illness,” she told the Hollywood Reporter. “She did ‘Celebrity Rehab’ and now she writes a book. The whole thing is timed.” (However, Michelle’s daughter, Chynna Phillips, has stated she believes her half-sister Mackenzie’s allegations.)

Cammy Blackstone, a longtime on-air personality on San Francisco’s KFRC who now works at San Francisco City Hall, had a similar reaction. Having interviewed Mackenzie Phillips on the radio, she wonders why the former child star of the ’70s sitcom ‘One Day at a Time’ would feel compelled to divulge her story now.

When Blackstone was on the air, there were numerous episodes involving core Oldies artists — Phil Spector’s murder case, James Brown’s domestic problems, accusations of child molestation against Michael Jackson and Gary Glitter. “I don’t recall any listeners every calling and saying, ‘Why are you playing that child molester?” she says.

WODS’s Jones also wonders where program directors should draw the line when it comes to unsavory news about popular artists: “Do you stop playing songs by Phil Spector or Elvis? Maybe our listeners want to hear ‘California Dreamin” and remember the Mamas and the Papas as the hit machine they were. We said, ‘Let’s let the audience decide.'”

Radio corporations do tend to reassess their playlists when news stories break, says Blackstone. “After 9/11, we didn’t play ‘Great Balls of Fire’ or ‘You Dropped a Bomb on Me.’ You do have to be considerate about people’s emotions over what’s happening in the news.”

But in the case of the Mamas and the Papas, although John Phillips was the group’s acknowledged mastermind, most listeners aren’t likely to “make that connection,” says Blackstone. “It’s the song more than the group.”

Allen agrees. “The face of the Mamas and the Papas without a doubt was Mama Cass,” he says. “And she did nothing wrong.”

1,233 total views, 3 views today

NEJM: On Zoloft Homicidal Ideation Frequent In Those 17 & Under

Since I believe that people should always get credit for the hard work and contribution they make in life I want to give our thanks to Rosie Meysenburg for getting this out to us today and for her comments on it. Rosie has done so much, along with her husband Gene, in posting our years and years worth of work gathering these SSRI & SNRI cases together for the _www.ssristories.drugawareness.org_
(http://www.ssristories.drugawareness.org) site.

“This Adverse Event Report, from a study appearing in the New England Journal of Medicine, shows that of 133 children 17 & under on Zoloft there were 2 who reported “Homicidal Ideation”. There were no reports of “Homicidal Ideation” in the placebo group.

[According to the Physicians Desk Reference, a Frequent adverse reaction is one that occurs in 100 people or less.  Homicidal Ideation occurred in 1 in 66 children on Zoloft aged 17  and under.]

“According to the Physicians Desk Reference, a Frequent adverse reaction is one that occurs in 100 people or less. Homicidal Ideation occurred in 1 in 66 children on Zoloft aged 17 and under.

“This Adverse Event Report was the appendix for this study in the New England Journal of Medicine.”

adverse event report1.pdf

This Adverse Event Report was the appendix for this study in the New England Journal of Medicine:

http://content.nejm.org/cgi/content/full/NEJMoa0804633

And with this new information from the New England Journal of Medicine I want to include information out of Australia which is that Pfizer, the maker of Zoloft, along with the Therapeutic Goods Administration (TGA similar to our FDA), recommends that any SSRI antidepressant should not be prescribed to Australians under the age of 24. Funny, but I missed that warning from Pfizer for Americans under 24, didn’t you?

Next I will send that article that just came out over the weekend because it ties in so closely with this new information on Zoloft. And because there is so much to read in this article alone I am going to cut my comments at this point and let the article speak for itself.

Ann Blake-Tracy, Executive Director,
International Coalition for Drug Awareness
_www.drugawareness.org_ (http://www.drugawareness.org/) &
_www.ssristories.org_ (http://www.ssristories.org/)
Author of Prozac: Panacea or Pandora? – Our
Serotonin Nightmare & the audio, Help! I Can’t
Get Off My Antidepressant!!! ()

_atracyphd1@…_ (mailto:atracyphd1@…)

_http://content.nejm.org/cgi/content/full/NEJMoa0804633_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633)

Published at www.nejm.org October 30, 2008 (10.1056/NEJMoa0804633)
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood
Anxiety

John T. Walkup, M.D., Anne Marie Albano, Ph.D., John Piacentini, Ph.D.,
Boris Birmaher, M.D., Scott N. Compton, Ph.D., Joel T. Sherrill, Ph.D., Golda
S. Ginsburg, Ph.D., Moira A. Rynn, M.D., James McCracken, M.D., Bruce Waslick,
M.D., Satish Iyengar, Ph.D., John S. March, M.D., M.P.H., and Philip C. Kendall, Ph.D.

ABSTRACT
Background Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy.

Methods In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at
weeks 4, 8, and 12.

Results The percentages of children who were rated as very much or much improved on the Clinician Global Impression “Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo
(23.7%). Combination therapy was superior to both monotherapies (P<0.001).

Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal
ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline.

Conclusions
Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate.

(ClinicalTrials.gov number,
NCT00052078 _[ClinicalTrials.gov]_
(http://content.nejm.org/cgi/external_ref?access_num=NCT00052078&link_type=CLINT\
RIALGOV
) .)

____________________________________
Anxiety disorders are common in children and cause substantial impairment in
school, in family relationships, and in social functioning._1_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R1) ,_2_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R2) Such disorders
also predict adult anxiety disorders and major depression._3_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R3) ,_4_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R4) ,_5_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R5) ,_6_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R6) Despite a high
prevalence (10 to 20%_3_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R3)
,_7_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R7) ,_8_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R8) ) and substantial
morbidity, anxiety disorders in childhood remain underrecognized and
undertreated._1_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R1)
,_9_

(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R9)

An improvement in outcomes for children with anxiety disorders would have important public health
implications.In clinical trials, separation and generalized anxiety disorders and social
phobia are often grouped together because of the high degree of overlap in
symptoms and the distinction from other anxiety disorders (e.g., obsessive compulsive disorder). Efficacious treatments for these disorders include cognitive behavioral therapy_10_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R10) ,_11_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R11) and
the use of selective serotonin-reuptake inhibitors (SSRIs)._12_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R12) ,_13_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R13)

However, randomized, controlled trials comparing cognitive behavioral therapy, the use of an SSRI, or the combination of both therapies with a control are lacking. The evaluation of combination therapy is particularly important because approximately 40 to 50% of children with these disorders do not have a response to short-term treatment with either monotherapy.
_14_(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R14) ,_15_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R15)

Our study, called the Child “Adolescent Anxiety Multimodal Study, was designed to address the current gaps in the treatment literature by evaluating the relative efficacy of cognitive behavioral therapy, sertraline, a combination of the two therapies, and a placebo drug. This article reports the results of short-term treatment.

