Suicides in Japan have decreased in light of the COVID-19 lockdown. According to The Guardian, “the suicide rate in Japan fell by 20% in April compared with the same time last year, the biggest drop in five years.” The stay-at-home mandates affected about 40% of suicide prevention organizations that shut down or reduced workers’ hours. Also seeming to contribute to this drop includes the lack of commuting vs many people working long hours in the office.

In May, The National Suicide Hotline Designation Act, a bipartisan bill, passed in the US Senate to make the national suicide prevention hotline a 3-digit number. Currently, the hotline is only accessible by the usual 10-digit number 1-800-273-TALK (8255). (If we’re honest, is not that easy to remember.) Should the bill pass in the House and get signed by the president, the number would be 9-8-8, however, the 10-digit number would still be valid.

A study published in General Hospital Psychiatry found that use of antidepressants among patients hospitalized with heart failure (HF) is associated with “minor depression, history of major depression, younger age, unemployment, white race, nonischemic heart failure, polypharmacy, and functional incapacity.” The study, held from 2014-2016, had 400 patients with HF enrolled and found that there was no increase in the patients with major depression taking antidepressants compared with those who did not have depression.

Adam Lanza, Violence, and Mental Illness

Much has been made of the Newtown shooting. After many inaccuracies by the media, the truth finally emerged that 20-year-old Adam Lanza shot and killed his mother then proceeded to his old school to murder 20 children and 6 adults before killing himself. Then another detail emerged that he may have struggled with Asperger’s syndromeThinking the Unthinkable (also now known as the infamous “I Am Adam Lanza’s mother” post) at the Anarchist Soccer Mom’s blog has gone viral about violent people who struggle with mental illness. (Or rather, a mentally ill person who struggles with being violent.)

I want you to know that you don’t need to be mentally ill to do what Adam Lanza did. His plan to kill was not merely cold but also very calculated. That is not the rash act of a mentally ill person; that is the meticulous act of a mastermind. He destroyed his hard drive beforehand so people would not be able to figure out why he did what he did, and according to the Daily Telegraph, rigged “his semi-automatic rifle… to fire with maximum efficiency.”

Now, autism groups and moms who have children with Asperger’s are scrambling to defend autistic people from the stigma that already comes with mental illness. The truth is while mentally ill people have moments of violence—I have kicked and punched my own mother in the throes of bipolar disorder—they are never planned acts of violence. Psych Central addressed the issue of mental illness and violence back in 1998:

Unless drugs or alcohol are involved, people with mental disorders do not pose any more threat to the community than anyone else.

It’s high time that people stop blaming cold, calculated acts of murder on mental illness.

(From a Christian perspective, sin, or an evil heart, is the real reason why things turned out the way they did.)

Welcome to Philadelphia: where our judges like to jail kids in return for money

This isn't mental health related but it's a story despicable enough that I had to put it here. As if the Philly area didn't have enough murders and stuff going on, we've got judges who would rather get rich than be concerned with children's welfare.

PHILADELPHIA (Reuters) – Two judges pleaded guilty on Thursday to
accepting more than $2.6 million from a private youth detention center
in Pennsylvania in return for giving hundreds of youths and teenagers
long sentences.

–snip–

When someone is sent to a detention center, the company running the
facility receives money from the county government to defray the cost
of incarceration. So as more children were sentenced to the detention
center, PA Childcare and Western PA Childcare received more money from
the government, prosecutors said.

–snip–

One 17-year-old boy was sentenced to three months' detention for being in the company of another minor caught shoplifting.

Others were given similar sentences for "simple assault" resulting
from a schoolyard scuffle that would normally draw a warning, a
spokeswoman for the Juvenile Law Center said.

The Constitution guarantees the right to legal representation in
U.S. courts. But many of the juveniles appeared before Ciavarella
without an attorney because they were told by the probation service
that their minor offenses didn't require one.

Read the entire article.

Happy Valentine's Day (for real this time)

I get so negative on this blog with negative stories and negative anecdotes that sometimes we all just need to think about the positive things in the world. Instead of me focusing on suicide for a day, how about I focus on life?

Check out this story from the Boston Globe of a white firefighter who saved a black baby girl 40 years ago during the a time when racial tensions were still high. It's good to read of a story that reminds me of life rather than death. Maybe I can use this story to celebrate life on Valentine's Day rather than… death.

(H/T: No Quarter)

Done deal: Pfizer buys Wyeth for $68 billion

Pfizer-Wyeth merger

The New York Times puts it this way:

The deal, if completed, would not only create a pharmaceutical behemoth but would be a rarity in the current financial tumult: a big acquisition that is not a desperate merger of two banks orchestrated by the government. [emphasis mine]

Funny the writers decided to add that. A year ago, that clause would have never been considered yet alone thought of.

