Johnson & Johnson, one of the largest and most profitable BigPharma companies, is being sued for illegally promoting the use of Risperdal, an antipsychotic with dangerous side effects, in children as young as two years old. J & J isn't the only one doing it, though. Why are they doing it? Profits, pure and simple. As I've written elsewhere, anti-psychotics are now the most prescribed class of drugs in the United States. It's not because there's been an epidemic of schizophrenia or other psychotic disorders. BigPharma has aggressively marketed these medications as the answer for a variety of ills for which they were never intended. More importantly, there is growing evidence that these drugs have very significant side effects in long term use with both adults and children. There has also been no serious investigation into the effects of these drugs on the developing brain. In addition to the harm done patients (see my previous post on PTSD in combat veterans) the overprescription of these medications contributes to our burgeoning health care costs. We spend more money on health care than any other developed country but are in the middle of the pack at best with respect to most important health outcome measures. One of the reasons is Big Pharma's pursuit of profits at any cost in patient well-being, aided and abetted by a medical and psychiatric profession corrupted by incentives and rewards for prescribing the desired drugs.

BigPharma Pushing Anti-psychotics on Little Kids

Celexa and St. John's Wort Ineffective in Treating Depression

This NIMH study adds to the growing body of evidence that antidepressants are ineffective in treating minor depression. In this instance, the antidepressant is Celexa (citalopram.) A popular alternative treatment, St. John's Wort, was also found to be no better than placebo. By the way, the term minor depression is a bit misleading. No depression is minor to the person experiencing it, and it can have debilitating effects. It needs to be treated - just not with antidepressants or St. John's Wort.

No Better Than Placebo

Meds Ineffective and Harmful in Treating Combat PTSD

The trend of throwing powerful psychotropics at all emotional and behavioral problems has many casualties. Now, it seems, our soldiers and marines are among them. The over-marketing of and over prescribing of psychiatric medications, especially anti-psychotics, has accelerated greatly in the last ten years as a matter of profit and convenience. I've written before about the impact on children and  the epidemic of certain diagnoses that are driven by the drugs that can be prescribed for them rather than any scientific evidence. The link below reports that these medications are not only ineffective but harmful. The questions in this case are whether anyone will pay attention and whether the government will resist the inevitable blowback from the BigPharma and psychiatric lobbies designed to keep the cash cow flowing.

Meds Ineffective in Treating PTSD

Is Childhood a "Brain Disease"?

The link below is to a letter by Dr. Mark Foster, a board certified family physician. Dr. Foster tells the story of a six year old boy he saw in an urgent care facility one weekend when his mom brought him in to get an Adderall XR refill. The story is chilling precisely because it is so ordinary and because it reveals what has now become the standard of care in treating childhhod behavioral concerns. It is frightening.

Medicating Kids

Unintended Consequences: Do Antidepressants Increase Risk of Recurrent Depression?

There is strong evidence that long term use of many psychiatric medications actually increases the severity, disabling effects, and recurrence rates of the conditions they purport to treat. I've written about this before (http://raybepko.blogspot.com/2011/01/epidemic-or-marketing.html) in discussing Robert Whitaker's landmark work, Anatomy of An Epidemic. Below is a link to a new study that indicates taking antidepressants actually may lead to rather than prevent chronic depression. They do so by interfering with the brain's natural regulatory mechanisms for managing neurotransmitters, actually creating the "chemical imbalance" they are supposed to treat. It suggests that the reason people experience an increase in depressive symptoms when they stop antidepressants is not because "the depression is coming back" but because the medication has altered the brain's ability to regulate itself. This may also  help in understanding why depression has become a much more chronic condition than it was prior to the Age of Prozac.

Antidepressants May Increase Relapse Risk

Prevention Rather Than Medication???

This interesting article describes a program designed to prevent the development of antisocial behavior in at risk children. The three month program engaged children in activities designed to improve self-management and social interactions. Oppositional and disruptive behavior decreased significantly and there was also a decline in reported hyperactivity and inattention.

This study has important implications that I will be developing over the next several weeks: Prevention works and is much less expensive than treatment in the long run. There are effective non-drug treatments for most behavioral problems. The trend toward identifying all problems as discrete "brain diseases" requiring long term medication is dangerous and disempowers the very people it intends to help.