Methods

Study Design and Implementation

This study was designed as a two-phase, multicenter, randomized, controlled trial for children and adolescents between the ages of 7 and 17 years who had separation or generalized anxiety disorder or social phobia. Phase 1 was a 12-week trial of short-term treatment comparing cognitive behavioral therapy, sertraline, and their combination with a placebo drug. Phase 2 is a 6-month open extension for patients who had a response in phase 1.

The authors designed the study, wrote the manuscript, and vouch for the data gathering and analysis. Pfizer provided sertraline and matching placebo free of charge but was not involved in the design or implementation of the study, the analysis or interpretation of data, the preparation or review of the manuscript, or the decision to publish the results of the study.

Study Subjects

Children between the ages of 7 and 17 years with a primary diagnosis of separation or generalized anxiety disorder or social phobia (according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision
[DSM-IV-TR]_16_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R16) ),
substantial impairment, and an IQ of 80 or more were eligible to participate. Children with coexisting psychiatric diagnoses of lesser severity than the three target disorders were also allowed to participate;
such diagnoses included attention deficit–hyperactivity disorder (ADHD) whilereceiving stable doses of stimulant and obsessive compulsive, post-traumatic stress, oppositional defiant, and conduct disorders. Children were excluded if they had an unstable medical condition, were refusing to attend school
because of anxiety, or had not had a response to two adequate trials of SSRIs or an adequate trial of cognitive behavioral therapy.

Girls who were pregnant or were sexually active and were not using an effective method of birth control
were also excluded. Children who were receiving psychoactive medications other than stable doses of stimulants and who had psychiatric diagnoses that made participation in the study clinically inappropriate (i.e., current majordepressive or substance-use disorder; type ADHD; or a lifetime history of bipolar, psychotic, or pervasive developmental disorders) or who presented an acute risk to themselves or others were also excluded.

Recruitment occurred from December 2002 through May 2007 at Duke University Medical Center, New York State Psychiatric Institute Columbia University Medical Center New York University, Johns Hopkins Medical Institutions, Temple University University of Pennsylvania, University of California, Los Angeles,and
Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center. The protocol was approved and monitored by institutional review boards at each center and by the data and safety monitoring board of the National Institute of Mental Health. Subjects and at least one parent provided written informed consent.

Interventions

Cognitive behavioral therapy involved fourteen 60-minute sessions, which included review and ratings of the severity of subjects’ anxiety, response to treatment, and adverse events. Therapy was based on the Coping Cat program,_17_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R17) ,_18_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R18) which was adapted for the
subjects’ age and the duration of the study._19_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R19)

Each subject who was assigned to receive cognitive behavioral therapy received training in anxiety-management skills, followed by behavioral exposure to anxiety-provoking situations. Parents
attended weekly check-ins and two parent-only sessions. Experienced psychotherapists, certified in the Coping Cat protocol, received regular site-level and cross-site supervision.

Pharmacotherapy involved eight sessions of 30 to 60 minutes each that included review and ratings of the severity of subjects’ anxiety, their response to treatment, and adverse events. Sertraline (Zoloft) and matching placebo were administered on a fixed flexible schedule beginning with 25 mg per day and adjusted up to 200 mg per day by week 8. Through week 8, subjects who were considered to be mildly ill or worse and who had minimal side effects were eligible for dose increases.

Psychiatrists and nurse clinicians with experience in medicating children with anxiety disorders were certified in the study pharmacotherapy protocol and received regular site-level and cross-site supervision.
Pill counts and medication diaries were used to facilitate and document adherence. Combination therapy consisted of the administration of sertraline and cognitive behavioral therapy. Whenever possible, therapy and medication sessions occurred on the same day for the convenience of subjects.

Objectives
Study objectives were, first, to compare the relative efficacy of the three active treatments with placebo; second, to compare combination therapy with either sertraline or cognitive behavioral therapy alone; and third, to assess the safety and tolerability of sertraline, as compared with placebo. We hypothesized that all three active treatments would be superior to placebo and that combination therapy would be superior to either sertraline or cognitive behavioral therapy alone.

Outcome Assessments
We obtained demographic information, information on symptoms of anxiety, and data on coexisting disorders and psychosocial functioning using reports from both the subjects and their parents and from interviews of subjects and parents at the time of screening, at baseline, and at weeks 4, 8, and 12.

The interviews were administered by independent evaluators who were unaware of study-group assignments.
We used the Anxiety Disorders Interview Schedule for DSM-IV-TR, Child Version,_20_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R20) to establish diagnostic eligibility. The categorical primary outcome was the treatment response at week 12, which was defined as a score of 1 (very much improved) or 2 (much improved) on the Clinical Global Impression Improvement scale,_21_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R21) which ranges from 1 to 7, with lower scores indicating more improvement, as compared with baseline. A score of 1 or 2 reflects a substantial, clinically meaningful improvement in anxiety severity and normal functioning. The dimensional primary
outcome was anxiety severity as measured on the Pediatric Anxiety Rating Scale, computed by the summation of six items assessing anxiety severity, frequency, distress, avoidance, and interference during the previous week._22_(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R22)

Total scores on this scale range from 0 to 30, with scores above 13 indicating clinically meaningful anxiety. The Children’s Global Assessment Scale_23_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R23) was used to rate
overall impairment.

Scores on this scale range from 1 to 100; scores of 60 or lower are considered to indicate a need for treatment, and a score of 50 corresponds to moderate impairment that affects most life situations and is readily observable. Agreement among the raters was high for anxiety severity (r=0.85) and diagnostic
status (intraclass correlation coefficient= 0.82 to 0.88) on the basis of a videotaped review of 10% of assessments by independent evaluators that were performed at baseline and at week 12.

Adverse Events
Adverse events were defined as any unfavorable change in the subjects’ pretreatment condition, regardless of its relationship to a particular therapy. Serious adverse events were life-threatening events, hospitalization, or events leading to major incapacity. Harm-related adverse events were defined as thoughts of harm to self or others or related behaviors. All subjects were interviewed at the start of each visit by the study coordinator with the use of a standardized script. Identified adverse events and harm-related events were then evaluated and rated by each subject’s study clinician.

This report presents data on all serious adverse events, all harm-related adverse events, andmoderate and severe (i.e., functionally impairing) adverse events that occurred in 3% or more of subjects in any study group. The data and safety monitoring board of the National Institute of Mental Health performed a quarterly review
of reported adverse events. Given the greater number of study visits (and hence more reporting
opportunities) and the unblinded administration of sertraline in the combination-therapy group, the test of the adverse-event profile of sertraline focused on statistical comparisons between sertraline and placebo and sertraline and cognitive behavioral therapy.

