08/02/1999 – SSRI Prescribing in Primary Care Draws Fire

Note that 8% of all general hospital psychiatric admissions caused by
SSRI-induced psychoses!–Thanks to Ann Blake-Tracy for passing this along.
Mark
———–

FromClinical Psychiatry News

SSRI Prescribing in Primary Care Draws Fire

Todd Zwillich, Senior Writer

[Clinical Psychiatry News 27(6):34, 1999. © 1999 International Medical
News
Group.]

————————————————————————
More primary care physicians are prescribing antidepressants, but some
observers worry that patients aren’t being evaluated closely enough for
potential adverse reactions or monitored appropriately while taking the
drugs.

Research is beginning to show that “large numbers” of prescriptions for
selective serotonin reuptake inhibitors (SSRIs) aren’t accompanied by a
diagnosis of depression or any other mental condition, said Stephen
Crystal, Ph.D., a researcher who studies prescribing trends at Rutgers
University in New Brunswick, N.J.

“We have a massive uncontrolled experiment going on out there,” he
said.

The number of doctor office visits including an antidepressant
prescription more than doubled between 1985 and 1994 to more than 24
million, according to data from the National Ambulatory Medical Care
Survey (NAMCS). Researchers attribute the rise to the popularity of
SSRIs.

While an estimated 11 million psychiatrist appointments included an
antidepressant prescription in 1994, more than 10 million other
antidepressant prescriptions were written by primary care doctors.
Preliminary analysis of survey data extending through 1996 shows that
antidepressant prescriptions are now more common in primary care
offices than in psychiatrists’ practices, according to Dr. Crystal.

Managed care is at least partly responsible for the trend. Primary care
physicians acting as gatekeepers in HMOs have been encouraged to treat
potentially depressed patients rather than refer them to specialists.
At the same time, primary care doctors are becoming more comfortable
with the newer SSRIs because they are relatively easy to use.

Toxicity and overdoses are rare, and potential drug interactions are
far less common than with other drug classes. The drugs may also
provide a convenient way to treat somatizing patients who have a few
depressive symptoms without a full-blown depressive episode.

But relatively few data exist to support SSRIs’ efficacy in treating
the “subthreshold” patients often seen in primary care. Many of those
patients may get SSRIs without any official diagnosis, according to Dr.
Harold Pincus, who last year published a study on psychotropic
prescribing using NAMCS data.

Office-based psychiatry practices tend to aggregate around more
affluent and better-educated patients in medium and large cities. Most
observers agree that primary care’s new dominance in antidepressant
prescribing makes the drugs available to a wider range of patients.

“Those who are underserved by specialists are nonwhite and not wealthy.
They are the ones who benefit most from primary care physician
prescribing,” said Dr. Gregory Simon, a psychiatrist who studies
prescribing patterns at Group Health Cooperative of Puget Sound in
Seattle.

The American Psychiatric Association recommends in its depression
treatment guidelines that patients continue their SSRI prescription for
4-5 months after complete remission of their symptoms. But data from
Group Health Cooperative–an HMO that emphasizes primary care treatment
of mental conditions–show that only 34% of patients on SSRIs refill
their prescriptions often enough to suggest continuous use.

At the same time, new data from the Rutgers group show that Medicare
patients treated in primary care are more than twice as likely as
similar patients treated in psychiatric settings to fill their SSRI
prescriptions only once, Dr. Crystal commented.

Others worry that physicians are not paying enough attention to patient
factors that could make initiation of SSRIs dangerous. Dr. Malcolm B.
Bowers Jr., a psychiatrist at Yale University in New Haven, told
CLINICAL PSYCHIATRY NEWS that SSRI-induced psychosis has accounted for
8% of all general hospital psychiatric admissions over a recent
14-month period. [emphasis added]

The pattern suggests that while SSRIs are a help to the majority of
patients who take them, more needs to be done to make sure that doctors
prescribing the drugs evaluate patients for psychotic predispositions
vulnerable to SSRIs. Such patients may include those with a history of
psychotic illness or early signs of mania.

