Archive for the ‘Treatment’ Category

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Newly Prescribed ADHD Medications May Cause Psychosis, Study Finds

https://www.nbcnews.com/health/kids-health/common-adhd-medications-may-cause-psychosis-study-finds-n985616  News Story in Link

Newly prescribed ADHD medications may cause psychosis, study finds

“Those those who have taken the drug and tolerated it well, should not be concerned,” experts say.

By Linda Carroll

 

Certain medications used to treat ADHD in teens and young adults may be more likely to cause symptoms such as paranoia, hallucinations, delusions and hearing voices, a new study suggests.

Researchers found that patients who had been newly prescribed amphetamines, such as Adderall and Vyvanse, were more likely to develop psychosis than those who had received a prescription for methylphenidates, such as Ritalin and Concerta, according to the study published Wednesday by the New England Journal of Medicine.

While psychosis with either class of medication is still relatively rare — occurring at a rate of one in 660 patients — experts cautioned that patients should know about the increased risk.

They also noted that the increased risk was only for those who recently began treatment with a new amphetamine prescription for ADHD and that those who have taken the drug and tolerated it well should not be concerned.

“If someone has been on Adderall, they’re tolerating it well, it’s helpful for their symptoms, and they’re taking it as prescribed, there’s really not much cause for concern,” said the study’s lead author, Dr. Lauren Moran, an assistant professor at the Harvard Medical School and a psychiatrist at McLean Hospital.

“Still you have to think about it from the public health scale,” Moran added. “If it’s a fraction of a percent of millions of people then that means there could be thousands of additional cases of psychosis across the United States. In my mind that’s a serious problem.”

Amphetamine prescriptions to treat ADHD have been steadily rising, increasing cause for concern.

“At the beginning of our study, in 2005, a patient had about a 50-50 chance of getting Adderall or Ritalin. There has been a huge increase in Adderall prescriptions over the course of the study to almost four times as many prescriptions for Adderall,” Moran said.

As the number of students with psychosis grew, Moran decided to look further into the issue. What she found was that a common factor among the cases seemed to be amphetamine prescriptions for ADHD.

To determine whether there really was a higher risk of psychosis associated with amphetamines, Moran and her colleagues turned to two large commercial insurance claims databases, which included more than 5 million patients with a stimulant prescription.

The researchers focused on patients 13 to 25 years old who started taking either amphetamines or methylphenidates from Jan. 1, 2004, to Sept. 30, 2015. Among more than 221,846 patients included in the study, 110,923 were taking methylphenidate and 110,923 were taking amphetamines. The study focused only on new users of the medication.

New cases of psychosis were identified in 106 of the patients taking methylphenidate, as compared to 237 in those taking amphetamines, nearly double the rate.

The Food and Drug Administration has been aware of the issue of psychosis. In fact, in 2007 the federal agency mandated that ADHD medication labels include warnings about potential psychiatric and heart issues.

In Moran’s experience, ADHD patients hospitalized for psychosis recovered in two weeks on average, but some patients took as long as two months.

Moran isn’t suggesting that ADHD medications are too dangerous to be prescribed, but wants to inform patients about its use.

“We’re trying to raise awareness,” she said. “Physicians need to be aware of this when prescribing, and people who are getting these medications from friends in college need to know this is a risk.”

Experts interviewed by NBC News agreed that there should be greater awareness of the risks associated with these medications.

The new study emphasizes the need for physicians to be “extremely careful to diagnose ADHD appropriately and to provide appropriate treatment,” said Dr. Antoine Douaihy, a professor of psychiatry and medicine at the University of Pittsburgh School of Medicine and senior academic director of Addiction Medicine Services at the University of Pittsburgh Medical Center. “And they need to monitor patients closely so they can identify early signs of behavioral changes related to psychotic or manic symptoms.”

While the study shows that psychosis is a risk for both stimulants, it does suggest that amphetamines “may be more implicated than methylphenidates,” said Dr. David Goodman, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and director of the Adult Attention Deficit Disorder Center of Maryland. A limitation of the study is that the databases used by the researchers don’t have detailed information on how patients were diagnosed, Goodman said.

Goodman hopes that the study, and the coverage it gets, will make doctors and patients treat these medications with care. But he hopes all the attention won’t scare patients away from ADHD drugs.