Randomization and Masking
The randomization sequence in a 2:2:2:1 ratio was determined by a computer-generated algorithm and maintained by the central pharmacy, with stratification according to age, sex, and study center. Subjects were assigned to study groups after being deemed eligible and undergoing verbal reconsent with a study investigator. Subjects in the sertraline and placebo groups did not know whether they were receiving active therapy, nor did their clinicians. However, subjects who received combination therapy knew they were receiving active sertraline. The study protocol called for independent evaluators who completed assessments to be unaware of all treatment assignments.

Statistical Analysis
On the basis of previous studies,_10_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R10) ,_11_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R11) ,_12_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R12)
,_13_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R13) ,_14_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R14) ,_15_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R15)
we hypothesized that 80% of children in the combination-therapy group, 60% in either the sertraline group
or the cognitive-behavioral-therapy group, and 30% in the placebo group would be considered to have had a response to treatment at week 12. We determined that we needed to enroll 136 subjects in each active-treatment group and 70 subjects in the placebo group for the study to have a power of 80% to detect a minimum difference of 17% between any two study groups in the rate of response, assuming an alpha of 0.05 and a two-tailed test with no adjustment for multiple comparisons.

Analyses were performed with the use of SAS software, version 9.1.3 (SAS Institute). For categorical outcomes (including data regarding adverse events), treatments were compared with the use of Pearson’s chi-square test, Fisher’s exact test, or logistic regression, as appropriate. Logistic-regression models included the study center as a covariate. For dimensional outcomes, linear mixed-effects models (implemented with the use of PROC MIXED) were used to determine predicted mean values at each assessment point (weeks 4, 8, and 12)
and to test the study hypotheses with respect to between-group differences at week 12.

In each linear mixed-effects model, time and study group were included as fixed effects, with linear and quadratic time and time-by-treatment group interaction terms. Each model also began with a limited number of covariates (e.g., age, sex, and race), followed by backward stepping to identify thebest-fitting and most parsimonious model. In all models, random effects included intercept and linear slope terms, and an unstructured covariance was used to account for within-subject correlation over time. All comparisons were planned and tests were two-sided. A P value of less than 0.05 was considered to indicate statistical significance. The sequential Dunnett test was used to control the overall (familywise) error rate._24_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R24)

We analyzed data from all subjects according to study group. Sensitivity analyses were performed with the last observation carried forward (LOCF) and multiple imputation assuming missingness at random. Results were similar for the two missing-data methods. We report the results of the LOCF analysis because the
response rates were lower and hence provide a more conservative estimate of outcomes.

Results
Subjects
A total of 3066 potentially eligible subjects were screened by telephone
(_Figure 1_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#F1) ). Of these subjects, 761 signed consent forms and completed the inclusion and exclusion evaluation, 524 were deemed to be eligible and completed the baseline assessment, and 488 underwent randomization. Eleven subjects (2.3%) stopped
treatment but were included in the assessment (treatment withdrawals); 46 subjects (9.4%) stopped both treatment and assessment (study withdrawals).

On the basis of logistic-regression analyses, pairwise comparisons indicated that subjects in the cognitive-behavioral-therapy group were significantly less likely to withdraw from treatment than were those in the sertraline group (odds ratio, 0.33; 95% confidence interval [CI], 0.13 to 0.87; P=0.03) or the placebo
group (odds ratio, 0.24; 95% CI; 0.09 to 0.67; P=0.006). Of the 488 subjects who underwent randomization, 459 (94.1%) completed at least one postbaseline assessment, 396 (81.1%) completed all four assessments, and 440 (90.2%) completed the assessment at week 12. Subjects were recruited primarily through advertisements (52.2%) or clinical referrals (44.1%).
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/F1)
View larger version (30K):
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/F1)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/F1)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/F1)

Figure 1. Enrollment and Outcomes.

Subjects who are shown as having withdrawn from treatment discontinued their assigned therapy but continued to undergo study assessment. Subjects who are shown as having withdrawn from the study discontinued both therapy and assessment. CBT denotes cognitive behavioral therapy.

Of 14 possible sessions of cognitive behavioral therapy, the mean (±SD) number of sessions completed was 12.7±2.8 in the combination-therapy group and 13.2±2.0 in the cognitive-behavioral-therapy group. The mean dose of sertraline at the final visit was 133.7±59.8 mg per day (range, 25 to 200) in the combination-therapy group, 146.0±60.8 mg per day (range, 25 to 200) in the sertraline group, and 175.8±43.7 mg per day (range, 50 to 200) in the placebo group.

Demographic and Clinical Characteristics
There were no significant differences among study groups with respect to baseline demographic and clinical characteristics (_Table 1_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#T1) ). The mean age of participants was 10.7±2.8 years, with 74.2% under the age of 13 years.

There were nearly equal numbers of male and female subjects. Most subjects were white (78.9%), with
other racial and ethnic groups represented. Subjects came from predominantly middle-class and upper-middle-class families (74.6%) and lived with both biologic parents (70.3%). Most subjects had received the diagnosis of two or more primary anxiety disorders (78.7%) and one or more secondary disorders
(55.3%). At baseline, subjects had moderate-to-severe anxiety and impairment (_Table
2_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#T2) ).

Given the geographic diversity among study centers, there were significant differences among sites on several baseline demographic variables (e.g., race and socioeconomic status). Overall, these variables were equally distributed among study groups within each center; however, three centers had one instance each of
unequal distribution for sex, race, or socioeconomic status.

View this table:
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/T1)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/T1)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/T1)
Table 1. Baseline Characteristics of the Subjects and Recruitment According
to Study Center.

View this table:
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/T2)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/T2)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/T2)
Table 2. Key Outcomes at 12 Weeks.

Clinical Response
In the intention-to-treat analysis, the percentages of children who were rated as 1 (very much improved) or 2 (much improved) on the Clinical Global Impression–Improvement scale at 12 weeks were 80.7% (95% CI, 73.3 to 86.4) in the combination-therapy group, 59.7% (95% CI, 51.4 to 67.5) in the cognitive-behavioral-therapy group, 54.9% (95% CI, 46.4 to 63.1) in the sertraline group, and
23.7% (95% CI, 15.5 to 34.5) in the placebo group (_Table 2_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#T2) ).

With the study center as a covariate, planned pairwise comparisons from a logistic-regression model showed
that each active treatment was superior to placebo as follows: combination therapy versus placebo, P<0.001 (odds ratio, 13.6; 95% CI, 6.9 to 26.8); cognitive behavioral therapy versus placebo, P<0.001 (odds ratio, 4.8; 95% CI, 2.6 to 9.0); and sertraline versus placebo, P<0.001 (odds ratio, 3.9; 95% CI, 2.1 to 7.4). Similar pairwise comparisons revealed that combination therapy was superior to either sertraline alone (odds ratio, 3.4; 95% CI, 2.0 to 5.9; P<0.001) or cognitive behavioral therapy alone (odds ratio, 2.8; 95% CI, 1.6 to 4.8; P=0.001). However, there was no significant difference between sertraline and cognitive behavioral therapy (P=0.41).