“What is surprising is that this particular group of side effects is
really
underplayed,” Dr. Bowers said.

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12/02/1999 – Boys Will Be Boys

We shout a public “WELL DONE AND THANK YOU!!!!” to George Will and the
Washington Post for their encouraging article on the Colorado School
Board Resolution. Ann Blake-Tracy who was one of three invited to present
documentation to the school board on the damage caused by these drugs
will be doing a radio show this Saturday on this issue. She will be
joined by Patti Johnson, the Colorado School Board member who
introduced the resolution. The interview will be with Phyllis Schlafly,
national head of the Eagle Forum (www.eagleforum.org) at 11:30 AM
Central Time. For a station near you that may carry the show check
their web site or the drugawareness.org site or members.aol.com/atracyp
hd.

Boys Will Be Boys
Or you can just drug them.
By George F. Will
Thursday, December 2, 1999; Page A39

A reaction is underway against drugging children because they are
behaving like children, especially boy children. Colorado’s elected
school board recently voted to discourage what looks like drug abuse in
the service of an ideological agenda. The board urged teachers and
other school personnel to be more restrained about recommending drugs
such as Ritalin for behavior modification of children, and to rely more
on discipline and instruction.

One reason for the vote is that some school violence has been committed
by students taking psychotropic drugs. But even absent a causal
connection between the drugs and violence, there are sound reasons to
recoil from the promiscuous drugging of children.

Consider the supposed epidemic of attention deficit/hyperactivity
disorder (ADHD) that by 1996 had U.S. youngsters consuming 90percent of
the world’s Ritalin. Boys, no parent of one will be surprised to learn,
are much more likely than girls to be diagnosed with ADHD. In1996, 10
percent to 12 percent of all American schoolboys were taking the
addictive Ritalin. (After attending classes on the dangers of drugs?)

One theory holds that ADHD is epidemic because of the modern
acceleration of life–the environmental blitzkrieg of MTV, video games,
e-mail, cell phones, etc. But the magazine Lingua Franca reports that
Ken Jacobson, a doctoral candidate in anthropology at the University of
Massachusetts, conducted a cross-cultural study of ADHD that included
observation of two groups of English school children, one diagnosed
with ADHD, the other not. He observed them with reference to 35
behaviors (e.g., “giggling,” “squirming,” “blurting out”) and found no
significant differences between the groups.

Children, he says, tend to talk, fidget and fool around–“all the
classical ADHD-type behaviors. If you’re predisposed to label any child
as ADHD, the distracted troublemaker or the model student, you’ll find
a way to observe these behaviors.” So what might explain such a
predisposition? Paul R. McHugh, professor of psychiatry at Johns
Hopkins, writing in Commentary, argues that ADHD, “social phobia”
(usual symptom: fear of public speaking) and other disorders certified
by the American Psychiatric Association’s “Diagnostic and Statistical
Manual of Mental Disorders” are proliferating rapidly. This is because
of a growing tendency to regard as mental problems many characteristics
that are really aspects of individuality.

So pharmacology is employed to relieve burdensome aspects of
temperament. “Psychiatric conditions,” says McHugh, “are routinely
differentiated by appearances alone,” even when it is “difficult to
distinguish symptoms of illness from normal variations in human life,”
or from the normal responses of sensitive people to life’s challenges.
But if a condition can be described, it can be named; once named, a
distinct disorder can be linked to a particular treatment. McHugh says
some experts who certify new disorders “receive extravagant annual
retainers from pharmaceutical companies that profit from the promotion
of disorders treatable by the companies’ medications.”

The idea that most individuals deficient inattentiveness or confidence
are sick encourages what McHugh calls pharmacological “mental
cosmetics.” This “should be offensive to anyone who values the richness
of human psychological diversity. Both medically and morally,
encumbering this naturally occurring diversity with the terminology of
disease is a first step toward efforts, however camouflaged, to control
it.” Clearly some children need Ritalin. However, Ken Livingston, of
Vassar’s department of psychology, writing in the Public Interest, says
Ritalin is sometimes used as a diagnostic tool–if it improves a
child’s attention, ADHD is assumed.