Pfizer isn’t doing badly; in fact, despite the credit crunch, they’ve been able to snag $22.5 billion in loans since they also have $26 billion cash on hand. The NYTimes also reports that this merger would be the biggest since AT&T and BellSouth merged back in March 2006. But of course, with mergers always come layoffs. And what a time to have layoffs. Pfizer today announced that they’ll be cutting 8,000 jobs.

But as I said in a previous post, Pfizer’s biggest challenge is get some pipeline products out to market soon since some of the patents on their big names (ie, Lipitor) are expiring soon. Don’t hold me to this but I think Wyeth has a bit more sitting in their pipeline, hence why the merger would make sense. But I hope Wyeth can produce a new blockbuster drug for Pfizer otherwise Pfizer’s really going to be hurting for money. Especially since Wyeth’s best-selling drug, Effexor, is now generic and Pristiq isn’t completely cutting it.

Emotional depression along with economic recession?

suicide rates compared to employment ratesCNN has a story looking into whether suicides increase as the economy falls into a recession and investors begin to lose thousands of dollars in the stock market. According to a chart by the NIH & Bureau of Labor Statistics, there seems to be a correlation. Here are the latest high-profile suicides that seem to have been prompted by the economic downturn:

  • Steven Good, a chairman and CEO of Sheldon Good & Co., a major U.S. real estate auction company, may have shot himself, according to police.
  • Adolf Merckle, a 74-year-old German billionaire who was ranked the 94th richest person in the world by Forbes magazine, killed himself by walking in front of a train. According to the CNN article, “in recent months his empire had been near collapse.”
  • Rene-Thierry Magon de la Villehuchet, a 65-year-old French investor, killed himself after losing $1.4 billion in the Ponzi scheme that Bernard Madoff ran.
  • Kirk Stephenson, 47-year-old English financier  and COO of Olivant Ltd., jumped in front of a train in September (the real climax in the economic collapse).

The Centers for Disease Control and Prevention (CDC) estimates more than 32,000 people commit suicide each year but public health experts expect an increase upwards to an additional 1200 suicides because of the economic climate. Here are a few more stats that are worth reading:

  • Calls to the National Suicide Prevention Hotline went from 412,768 in 2007 up to 540,041 in 2008.
  • Unemployed people are two to four times more likely to kill themselves than those who are employed.

I have to admit, I found that following paragraph interesting:

So what about these wealthy and powerful men who have recently killed themselves? Mental health experts say it’s impossible to say why they did it, but they say that people who kill themselves have an underlying psychological issue, such as depression or bipolar disorder, so it’s not only about the money.

So I pose a question: Do all those who commit suicide have a mental illness? Or is it possible to kill oneself without being mentally ill?

Study shows atypical antipsychotics pose a higher risk for cardiac arrest

The New York Times has reported that a recent study found atypical antipsychotics, which include the friendly family of Clozaril, Abilify, Risperdal, Zyprexa, and Seroquel (maybe Saphris soon), can increase a patient’s risk of dying from cardiac arrest twofold.

The study published in The New England Journal of Medicine also concluded that the risk of death from the psychotropic medications isn’t high. However, an editorial also published in the same issue “urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients, who can be highly susceptible to the drugs’ side effects.”

A U.S. News & World Report article linked to the FDA’s atypical antipsychotics page for further patient information. If you’re on an atypical, I’d recommend reading each word in the patient safety info that applies to you. Proofreaders like me shouldn’t be the only ones tortured with reading all the fine print. *winks*

Eli Lilly settles with U.S. Gov't for $1.42 billion over illegal Zyprexa off-label marketing

payoutYes, you read that right. Eli Lilly has reached a settlement for $1.42 billion with the U.S. government over the illegal off-label marketing of Zyprexa. The company also pleaded guilty to criminal misdemeanor charges. Basically this is how I see it:

U.S. Gov’t: Eli Lilly, you did a bad, bad thing by doing illegal things. Pay a fine, please, and then you can go.

Eli Lilly: Okayyyy. [reluctantly hands over $1.42 billion to the government]

U.S. Gov’t: [slaps Eli Lilly on the hand] Now, don’t you ever, ever do this again!

It’s a record settlement for a whistleblowing case. According to Philip Dawdy at Furious Seasons, Eli Lilly has paid over $2.7 billion in settlement payouts so far. (With certainly more to come.)