There was no main effect for center (P=0.69); however, a comparison among centers according to study group revealed a significant difference in response to combination therapy but no differences with respect to the response to sertraline alone (P=0.15) or cognitive behavioral therapy alone (P=0.25).

Further evaluation of response rates revealed that the average response rate for combination therapy at one center was significantly lower than at the other centers (P=0.002). A sensitivity analysis of site response rates showed that when data from the one site were removed, the average response rate of the other sites was consistent with that of the full sample.

The mixed-effects model for the Pediatric Anxiety Rating Scale revealed a significant quadratic effect for time (P<0.001) and a significant quadratic time-by-treatment interaction for cognitive behavioral therapy versus placebo (P=0.01) but not for either combination therapy or sertraline versus placebo. In other words, as compared with placebo, cognitive behavioral therapy had a linear mean trajectory (_Figure 2_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#F2) ). Planned pairwise comparisons of the expected mean scores on the Pediatric Anxiety Rating Scale at week 12 revealed a similar ordering of
outcomes, with all active treatments superior to placebo, according to the following comparisons: combination therapy versus placebo, t=–5.94 (P<0.001); cognitive behavioral therapy versus placebo, t=–2.11 (P=0.04); and sertraline versus placebo, t=–3.15 (P=0.002). In addition, combination therapy was
superior to both sertraline alone (t=–3.26, P=0.001) and cognitive behavioral therapy alone (t=–4.73, P<0.001). No significant difference was found between sertraline and cognitive behavioral therapy (t=1.32, P=0.19). The same magnitude and pattern of outcome was found for the Clinical Global Impressio Severity
scale and the Children’s Global Assessment Scale.
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/F2)
View larger version (21K):
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/F2)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/F2)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/F2)
Figure 2. Scores on the Pediatric Anxiety Rating Scale during the 12-Week
Study.

Scores on the Pediatric Anxiety Rating Scale range from 0 to 30, with scores higher than 13 consistent with moderate levels of anxiety and a diagnosis of an anxiety disorder. The expected mean score is the mean of the sampling distribution of the mean.

Estimates of the effect size (Hedges’ g) and the number needed to treatbetween the active-treatment groups and the placebo group were calculated. Effect sizes are based on the expected mean scores on the Pediatric Anxiety
Rating Scale, derived from the mixed-effects model. The number needed to treat is based on the dichotomized, end-of-treatment scores on the Clinical Global Impression–Improvement scale with the use of LOCF. The effect size was 0.86 (95% CI, 0.56 to 1.15) for combination therapy, 0.45 (95% CI, 0.17 to 0.74) for
sertraline, and 0.31 (95% CI, 0.02 to 0.59) for cognitive behavioral treatment.

The number needed to treat was 1.7 (95% CI, 1.7 to 1.9) for combination therapy, 3.2 (95% CI, 3.2 to 3.5) for sertraline, and 2.8 (95% CI, 2.7 to 3.0) for cognitive behavioral therapy. Treatment and Study Withdrawals
Most treatment and study withdrawals were attributed to reasons other than adverse events (43 of 57, 75.4%) (_Table 3_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#T3) ).

Of the 14 withdrawals that were attributed to an adverse event, 11 (78.6%) were in the groups receiving either sertraline alone or placebo and consisted of 3 physical events (headache, stomach pains, and tremor) and 8 psychiatric adverse events (worsening of symptoms, 3 subjects; agitation or disinhibition, 3; hyperactivity, 1; and nonsuicidal self-harm and homicidal ideation, 1).
View this table:
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/T3)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/T3)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/T3)
Table 3. Subjects Who Withdrew from Treatment or the Study.

Serious Adverse Events
Three subjects had serious adverse events during the study period. One child in the sertraline group had a worsening of behavior that was attributed to the parents’ increased limit setting on avoidance behavior; the event was considered to be possibly related to sertraline. A child in the combination-therapy
group had a worsening of preexisting oppositional defiant behavior that resulted in psychiatric hospitalization; this event was considered to be unrelated to a study treatment. The third subject was hospitalized for a tonsillectomy, which was also considered to be unrelated to a study treatment
(_Table
4_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#T4) ).
View this table:
_[in this window]_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633v2/T4)
_[in a new window]_
(http://content.nejm.org/cgi/content-nw/full/NEJMoa0804633v2/T4)
(http://content.nejm.org/cgi/powerpoint/NEJMoa0804633v2/T4)
Table 4. Moderate-to-Severe Adverse Events at 12 Weeks.

Adverse Events
Subjects in the combination-therapy group had a greater number of study visits and therefore significantly more opportunities for elicitation of adverse events than did those in the other study groups, with a mean of 12.8±4.0 opportunities (range, 1 to 22) in the combination-therapy group, as compared with 9.9±3.6 (range, 1 to 14) in the sertraline group, 10.6±2.0 (range, 1 to 14) in the cognitive-behavioral-therapy group, and 9.7±4.2 (range, 1 to 14) in the placebo group (P<0.001 for all comparisons). Rates of adverse events,
including suicidal and homicidal ideation, were not significantly greater in the sertraline group than in the placebo group. No child in the study attempted suicide. Among children in the cognitive-behavioral-therapy group, there were fewer reports of insomnia, fatigue, sedation, and restlessness or fidgeting than in the sertraline group (P<0.05 for all comparisons). For a list of mild adverse events that were not associated with functional impairment, as well as moderate and severe events, see the _Supplementary Appendix_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633/DC1) ,

available with the full text of this article at www.nejm.org.

Discussion
Our study examined therapies that many clinicians consider to be the most promising treatments for childhood anxiety disorders. Our findings indicate that as compared with placebo, the three active therapies combination therapy with both cognitive behavioral therapy and sertraline, cognitive behavioral therapy alone, and sertraline alone — are effective short-term treatments for children with separation and generalized anxiety disorders and social phobia, with combination treatment having superior response rates. No physical,psychiatric, or harm-related adverse events were reported more frequently in the sertraline group than in the placebo group, a finding similar to that for SSRIs, as identified in previous studies of anxious children._12_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R12) ,_13_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R13) ,_25_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R25)

Few withdrawals from either treatment or the study were attributed to adverse events. Suicidal ideation and homicidal ideation were uncommon. No child attempted suicide during the study period. Since they were recruited at multiple centers and locations, the study subjects were racially and ethnically diverse. However, despite intense outreach, the sample did not include the most socioeconomically disadvantaged children.
Subjects were predominantly younger children and included those with ADHD and other anxiety disorders, factors that allow for generalization of the results to these populations.