But Ritalin, like other stimulants such as caffeine and nicotine,
improves almost everyone’s attention. And Ritalin is a ready resource
for teachers who blur the distinction between education and therapy.
One alternative to Ritalin might be school choice–parents finding
schools suited to their children’s temperaments. But, says Livingston,
when it is difficult to change the institutional environment, “we don’t
think twice about changing the brain of the person who has to live in
it.” This is an age that tries to medicalize every difficulty or
defect. Gwen Broude, also of Vassar, believes that the rambunctiousness
of boys is treated as a mental disorder by people eager to interpret
sex differences as personal deficiencies.

Danielle Crittenden of the Independent Women’s Forum sees the “anti-boy
lobby” behind handwringing about the supposed dangers of reading the
Harry Potter novels, which feature wizardry, witchcraft and other
really neat stuff. The androgyny agenda of progressive thinkers has
reduced children’s literature to bland gruel because, Crittenden says,
there is “zero tolerance for male adventurousness.” The Potter books
recall those traditional boys’ books that satisfied boys’ zeal for
strife and Adventure. Today, Crittenden says, that zeal causes
therapists–they are everywhere–to reach for Ritalin. Harry is brave,
good and constantly battling evil. He should point his broomstick
toward Colorado, where perhaps boys can be boys.

Copyright 1999 The Washington Post Company

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11/15/1999 – Ann Blake-Tracy Appearances

Here are some upcoming broadcast appearances for Ann Blake-Tracy:

Dr. Ann Tracy will be appearing on the Leeza Gibbons Show tomorrow,
Tuesday, November 16th. To find show times and a station near you,
please go to information is available at http:/members.aol.com/atracyph
d/appear.htm.

Or you can go directly to Leeza’s homepage at http://www.leezashow.com/ban_show.htm

In addition, Ann Blake-Tracy has a radio show scheduled for next Saturday the
20th at 10-11 AM CST on KIXL 970 AM out of Austin Texas.

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10/24/1999 – The Pain in Littleton Continues

A Message from Ann Blake-Tracy…

As if the people of Littleton have not suffered enough via the
Luvox-induced nightmare of Eric Harris and Dylan Klebold, now they must
go through their own SSRI-induced nightmares!!!! While in Littleton
last month I was told by one of the teachers at Columbine that close to
half of their students are now on something to cope with the
Luvox-induced tragedy carried out by Eric Harris and Dylan Klebold.
Oct. 21 we heard that a friend of the boys was arrested for making
threats about finishing the job for Eric and Dylan. Now we hear that
one of the mothers of a wounded student has committed one of the most
impulsive suicides I have heard of to date. The striking impulsive
compulsion to die coupled with the personality changes and loss of the
ability to cope, makes it clear to me that this is without doubt
another SSRI-induced tragedy!

How many more?

How many more?

How many more must die before the bloodshed ends? If you have been
afraid to speak out on this issue, PLEASE do not allow your silence to
contribute to these tragedies any longer!!! We must all warn all we
know that this is a clear and very present danger that MUST
end!!!!!!!!!!!!!!!!

Ann Blake-Tracy, Executive Director,
International Coalition for Drug Awareness
www.drugawareness.org

——————————————————————–
Mom of Columbine Victim Kills Self

By COLLEEN SLEVIN Associated Press Writer

DENVER (AP) — The mother of a student wounded in the Columbine High
School massacre walked into a suburban pawn shop Friday, asked to see a
handgun, loaded it and killed herself with a shot to the head.

Carla June Hochhalter’s suicide occurred about six months after her
17-year-old daughter, Anne Marie, was critically wounded in the April
20 tragedy and left partially paralyzed.

It was not immediately known what other factors might have contributed
to Ms. Hochhalter’s suicide.

Ms. Hochhalter, 48, entered the Alpha Pawn Shop in Englewood Friday
morning and asked to see a handgun.

When a clerk turned around to fill out paperwork, Ms. Hochhalter loaded
the weapon with bullets that she brought, then fired one round that hit
the wall and a second round into her head, Englewood police spokeswoman
Leticia Castillo said.