“Left untreated, ADHD has so many negative consequences,” Goodman said.

 

Tick-Borne Relapsing Fever in Arizona

https://wwwnc.cdc.gov/eid/article/25/4/18-1369_article

Volume 25, Number 4—April 2019

Tick-Borne Relapsing Fever in the White Mountains, Arizona, USA, 2013–2018

Neema Mafi, Hayley D. Yaglom, Craig Levy, Anissa Taylor, Catherine O’Grady, Heather Venkat, Kenneth K. Komatsu, Brentin Roller, Maria T. Seville, Shimon Kusne, John Leander Po, Shannon Thorn, and Neil M. Ampel

Abstract

Tick-borne relapsing fever (TBRF) is a bacterial infection transmitted by tick bites that occurs in several different parts of the world, including the western United States. We describe 6 cases of TBRF acquired in the White Mountains of Arizona, USA, and diagnosed during 2013–2018. All but 1 case-patient had recurrent fever, and some had marked laboratory abnormalities, including leukopenia, thrombocytopenia, hyperbilirubinemia, and elevated aminotransaminases. One patient had uveitis. Diagnosis was delayed in 5 of the cases; all case-patients responded to therapy with doxycycline. Two patients had Jarisch-Herxheimer reactions. The White Mountains of Arizona have not been previously considered a region of high incidence for TBRF. These 6 cases likely represent a larger number of cases that might have been undiagnosed. Clinicians should be aware of TBRF in patients who reside, recreate, or travel to this area and especially for those who sleep overnight in cabins there.

_______________

**Comment**

Do you see the trend yet?  Ticks, pathogens, and disease where they aren’t supposed to exist.  Yet they do.  This study also demonstrates that the Lyme caused by B. burgdorferi is NOT the only borrelia spirochete we need to be concerned about. While the study states,

“In the United States, B. hermsii is thought to be the most common cause of TBRF, and transmission is associated with the bite of soft O. hermsi ticks. Ornithodoros spp,” 

they are not the sole perps as seen below.  A U.S. solider acquired TBRF with the B. turicatae strain and in Europe the strain was caused by B. corocidurae.  The truly frightening aspect is the potential rapid transmission.

https://madisonarealymesupportgroup.com/2017/12/22/tbrf-in-texan-dogs-yep-despite-poor-tests-its-there/

https://madisonarealymesupportgroup.com/2019/01/10/relapsing-fever-found-at-popular-recreation-site-in-ca-ticks/

https://madisonarealymesupportgroup.com/2018/12/20/tick-borne-relapsing-fever-as-a-potential-veterinary-medical-problem/

https://madisonarealymesupportgroup.com/2017/05/04/us-soldier-aquires-tickborne-relapsing-fever-caused-by-b-turicatae-from-a-ornithodoros-turicata-tick/

https://madisonarealymesupportgroup.com/2019/03/17/first-case-of-b-corocidurae-in-native-european-presenting-as-meningitis-with-cranial-polyneuritis-cavernous-sinus-thrombosis/

https://madisonarealymesupportgroup.com/2018/12/28/relapsing-fever-spirochete-uniquely-adapted-to-highly-oxidative-salivary-glands-of-soft-bodied-tick/

A population persists in the salivary glands allowing for rapid transmission to mammalian hosts during tick feeding.

Much can be learned about Borrelia turicatae by reading this case study:  https://wwwnc.cdc.gov/eid/article/23/5/16-2069_article

We learn:

  • Ornithodoros turicata soft bodied ticks, are endemic to Texas and Florida
  • They are found in caves and ground squirrel or prairie dog burrows  https://madisonarealymesupportgroup.com/2018/04/23/tick-borne-relapsing-fever-found-in-austin-texas-caves/
  • Once infected, they remain infected for the rest of their lives, which can be up to ten years.
  • Attachment is painless
  • They are rapid night feeders (5-60min)
  • Due to their rapid feeding they are rarely found or leave lesions
  • Patient in study suffered with headache, nausea, & pain behind knees
  • Had numerous lesions which resolved after 6 days (without treatment)
  • Developed persistent fever
  • Developed thrombocytopenia (low platelets)
  • Developed elevated Erythrocyte sedimentation rate & C-reactive protein
  • Improved rapidly with doxycycline
  • Platelet count normalized within 2 weeks
  • Asymptomatic soldiers with similar exposure were treated prophylactically
  • TBRF is a neglected and probably underdiagnosed disease
  • Published cases in Texas have been supported by serology for the TBRF group, exposure location, and tick collections, but the authors state successful identification of B. turicatae in a human has not been reported
  • Military training groups in Israel have declared certain caves off limits because of heavy tick presence https://madisonarealymesupportgroup.com/2017/10/27/israeli-kids-get-lyme-disease-from-ticks-in-caves/ and have prophylactically administered doxycycline to those suspected to have been exposed
  • Asymptomatic patients given doxy don’t have a Jarisch-Herxheimer reaction but those with active illness do
ANOTHER STUDY DEMONSTRATING THE WILY AND ADAPTABLE NATURE OF SPIROCHETES.