Conversely, the exclusion of children and teens with major depression and pervasive developmental disorders may have limited the generalizability of the results to these populations.The observed advantage of combination therapy over either cognitive behavioral therapy or sertraline alone during short-term treatment (an improvement of 21 to 25%) suggests that among these effective therapies, combination therapy
provides the best chance for a positive outcome. The superiority of combination therapy might be due to additive or synergistic effects of the two therapies. However, additional contact time in the combination-therapy group, which was unblinded, and expectancy effects on the part of both subjects and
clinicians cannot be ruled out as alternative explanations.

Nonetheless, the magnitude of the treatment effect in the combination-therapy group (with two
subjects as the number needed to treat to prevent one additional event) suggests that children with anxiety disorders who receive quality combination therapy can consistently expect a substantial reduction in the severity of anxiety. An increased number of visits in the combination-therapy group resulted in increased opportunities for elicitation of adverse events. Consequently, the potential for expectancies among subjects, parents, and clinicians regarding the side effects of medications in the context of more visits may have increased the rate of some adverse events in the combination-therapy group and may limit conclusions that can be drawn regarding the rates of adverse events in combination therapy.

The positive benefit of cognitive behavioral therapy, as compared with placebo, adds new information to the existing literature._26_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R26)
The number needed to treat for cognitive behavioral therapy in this study (three subjects) is the same as that
identified in a meta-analysis of studies comparing subjects who were assigned to cognitive behavioral therapy with those assigned to a waiting list for therapy or to sessions without active therapy._14_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R14)

Our study’s test of cognitive behavioral therapy included children with moderate-to-severe anxiety and addresses criticism of previous trials that included children with only mild-to-moderate
anxiety._14_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R14)
Before our study, cognitive behavioral therapy for childhood anxiety was considered to be
“probably efficacious.”_26_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R26)

This evaluation of cognitive behavioral therapy and other recent studies_27_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R27)
,_28_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R28) suggests that
such therapy for childhood anxiety is a well-established, evidenced-based treatment._29_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R29)

Given that the risk of some adverse events was lower in the behavioral-therapy group than in the sertraline group, some parents and their children may consider choosing cognitive behavioral therapy as their initial treatment.

The results of our study confirm the short-term efficacy of sertraline for children with generalized anxiety disorder_25_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R25) and show that
sertraline is effective for children with separation anxiety disorder and social phobia. The number needed
to treat for sertraline in our study (three subjects) was the same as that previously identified in a meta-analysis_15_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R15) of six
randomized, placebo-controlled trials of SSRIs for childhood anxiety disorders._12_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R12) ,_13_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R13) ,_25_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R25)
,_30_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R30) ,_31_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R31)

These studies and others_27_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R27)
suggest that SSRIs, as a class, are the medication of choice for these conditions. The titration schedule that we used, which emphasized upward dose adjustment in the absence of response and adverse events, suggests that the average end-point dose of sertraline in this study is the highest dose consistent with good outcome and tolerability. No adverse events were observed more frequently in the sertraline group than in the placebo group. In contrast to the apparent risk of suicidal ideation and behavior in studies of depression in children and
adolescents,_15_ (http://content.nejm.org/cgi/content/full/NEJMoa0804633#R15) our study did not demonstrate any increased risk for suicidal behavior in the sertraline group. Given the benefit of sertraline alone or in combination with cognitive behavioral therapy and the limited risk of adverse events associated with the drug in our study, the well-monitored use of sertraline and other SSRIs in the treatment of childhood anxiety disorders is indicated.

Cognitive behavioral therapy and sertraline either in combination or as monotherapies appear to be effective treatments for these commonly occurring childhood anxiety disorders. Results confirm those of previous studies of SSRIs and cognitive behavioral therapy and, most important, show that combination
therapy offers children the best chance for a positive outcome. Our findings indicate that all three of the treatment options may be recommended, taking into consideration the family’s treatment preferences, treatment availability, cost, and time burden. To inform more prescriptive selection of patients for
treatment, further analysis of predictors and moderators of treatment response may identify who is most likely to respond to which_32_
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#R32) of these
effective alternatives.
Supported by grants (U01 MH064089, to Dr. Walkup; U01 MH64092, to Dr.
Albano; U01 MH64003, to Dr. Birmaher; U01 MH63747, to Dr. Kendall; U01 MH64107,
to Dr. March; U01 MH64088, to Dr. Piacentini; and U01 MH064003, to Dr. Compton)
from the National Institute of Mental Health (NIMH).

Sertraline and matching placebo were supplied free of charge by Pfizer. Dr. Walkup reports receiving consulting fees from Eli Lilly and Jazz Pharmaceuticals and fees for legal consultation to defense counsel and
submission of written reports in litigation involving GlaxoSmithKline, receiving lecture fees from CMP Media, Medical Education Reviews, McMahon Group, and DiMedix, and receiving support in the form of free medication and matching placebo from Eli Lilly and free medication from Abbott for clinical trials funded by the NIMH; Dr. Albano, receiving royalties from Oxford University Press for the Anxiety Disorders Interview Schedule for DSM-IV, Child and Parent Versions, but not for interviews used in this study, and royalties from the Guilford Press; Dr. Piacentini, receiving royalties from Oxford University Press for treatmentmanuals on childhood obsessive compulsive disorder and tic disorders and from the Guilford Press and APA Books for other books on child mental health and receiving lecture fees from Janssen-Cilag; Dr. Birmaher, receiving consulting fees from Jazz Pharmaceuticals, Solvay Pharmaceuticals, and Abcomm, lecture fees from Solvay, and royalties from Random House for a book on children with bipolar disorder; Dr. Rynn, receiving grant support from Neuropharm, BoehringerIngelheim Pharmaceuticals, and Wyeth Pharmaceuticals, consulting fees from Wyeth, and royalties from APPI for a book chapter on pediatric anxiety disorders; Dr. McCracken, receiving consulting fees from Sanofi-Aventis and Wyeth, lecture fees from Shire and UCB, and grant support from Aspect, Johnson & Johnson, Bristol-Myers Squibb, and Eli Lilly; Dr. Waslick, receiving grant support from Baystate Health, Somerset Pharmaceuticals, and GlaxoSmithKline; Dr. Iyengar, receiving consulting fees from Westinghouse for statistical consultation; Dr. March, receiving study medications from Eli Lilly for an NIMH-funded clinical trial and receiving royalties from Pearson for being the author of the Multidimensional Anxiety Scale for Children, receiving consulting fees from Eli Lilly, Pfizer, Wyeth, and GlaxoSmithKline, having an equity interest in MedAvante, and serving on an advisory board for AstraZeneca and Johnson & Johnson; and Dr. Kendall, receiving royalties from Workbook Publishing for anxiety-treatment materials.

No other potential conflict of interest relevant to this article was reported.