The suicide was the latest shock for students and families in the
Columbine area. Jefferson County School District officials planned to
have grief counselors available this weekend to help deal with any
trauma.

A student was arrested this week for allegedly threatening “to finish
the job” begun by two student gunmen at Columbine.

In addition, CBS-TV was criticized by some in the community for
broadcasting a snippet of the security camera videotape that was taken
in the school cafeteria as the massacre unfolded.

Eric Harris, 18, and Dylan Klebold, 17, scattered gunfire and bombs at
the school near Englewood, killing 12 students and a teacher and
wounding about 26 others. Then they committed suicide.

Miss Hochhalter suffered injuries to her spinal cord, back and chest
when the gunmen fired at her in the parking lot. She moved her legs
for the first time last week.

Now a senior, she is taking a physics class at Columbine while a tutor
teaches the rest of her courses at home.

AP-NY-10-22-99 1947EDT
___________________________

Mom of CHS victim kills herself

By David Olinger
Denver Post Staff Writer

Oct. 22, 5:15 p.m. – Carla Hochhalter, the mother of a girl paralyzed
by the Columbine High shootings, walked into an Englewood pawn shop
Friday, asked to look at a revolver, loaded it and fatally shot
herself.

She died at Swedish Medical Center, minutes after paramedics carried
her into its emergency room.

Hochhalter, 48, killed herself at a time when her family seemed to be
battling back from a tragedy that had left her daughter Anne Marie
partially paralyzed by a bullet lodged in her back.

Anne Marie, a 17-year-old Columbine High senior, told friends a week
ago that she had managed to move her legs for the first time since
April 20. She and her parents had moved into a home renovated by
volunteers to accommodate her wheelchair. Dozens of students and
teachers at Leawood Elementary, where she once went to school, took
part in a Courage Walk last week to benefit the Hochhalters. Anne
Marie had thanked them all, adding bravely, “I think we’ll all
recover.”

Seven days later her mother walked into the Alpha Pawn Shop on South
Broadway and calmly asked to look at some handguns. A clerk showed her
three. She said she wanted to buy one, a .38 special revolver, and
asked to examine it.

While the clerk turned his attention to the paperwork associated with a
gun purchase, Carla Hochhalter surreptitiously loaded the revolver
with ammunition she had brought into the shop. She fired one bullet
into a store wall. She fired the next into her right temple.

At least half a dozen pawn shop employees and customers witnessed the
shooting.

“I’m stunned,” said Richard Castaldo, another of the students partially
paralyzed by the Columbine High gunmen. “My heart goes out to that
family. To go through what they this summer, and then this.”
Castaldo’s mother, Connie Michalik, said Carla Hochhalter suffered
terribly during the six months she watched her daughter fighting to
survive, then coping with life in a wheelchair.

“When this whole thing started, she was a different person. I saw her
slide downhill,” Michalik said. “You could see it was too much for
her. At the beginning, she was upset but a normal distraught person,
like we all were. But you’d look in her eyes and see she was … lost.
It didn’t seem like she was there any more. She was sweet and loving
and kind, but it was too much for her.”

Jefferson County Sheriff John Stone, whose department investigated the
Columbine High massacre, has watched deputies call it quits in the last
six months as the enduring stresses of this tragedy took their toll.
He expressed sympathy for the Hochhalters, saying, “I’d ask people to
pray for the family to help them get through this difficult part.”

Copyright 1999 The Denver Post.
____________________________

Columbine victim’s mother kills self in pawn shop

By Karen Abbott
Denver Rocky Mountain News Staff Writer

Carla Hochhalter, whose 17-year-old daughter was gravely wounded in the
Columbine High School shootings six months ago, took her own life
Friday.

Englewood police said Mrs. Hochhalter, 48, shot herself once in the
head at about 10 a.m. inside a South Broadway pawn shop where she had
just told a clerk she wanted to buy a gun.

“She was such a loving mother,” Connie Michalik, mother of wounded
Columbine student Rich Castaldo, said Friday.