US Airways jet falls into Hudson shortly after takeoff; all onboard survive

Praise the Lord! Seriously. God is so merciful. Tragedy averted. A lot of people were spared grief, heartache, and—of course—depression.

US Airways jet
From The New York Times:

A US Airways jetliner with 148 passengers and 5 crew members plunged into the icy Hudson River on Thursday afternoon five minutes after taking off from LaGuardia Airport, and a spokeswoman for the Federal Aviation Administration said everyone on board escaped safely.

Moments after the plane, a twin jet Airbus A320 bound for Charlotte, N.C., landed on the river near the mouth of the Lincoln Tunnel, at least a half-dozen small craft rushed to aircraft to rescue the freezing passengers and crew.

I’m sure more details will be released in the following hours, days, and weeks but I’m so happy to hear that everyone on board the plane was okay. Here’s my favorite quote from the Times article:

“The plane was totally intact,” Mr. Duckworth said. “Everybody thought it was a sea plane. I kept trying to tell them no.”

Actually it looked like everybody was really calm, like on the subway platform when it’s really, really crowded, and everyone’s standing shoulder to shoulder,” he said. “Everyone was standing right up against each other on the wings.”

FDA: No link between Singulair and suicidal behavior

On Tuesday, the FDA announced that an investigation into Merck’s clinical trial data did not discover a link between Singulair (montelukast) and suicidal behavior. The investigation, which began 9 months ago, was prompted by a number of reported suicides, especially that of 15-year-old Cody Miller who took the drug and appeared to have no history of mood or behavioral problems. (It is worth noting here that Singulair “is the top-selling drug for people under 17 years old” and Merck’s biggest seller with annual sales of close to $4.5 billion.)

In attempt to assess Merck’s data better, the FDA also investigated AstraZeneca’s Accolate (zafirlukast) and Cornerstone Therapeutics’s Zyflo (zileuton). Although the FDA did imply that “the data were inadequate to draw a firm conclusion” and said that the clinical trials were not set up to observe any psychiatric behavior. Here are the data the FDA discovered during their review of these trials:

SingulairSingulair: 41 placebo-controlled trials that included 9,929 patients

  • Reports of suicidal thoughts: 1 (treated with Singulair)
  • Attempted suicides: None reported
  • Completed suicides: None reported

AccolateAccolate: 45 placebo-controlled trials that included 7,540 patients

  • Reports of suicidal thoughts: 1 (placebo group)
  • Attempted suicides: 1 (placebo group)
  • Completed suicides: None reported

ZyfloZyflo: 11 placebo-controlled trials (number of patients unknown)

  • Reports of suicidal thoughts: None reported
  • Attempted suicides: None reported
  • Completed suicides: None reported

Forgive me for being cynical but the data sounds fishy. I can’t pinpoint why but it does. The suicide numbers and patient involvement data seem to deviate some from the numbers listed in Merck’s PR issued last March. (I’m seeing 11,000+ patients vs. 9,929 patients.) Regardless of the clinical trial data, it appears that the FDA as of yet have not reviewed post-marketing data.

Scott Korn, a senior safety surveillance executive for Merck said in an article for Reuters:

“‘At the time we did not believe, and we still don’t think a link has been established’ between Singulair and the suicides.”

In the same article, Sanford Berstein analyst Tim Anderson had this to say about the possibility of the FDA finding a link:

“If the… safety review leads to a stern warning about behavioral changes in the Singulair label, this could frighten users of the drug or their parents and give Merck’s competitors ammunition to attack the brand.”

The Washington Post has Dr. David Weldon, director of the Allergy and Pulmonary Lab Services at Scott & White in College Station, Texas, on record saying that he had not “seen any increase in psychiatric problems with the drug but that some patients had complained of nightmares after starting on Singulair.” (Note: It appears that the closest conflict of interest Weldon would have here is that he served as a consultant and is honoraria for AstraZeneca.)

Dr. Rauno Joks, head of the SUNY Downstate division of allergy and immunology, made an interesting point in the Washington Post article:

“The physician really needs to review whether there are symptoms that have developed since patients started taking the medication, if there’s an underlying depression that was there before medication started.

Also, seasonal allergies in and of themselves can cause fatigue and lethargy, which makes it harder to assess, because those are some of the symptoms you have with depression.”

The FDA says they’ve completed analyses of submitted clinical trial data but their “safety review will continue” for several more months before they come to a concrete conclusion. For customer testimonials, check out medications.com that has over 2,300 people reporting side effects and askapatient.com that has an average 2.3 rating from 524 reviewers. The most commonly reported mood-related side effect on both of the sites is irritability.