The views expressed in this article are those of the authors and do not necessarily represent the official views of the NIMH, the National Institutes of Health, or the Department of Health and Human Services.
We thank the children and their families who made this study possible; and J. Chisar, J. Fried, R. Klein, E. Menvielle, S. Olin, J. Severe, D. Almirall, and members of NIMH’s data and safety monitoring board.
* The study investigators are listed in the Appendix.
(http://content.nejm.org/cgi/content/full/NEJMoa0804633#RFN1)

Source Information
From the Johns Hopkins Medical Institutions, Baltimore (J.T.W., G.S.G.); New York State Psychiatric Institute–Columbia University Medical Center, New York (A.M.A., M.A.R.); the University of California at Los Angeles, Los Angeles (J.P., J.M.); Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center, Pittsburgh (B.B., S.I.); Duke University Medical Center, Durham, NC (S.N.C., J.S.M.); the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD (J.T.S.); Baystate
Medical Center, Springfield, MA (B.W.); and Temple University, Philadelphia
(P.C.K.).

This article (10.1056/NEJMoa0804633) was published at www.nejm.org on
October 30, 2008. It will appear in the December 25 issue of the Journal.
Address reprint requests to Dr. Walkup at the Division of Child and
Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns
Hopkins Medical Institutions, 600 N. Wolfe St., Baltimore, MD 21287.
References
1. Benjamin RS, Costello EJ, Warren M. Anxiety disorders in a pediatric
sample. J Anxiety Disord 1990;4:293-316. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1016/0887-6185(90)90027-\
7&link_type=DOI)
_[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1990EJ54500002&link_type=I\
SI
)
2. Birmaher B, Yelovich AK, Renaud J. Pharmacologic treatment for
children and adolescents with anxiety disorders. Pediatr Clin North Am
1998;45:1187-1204. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1016/S0031-3955(05)70069\
-9&link_type=DOI) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000076256400011&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=9884682&link_type=MED)
3. Achenbach TM, Howell CT, McConaughy SH, et al. Six-year predictors
of problems in a national sample of children and youth: I. Cross-informant
syndromes. J Am Acad Child Adolesc Psychiatry 1995;34:336-347. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1097/00004583-199503000-\
0002

0&link_type=DOI) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1995QK02500020&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=7896676&link_type=MED)
4. Ferdinand RF, Verhulst FC. Psychopathology from adolescence into
young adulthood: an 8-year follow-up study. Am J Psychiatry 1995;152:1586-1594.
_<NOBR Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=ajp&resid=152/11/1\
586
)
5. Pine DS, Cohen P, Gurley D, Brook J, Ma Y. The risk for
early-adulthood anxiety and depressive disorders in adolescents with anxiety
and
depressive disorders. Arch Gen Psychiatry 1998;55:56-64. _<NOBR Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=archpsyc&resid=55/\
1/56
)
6. Pine DS. Child-adult anxiety disorders. J Am Acad Child Adolesc
Psychiatry 1994;33:280-281. _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1994MT23000019&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=8150802&link_type=MED)
7. Gurley D, Cohen P, Pine DS, Brook J. Discriminating depression and
anxiety in youth: a role for diagnostic criteria. J Affect Disord
1996;39:191-200. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1016/0165-0327(96)00020-\
1&link_type=DOI) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1996VA95900004&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=8856423&link_type=MED)
8. Shaffer D, Fisher P, Dulcan MK, et al. The NIMH Diagnostic Interview
Schedule for Children Version 2.3 (DISC-2.3): description, acceptability,
prevalence rates, and performance in the MECA study. J Am Acad Child Adolesc
Psychiatry 1996;35:865-877. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1097/00004583-199607000-\
00012&link_type=DOI
) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1996UT65000012&link_type=I\
SI
)
_[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=8768346&link_type=MED)
9. Klein R. Anxiety disorders. In: Rutter M, Taylor E, Hersov L, eds.
Child and adolescent psychiatry: modern approaches. 3rd ed. London: Blackwell
Scientific, 1995:351-74.
10. Kendall PC, Treating anxiety disorders in children: results of a
randomized clinical trial. J Consult Clin Psychol 1994;62:100-111. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1037/0022-006X.62.1.100&
link_type=DOI) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1994MW67500015&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=8034812&link_type=MED)
11. Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM,
Southam-Gerow M, Henin A, Warman M. Therapy for youths with anxiety disorders:
a second
randomized clinical trial. J Consult Clin Psychol 1997;65:366-380. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1037/0022-006X.65.3.36
6&link_type=DOI) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1997XA22300002&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=9170760&link_type=MED)
12. Birmaher B, Axelson DA, Monk K, et al. Fluoxetine for the treatment
of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry
2003;42:415-423. _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000181706500007&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=12649628&link_type=MED)
13. The Research Unit on Pediatric Psychopharmacology Anxiety Study
Group. Fluvoxamine for the treatment of anxiety disorders in children and
adolescents. N Engl J Med 2001;344:1279-1285. _<NOBR Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=nejm&resid=344/17/\
1279
)
14. James A, Soler A, Weatherall R. Cognitive behavioural therapy for
anxiety disorders in children and adolescents. Cochrane Database Syst Rev
2005;4:CD004690-CD004690. _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=16235374&link_type=MED)
15. Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk
for reported suicidal ideation and suicide attempts in pediatric
antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA
2007;297:1683-1696. _<NOBR Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=jama&resid=297/15/\
1683
)
16. Diagnostic and statistical manual of mental disorders, 4th ed., text
rev.: DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000.
17. Kendall PC, Hedtke KA. Cognitive-behavioral therapy for anxious
children: therapist manual. 3rd ed. Ardmore, PA: Workbook Publishing, 2006.
18. Idem. Coping Cat workbook. 2nd ed.. Ardmore, PA: Workbook
Publishing, 2006.
19. Kendall PC, Gosch E, Furr JM, Sood E. Flexibility within fidelity. J
Am Acad Child Adolesc Psychiatry 2008;47:987-993. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1097/CHI.0b013e31817eed2\
f&link_type=D

OI) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=18714195&link_type=MED)
20. Albano AM, Silverman WK. The anxiety disorders interview schedule
for DSM-IV, child version: clinician manual. New York: Oxford University Press,
1996.
21. Guy W, Bonato R, eds. CGI: Clinical Global Impressions. Chevy Chase,
MD: National Institute of Mental Health, 1970.
22. The Pediatric Anxiety Rating Scale (PARS): development and
psychometric properties. J Am Acad Child Adolesc Psychiatry 2002;41:1061-1069.
_[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1097/00004583-200209000-\
00006&link_type=DOI
) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000177597000006&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=12218427&link_type=MED)
23. Shaffer D, Gould MS, Brasic J, et al. A Children’s Global Assessment
Scale (CGAS). Arch Gen Psychiatry 1983;40:1228-1231. _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A1983RP17500010&link_type=I\
SI
)
_[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=6639293&link_type=MED)