The Hochhalter family, whose daughter, Anne Marie, suffered spinal cord
injuries and has been attending Columbine in a wheelchair this fall,
declined to comment.

Michalik said she and Mrs. Hochhalter spent many hours together at the
hospital in the weeks after their children were shot. Teenage gunmen
Eric Harris and Dylan Klebold opened fire at the school, killing 12
students and a teacher and injuring more than 20 other people before
killing themselves.

“She was very sweet and loving and kind,” Michalik said. “This whole
thing just devastated her. This just destroyed her. It destroyed her.

“In my mind, I almost feel like Eric and Dylan killed her too.”

Police spokeswoman Letitia Castillo said the clerk at Alpha Pawn, 4155
S. Broadway in Englewood, handed Mrs. Hochhalter a .38 caliber handgun
at her request. While the clerk was doing the required background
check for the purchase, Castillo said, Mrs. Hochhalter apparently
loaded the gun with bullets she had brought with her.

Castillo said Mrs. Hochhalter fired one bullet into a wall of the store
before turning the gun on herself. No one else was injured.

Arapahoe County Coroner Dr. Michael Dobersen confirmed after an autopsy
Friday that Mrs. Hochhalter died of a gunshot wound to the head. The
death was classified as a suicide, he said.

Mrs. Hochhalter was pronounced dead at about 10:50 a.m. at Swedish
Medical Center, where Anne Marie underwent radical surgery and stayed
for weeks after she was shot twice as she ate lunch outside Columbine.

A Swedish spokeswoman said the hospital staff would not comment Friday.

Michalik said she had been concerned about Mrs. Hochhalter but never
imagined the depth of her depression.

“She was devastated, just like the rest of us,” Michalik said. “When it
first happened, she was just like any other parent.

October 22, 1999

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10/13/1999 – Ann Blake-Tracy on San Francisco Radio Saturday

Dr. Ann Tracy, Executive Director of the International Coalition of
Drug Awareness, will be interviewed this Saturday morning (10/16) from
9am to 10am PDT time on KGO Radio in San Francisco. You can listen to
live streaming audio on KGO’s web site at <www.kgo.com>.

[Start times in other Time Zones: MDT=10am; CDT=11am; EDT=Noon]

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09/07/1999 – Celexa & Alcohol

This is being remailed to make a minor correction. It comes from Dr.
Tracy and our ICFDA Director in Norway–

“I feel that this information coming in from our director in Norway is
so critical that it needs to get to all of you immediately. Hope you
can translate his English =-) Celexa has frightened me more than any
of these drugs since long before it was ever approved. We will be
hearing MUCH more about this extremely dangerous med. But if this is
happening with Celexa, the damage from the others being mixed with
alcohol is also there. How long will it take before anyone begins to
see this, who knows? The tragic twist to this is that these drugs
produce such an overwhelming craving for alcohol.” Ann
_________________________________

In Denmark the magazine: “Ugeskrift for Laeger” (a weekly magazine for
doctors) will publish a study that says that Celexa (citalopram,
Cipramil) can lead to death in combination with alcohol. They have
found that 4 users of celexa have died, and the obduction showed
normal doses of both Celexa and alcohol (0.8 per thousand) for some of
them. They say it’s to early to draw any conclutions, but the Danish
Legemiddelstyrelsen (the Danish FDA), are saying they will contact
other countries, and ask if they have noticed any of this problems. I
will try to pass along an abstract of this “obduction-study” when it
becomes available.

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09/03/1999 – Ann Blake-Tracy on Art Bell this Weekend

Dr. Ann Tracy, the Executive Director of the ICFDA, will again be
interviewed on the Art Bell Program Saturday Night/Sunday Morning
September 4/5, 1999, 11pm to 3am PDT.  If you miss this show, and want
to hear it, and if your computer is equipped for audio and has the Real
Player software installed, you can access the file on the Art Bell site
(artbell.com). For a list of affiliated radio stations, go to the
“Stations” listing on that site (artbell.com/stations.html)

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