 

 

FREE Webinar: Mold & Mycotoxins – Dr. Jill Carnahan

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Vibrant Presents Dr Jill Carnahan for Mold and Mycotoxins
Join us for this highly educational session with Dr Jill Carnahan, a leading expert in mold and mycotoxin illnesses while she discusses the available technology and testing methods for mold and mycotoxin exposure, walks through some case studies, and gives suggestions for pre-test measures and treatment.
Time:  Mar 26, 2019 6:00 PM in Central Time (US and Canada)

 

 

Raising Red Flag Over Lyme

https://www.suncommunitynews.com/articles/the-sun/raising-red-flag-over-lyme/

Raising red flag over Lyme

Eagle Lake resident warns public to take disease seriously

BY MARCH 1, 2019

________________

**Comment**

  1. We still don’t know everything about why some become chronically ill, and while delays in diagnosis are a factor, treatment failures have been documented since the beginning:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/
  2. There is also the issue of there being more subsets of patients besides “acute” and PTLDS:  https://madisonarealymesupportgroup.com/2019/02/25/medical-stalemate-what-causes-continuing-symptoms-after-lyme-treatment/
  3. Until the pleomorphic and polymicrobial nature of Lyme/MSIDS is recognized, patients are doomed:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/
  4. Blood tests for Lyme/MSIDS is abysmal, missing over half of all cases.  There has been a concerted suppression of microscopy and other forms of testing:  https://madisonarealymesupportgroup.com/2018/10/12/direct-diagnostic-tests-for-lyme-the-closest-thing-to-an-apology-you-are-ever-going-to-get/, https://madisonarealymesupportgroup.com/2019/02/27/should-lyme-patients-rico-lawsuit-include-yale/
  5. Climate change has NOTHING to do with this:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

“The authorities have been using tick expansion and climate change to get research dollars. Climate change is a popular topic right now, and that is a great source of funding for related research. However, any research on ticks and climate change is inconclusive––in essence, there is no validity. The long-range, futuristic projections and statistical models are bogus science because blacklegged ticks have already been found in northern Canada. In fact, we documented blacklegged ticks on migratory songbirds in northern Alberta dating back to 1998. Any allocation of government funding for ticks and climate change research is a complete waste of taxpayers’ money. It will not help Lyme disease patients one iota.”  Independent Canadian tick researcher, John Scott

Few LLMD’s take insurance forcing patients to pay expensive long-term bills out of pocket. Insurance companies are the ones coming after doctors who dare to treat in a way that is outside the CDC guidelines of essentially 21 days of doxycycline:  https://www.dailykos.com/stories/2012/01/29/1059800/-Wisconsin-Lyme-doctor-gets-reprieve?  Once they flag a doctor they nit-pick until they find any little thing:  https://sciencebasedmedicine.org/chronic-lyme-vip-daniel-cameron-disciplined-by-new-york-medical-authorities/

The Lyme Wars are far from over.

https://madisonarealymesupportgroup.com/2017/10/24/lyme-wars-part-1-julias-story/

https://madisonarealymesupportgroup.com/2017/10/25/lyme-wars-part-2-kyra-overcomes-chronic-lyme-diagnosis/

https://madisonarealymesupportgroup.com/2017/10/26/lyme-wars-part-3/

https://madisonarealymesupportgroup.com/2017/10/27/lyme-wars-part-4/

https://madisonarealymesupportgroup.com/2017/10/28/lyme-wars-part-5-coinfections/