24. Miller RG. Simultaneous statistical inference. New York:
McGraw-Hill, 1966.
25. Rynn MA, Siqueland L, Rickels K. Placebo-controlled trial of
sertraline in the treatment of children with generalized anxiety disorder. Am J
Psychiatry 2001;158:2008-2014. _<NOBR Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=ajp&resid=158/12/2\
008
)
26. Silverman WK, Pina AA, Viswesvaran C. Evidence-based psychosocial
treatments for phobic and anxiety disorders in children and adolescents. J Clin
Child Adolesc Psychol 2008;37:105-130. _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=18814641&link_type=MED)
27. Beidel DC, Turner SM, Sallee FR, Ammerman RT, Crosby LA, Pathak S.
SET-C versus fluoxetine in the treatment of childhood social phobia. J Am Acad
Child Adolesc Psychiatry 2007;46:1622-1632. _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000251141800011&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=18030084&link_type=MED)
28. Kendall PC, Hudson JL, Gosch E, Flannery-Schroeder E, Suveg C.
Cognitive-behavioral therapy for anxiety disordered youth: a randomized
clinical
trial evaluating child and family modalities. J Consult Clin Psychol
2008;76:282-297. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1037/0022-006X.76.2.282&\
link_type=DOI
) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000254539400010&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=18377124&link_type=MED)
29. Chambless DL, Hollon SD. Defining empirically supported therapies. J
Consult Clin Psychol 1998;66:7-18. _[CrossRef]_ (http://content
.nejm.org/cgi/external_ref?access_num=10.1037/0022-006X.66.1.7&link_type=DOI)
_[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000071929800002&link_type=I\
SI
)
_[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=9489259&link_type=MED)
30. Wagner KD, Berard R, Stein MB, et al. A multicenter, randomized,
double-blind, placebo-controlled trial of paroxetine in children and
adolescents
with social anxiety disorder. Arch Gen Psychiatry 2004;61:1153-1162. _<NOBR
Full Text]_
(http://content.nejm.org/cgi/ijlink?linkType=ABST&journalCode=archpsyc&resid=61/\
11/1153
)
31. March JS, Entusah AR, Rynn M, Albano AM, Tourian KA. A randomized
controlled trial of venlafaxine ER versus placebo in pediatric social anxiety
disorder. Biol Psychiatry 2007;62:1149-1154. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1016/j.biopsych.2007.02.\
025&link_type=DOI
)
_[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=000250905800012&link_type=I\
SI
) _[Medline]_
(http://content.nejm.org/cgi/external_ref?access_num=17553467&link_type=MED)
32. Kiesler DJ. Some myths of psychotherapy research and the search for
a paradigm. Psychol Bull 1966;65:110-136. _[CrossRef]_
(http://content.nejm.org/cgi/external_ref?access_num=10.1037/h0022911&link_type=\
DOI
) _[ISI]_
(http://content.nejm.org/cgi/external_ref?access_num=A19667673600005&link_type=I\
SI
)
Appendix
The following investigators participated in this study: Steering Committee:
J. Walkup (chair), A. Albano (cochair); Statistics–Experimental Design: S.
Compton, S. Iyengar, J. March; Cognitive Behavioral Therapy: P. Kendall, G.
Ginsburg; Pharmacotherapy: M. Rynn, J. McCracken; Assessment: J. Piacentini,
A. Albano; Study Coordinators: C. Keeton, H. Koo, S. Aschenbrand, L. Bardsley,
R. Beidas, J. Catena, K. Dever, K. Drake, R. Dublin, E. Fontaine, J. Furr, A.
Gonzalez, K. Hedtke, L. Hunt, M. Keller, J. Kingery, A. Krain, K. Miller, J.
Podell, P. Rentas, M. Rozenmann, C. Suveg, C. Weiner, M. Wilson, T. Zoulas;
Data Center: M. Fletcher, K. Sullivan; Cognitive Behavior Therapists: E.
Gosch, C. Alfano, A. Angelosante, S. Aschenbrand, A. Barmish, L. Bergman, S.
Best, J. Comer, S. Compton, W. Copeland, M. Cwik, M. Desari, K. Drake, E.
Fontaine, J. Furr, P. Gammon, C. Gaze, R. Grover, H. Harmon, A. Hughes, K.
Hutchinson, J. Jones, C. Keeton, H. Kepley, J. Kingery, A. Krain, A. Langley,
J. Lee, J. Levitt, J. Manetti-Cusa, E. Martin, C. Mauro, K. McKnight, T. Peris, K.
Poling, L. Preuss, A. Puliafico, J. Robin, T. Roblek, J. Samson, M.
Schlossberg, M. Sweeney, C. Suveg, O. Velting, T. Verduin; Pharmacotherapists:
M. Rynn, J. McCracken, A. Adegbola, P. Ambrosini, D. Axelson, S. Barnett, A. Baskina,
B. Birmaher, C. Cagande, A. Chrisman, B. Chung, H. Courvoisie, B. Dave, A.
Desai, K. Dever, M. Gazzola, E. Harris, G. Hirsh, V. Howells, L. Hsu, I.
Hypolite, F. Kampmeier, S. Khalid-Khan, B. Kim, D. Kondo, L. Kotler, M.
Krushelnycky, J. Larson, J. Lee, P. Lee, C. Lopez, L. Maayan, J. McCracken, R.
Means,L. Miller, A. Parr, C. Pataki, C. Peterson, P. Pilania, R. Pizarro, H. Ravi,
S. Reinblatt, M. Riddle, M. Rodowski, D. Sakolsky, A. Scharko, R. Suddath, C.
Suarez, J. Walkup, B. Waslick; Independent Evaluators: A. Albano, G.
Ginsburg, B. Asche, A. Barmish, M. Beaudry, S. Chang, M. Choudhury, B. Chu, S.
Crawley, J. Curry, G. Danner, N. Deily, R. Dingfelder, D. Fitzgerald, P.
Gammon, S. Hofflich, E. Kastelic, J. Keener, T. Lipani, K. Lukin, M. Masarik, T.
Peris, T. Piacentini, S. Pimentel, A. Puliafico, T. Roblek, M. Schlossberg, E.
Sood, S. Tiwari, J. Trachtenberg, P. van de Velde; Pharmacy: K. Truelove, H.
Kim; Research Assistants: S. Allard, S. Avny, D. Beckmann, C. Brice, B.
Buzzella, E. Capelli, A. Chiu, M. Coles, J. Freeman, M. Gringle, S. Hefton, D.
Hood, M. Jacoby, J. King, A. Kolos, B. Lourea-Wadell, L. Lu, J. Lusky, R. Maid, C.
Merolli, Y. Ojo, A. Pearlman, J. Regan, S. Rock, M. Rooney, N. Simone, S.
Tiwari, S. Yeager.