Prevention Works

Hammering Our Kids

I've written before (Ruminations: Little Pharma: Read It and Weep) about the troubling use of antipsychotics in children as young as 5 or 6. The study linked below reports the impact of these drugs on insulin resistance and increased adiposity, two significant risk factors for cardiovascular disease. Why are these drugs being used? It's not because there has been a sudden epidemic of psychosis in children. It's for purely behavioral reasons. These drugs reduce outbursts and disruptive behavior. Of course they do! If you're agitated, and I hit you over the head with a sledgehammer, I guarantee you will quiet down! That's what's happening here. Kids are being hit with a chemical sledgehammer that puts them at risk for major health problems. It quiets them down. It's quick and requires little thought or effort on anyone's part.What it doesn't do is address the behavior itself or the underlying reasons for the behavior. It also doesn't help children develop internal behavioral controls, coping skills, and ways to meet their needs effectively and appropriately. That would require the expenditure of effort and resources by clinicians, parents, and insurance companies. It's much easier and more profitable to just drug them.

Antipsychotics May Put Kids on the Fast Track to CVD

Preventing Relapse of Major Depression

All dis-ease has biological, psychological and social components. Here's an article about an educational intervention with family members of people who suffer from major depression. The family intervention proved highly effective in preventing or delaying relapse. 

Family Education Effective in Preventing Depression Relapse

Brief and Effective Insomnia Treatment

Insomnia plagues many people. Nobody ever dies of it but it sure makes you miserable! Due to heavy advertising, most people believe the only treatment for insomnia is addictive and expensive medication. It's not. CBT (cognitive behavioral therapy), mindfulness meditation, biofeedback, and hypnosis are all well established and efficacious. Here's a link to a very brief behavioral treatment that was demonstrated to be quite helpful.

Brief Behavioral Treatment of Insomnia

The Real Cost of Budget Cuts

This article by Dr. John Grohol in PsychCentral (America's Mental Health) discusses the Stephanie Moulton murder and the reasons behind it. If you don't come away from it angry, there's something wrong.

This is, of course, not a new problem. De-institutionalization took hold in the 80's as a response to civil rights concerns. Advocates for disability rights pushed for integration and full participation in society, something they believed could not be achieved in institutions. All in all, a worthy and noble goal. Sadly, over the course of the last 25 years or so, de-institutionalization became mainly about money. Resources that were to be shifted to community treatment never got there. Political trends resulted in a dismantling of government provided services and an emphasis on private, so called non-profit agencies. These agencies have a lower staff to patient ratio and thus more patients for fewer workers, pay employees significantly less with minimal benefits, and often have high turnover of younger, generally less well educated staff who get some experience and move on to the few remaining government jobs or get out of the field altogether. The irony is that de-institutionalization has really served no one particularly well. Many former psychiatric inpatients found themselves inmates, as the Corrections systems took over from the mental health system when these individuals were unable to successfully navigate in the community and wound up in trouble with the law. Communities saw increases in homeless populations and, often, crime. Families experienced increased stress in desperately trying to find services for their mentally ill relatives. Taxpayers failed to see a reduction in taxes as resources were shifted to much more expensive correctional services. (In New York, this was a highly visible process as former psychiatric and developmental centers were converted directly into prisons.) In this context, violence is not only unsurprising, it is predictable. Stephanie Moulton is not the first nor will she be the last victim. In February, 2008, Dr. Kathryn Faughey (Casualties of a Failed System and No Justice) was murdered in her New York City office by David Tarloff, a psychotic patient who couldn’t find his intended target and killed her instead. Two days later and a thousand miles away, Steven Kazmierczak walked into a college classroom and opened fire, killing Daniel Parmeter, Catalina Garcia, Ryanne Mace, Julianna Gehant, and Gale Dubowski before killing himself. What did the killers have in common? Both had long histories of mental illness, revolving door hospitalizations, and repeated refusal of medication.

The system worked as designed – and somebody died.

America's Mental Health

The System Worked - And Somebody Died

Stephanie Moulton was killed this January by Deshawn Chappell. Stephanie was a worker in a group home for the mentally ill in Massachusetts. Deshawn is a schizophrenic who was decompensating for some time prior to the killing. They were alone in the group home. The mental health system worked as designed - and somebody died. This isn't the first time and it certainly won't be the last. Mental health budgets are being slashed all over the country and, in time, more people will pay for the budget cuts with their lives. It's not just money, though. The system as designed is fatally flawed. I wrote about this issue after the murder in 2008 of Dr. Kathryn Faughey, a friend from graduate school (Casualties of a Failed System and No Justice.) Not only have things not changed. They've gotten worse. 

A Schizophrenic and A Slain Worker

Hypnosis Helpful in Breast Cancer Treatment and Recovery

"A new European study using hypnosis in combination with local anesthesia for certain types of surgery found the the paired approach aided healing, reduced drug usage and allowed an earlier hospital discharge."