**************Plan your next getaway with AOL Travel. Check out Today’s Hot
5 Travel Deals!
(http://pr.atwola.com/promoclk/100000075x1212416248x1200771803/aol?redir=http://\
travel.aol.com/discount-travel?ncid=emlcntustrav00000001
)

[Non-text portions of this message have been removed]

411 total views, 1 views today

Seroxat Caused my Movement Disorder

“I get involuntary movements and muscle spasms. I also still get electric shocks.”

Six years ago I had been taking Seroxat (Paroxetine) for about 2 weeks, I’d noticed that my hands and arms were twitching and moving -involuntary movements. I told the consultant, he told me it was a side effect of the drug but he still increased the dose by 10mg.within a short time of taking it I became very ill. my whole arms were moving and jerking, my legs moving, feet curling, back arching, neck twisting, head bobbing around, tongue twisting in my mouth it felt swollen, slurred speech.

I was writhing around, I couldn’t stand up, it effected my walking and balance, my eyes kept clamping shut so that I couldn’t open them. I was admitted to hospital. they filled in a yellow card. I was told I’d had a very rare adverse reaction to Seroxat and the Dr’s stopped the drug immediately, I now know it is not recommended to come off Seroxat abruptly but at the time I was too ill to question this.

A neurologist told me that Seroxat had called a condition called Dystonia, I’d never heard of it. I get involuntary movements and muscle spasms. I also still get electric shocks. I have had anemia, bad dreams, worsening of mood etc.

I am still effected by this movement disorder, I still get fizzy sensations in my legs, feet etc, I have problems with too much stimulation – feeling over loaded, sound, vibration, flashing lights etc can all trigger the movements off. When this first happened I couldn’t even hold a cup, I used straws.

I have had great support from my husband. My GP and psychiatrist are both convinced that Seroxat has caused my condition. Both the hospital and my GP have filled in the yellow card. I am a member of a on line support group which has helped me a lot.

cheryl farrelly
cheryl.farrelly2@ntlworld.com

 

442 total views, 1 views today

7/02/1999 – Welcome to the Drug Awareness E-Mail Group

The International Coalition For Drug Awareness is a private, non-profit group of
physicians, researchers, journalists and concerned citizens. Our primary focus
is to address the world’s most pervasive and subtle drug problem – prescription
drugs. We are dedicated to educating the people of the world regarding the
potential harmful and life threatening short and long term effects of these
drugs. As the cause of an estimated 200,000 deaths per year in America, drug
reactions are now the third leading cause of death! The most dangerous period of
time for a drug is upon market introduction. At that point physicians and their
patients have information on adverse reactions present in the controlled
environment of a clinical trial, but are unaware of the potential adverse
reactions of these new drugs when dispensed to the general public. We feel there
is a need to track and report patient reactions more carefully and more rapidly
than what is presently being done, which should result in lower medical costs
for the patients and doctors as well. And also might begin to breech the gap
that is beginning to form between well-meaning doctors and maltreated patients.
By keeping prescribing physicians and their patients abreast of recent adverse
reaction reports we hope to cut the number of unnecessary deaths due to drug
reactions and interactions and lessen the number of malpractice suits filed
against physicians as a result of those reactions. Beyond this public education
process our intention is to serve as an watch dog group in relationship with the
FDA and equivalent organizations around the world, encouraging them to remove
drugs which demonstrate high numbers of dangerous adverse reactions and threaten
the public safety.

689 total views, no views today

Zyban (Wellbutrin) “No Way”

“I think at this point the only thing that will save us is knowing about any medications before we take them.”

 

My husband’s horror story about Prozac and other SSRI anti depressants is posted in your web site– The Macula’s Story. We have been lucky because my husband is still alive. But we have been through a living hell, because our Primary Care Physician prescribed Prozac for my husband because he was a little down after our house burned. Who wouldn’t be?

Well last week I took my 17 year old son to our primary care physician for nasal congestion and a cough. While we were there I complained to our new Primary Care Physician, who we have been using for about 2 years now, that my son was smoking a pack of cigarettes daily. And that this was ridiculous at his age. The Doctor asked him why he was smoking and my son said, “school and work stress”. So The Doctor said to him, “I have something that will take the edge off the stress and the need to smoke”. Well I looked at the doctor and asked, “what that might be”. He said, “a new drug Zyban (Wellbutrin)”. I almost fell off the stool I was sitting on. This Doctor knew all about the adverse reaction that my husband had to Prozac and other SSRI anti-depressant drugs. We have explained it to him many times over the past 2 years.

I said, ” You forget I am the person who almost lost her husband to Prozac adverse reaction 2 years earlier, I couldn’t believe he wanted to prescribe this anti-depressant to my son. Knowing full well what had happened to my husband on anti-depressants”. He got somewhat defensive at this point and said, “this is not an SSRI anti-depressant like the others. This doesn’t work on the serotonin levels in the brain, this one works on the brain chemical dopamine”. I said, “after the hell we went through with my husband, my son will not take any medication that would alter any of his brain chemicals”.

Then I just told him, “no”. “There was no way my son was going on Zyban (Wellbutrin). I would not take the chance”. He then looked at my son, who will be 18 years old in 6 months. He laughingly told him, “come back to see me in 6 months”. I was very upset by this point. I felt like he was saying come back in 6 months so I can legally drug you without your mothers permission. Does he not think that my children went through hell also. Watching their father turn into a manic depressive, psychotic, suicidal wreck from a completely normal human being. Prozac and other anti-depressants took away their father for 1 12 years of their lives. Through my research and my finding Dr. Tracy, we helped him return to his normal self. But not without the pain and trauma it has caused all of us.

I have explained to this man over and over the hell and the trauma my husband and I and our children went through. Because some Doctor prescribed Prozac for a very stupid reason. Now I keep thinking, “I need to change Doctors”. But then I think “why”. They are all the same. They prescribe these drugs that they know nothing about. Have any of them stopped to read the adverse reactions or side effects these and any drugs can cause on the insert that come with the drugs. No, all they know is what the pharmaceutical salesperson tells them. And we know that the pharmaceutical sales person is not going to bad mouth their own medications. I think at this point the only thing that will save us is knowing about any medications before we take them. Know the adverse reactions and side effect they can cause. If you or someone you know has personality changes or things that seem different about them while on a medication, research it.

With my husband it took 1 1/2 years to realize what was going on, because we saw 5 or 6 different Doctors. I showed them the research I had done and what these drugs can do and I thought this was the cause of what he was going through. And they all said, “Prozac and these other SSRI drugs don’t do that”. Well my husband is living proof that they do. He didn’t get better until we took matters into our own hands and pulled him off all the medications they had him on. And about three weeks latter my husbands old personality started returning. But it took another 7 to 8 months for him to get to about 85% of his old self. He is still not 100% and we wonder if he ever will be. It is very frightening just going to the Doctors for my family and friends who saw what we went through anymore.

Patty Macula

 

1995

Years 2000 and Prior

This is Survivor Story number 94.
Total number of stories in current database is 96

325 total views, no views today