I've used hypnosis in my practice for many years and found it quite helpful in treating chronic pain, irritable bowel syndrome, and a number of other conditions. Most interesting to me is its utility in helping people get through surgery, chemotherapy, and radiation treatment. I've used it myself with my own surgeries and rehabilitation.

Hypnosis Effective in Breast Cancer Treatment and Recovery

"Good" Things That Might Make You Feel Worse!

There are things "everybody knows" that are actually wrong, sometimes even harmful. Here's a post on six common solutions to feeling bad that actually might make things worse. By the way, the blog, Psych Central, is quite informative and solid though sometimes, from my point of view, too prone to pathologizing normal human experience and too biased towards medication as the answer to life's problems.

Good Things to Do? Maybe Not!

Need Therapy? A Good Man is Hard To Find!

This is a complicated issue. Men find it difficult to go into therapy for many reasons. One is the relatively low number of male therapists. Should it matter? Perhaps not, but then you would have to argue that women should not prefer female therapists. Research indicates that in the long run the gender of the therapist is not significant to therapeutic outcome. It is in the decision to seek therapy that it matters. Patients believe, rightly or not, that having a same gender therapist will be more comfortable for them. This belief and the difficulty in finding a male therapist contributes, along with other factors, to the reluctance of men to enter a therapeutic relationship.

Need Therapy? A Good Man is Hard to Find

Abusing the Elderly with Antipsychotic Medication

Antipsychotics are too often used to control behavior in two of our most vulnerable groups: children and the elderly. The behavior is often an adaptation to an unsupportive, chaotic, dysfunctional, overstimulating or, in some cases, understimulating environment. I've written about the over use of medications with children before. Here is an article outlining the risks for seniors. Why is it done? Two reasons, mainly: convenience and money. If you have a depressed, unhappy, or angry resident in a nursing home, it's much easier to zonk them with meds than to address their concerns. It's easier for the administrators, staff, and physicians. It's also cheaper, at least in the short-run. So, our most vulnerable continue to be subjected to medications proven to be quite risky and not proven to be effective at much beyond over-sedation.

Antipsychotics Hazardous to Elderly

The Pill for SLS!

The ultimate pharmacotherapy for SLS (Sucky Life Syndrome.) 

Here's the ad tag line:

You don't have to change a damn thing! Just swallow this!

It'll make a gadzillion dollars!

Patients Aren't "Consumers"

This directly addresses a primary problem with health care in our country. It is now seen as a commodity like oil, cars, or soybeans. Patients are reduced to "consumers" while health care professionals are reduced to "providers." This absurd notion is at the heart of the Ryan/Tea Party/Republican plan to gut Medicare, shift more costs to seniors, and enrich (further) the insurance companies. When you, a family member, your parent, or grandparent is faced with a serious or life threatening health problem, you are not going to have the time,  information, inclination, or knowledge to compare several treatments or "providers" as you might do if you were buying a new high def TV. 

Health Care is NOT A Commodity

Pills for All Your Ills!

This very funny video really shows our culture's rush to pathologize normal human emotions, make everything a disease, and find a pill for every ill. We really have bought into the old DuPont slogan "Better Living Through Chemistry."

Pills for Your Ills

Be A Real Pain - It Could Save Your Life!

If you or a family member are hospitalized, you need an advocate who is not afraid to be considered a pain in the ass. It is literally a matter of life and death. Check out this link.

Be a Real Pain - It Could Save Your Life

Psychotherapy Effective in Treating Depression

Yet another study indicating the value of psychotherapy in comparison to medication: As effective in the short-term, more effective in the long term. And, of course, no side effects. So, why is psychotherapy so poorly reimbursed by insurance companies and generally ignored by psychiatry? The average reimbursement for psychotherapy has decreased since 1985, not in relative terms but in actual dollars. Do you know any other profession that makes less than it did in 1985? You? Your plumber? Your mechanic? Your physician? I didn't think so! Insurance companies maximize profit - that's their objective. Psychiatry has abandoned psychotherapy for one reason - you can make a hell of a lot more money in four fifteen minute prescription sessions than in a single one hour psychotherapy session. See the second link, below. The reality is that psychiatrists don't get much training in psychotherapy any more because the emphasis is medicate, medicate, medicate. So, why is this important to anyone but psychologists and other psychotherapists? For a couple of reasons, I think. One is scientific and one is social. To shift people away from proven, effective treatment is to deny patients the most efficacious treatment in the long run. The social reason is more insidious. There's an old saying that when the only tool you have is a hammer, everything begins to look like a nail. When the only treatment you are willing to employ is medication, everything - every human emotion, behavior, problem, difficulty - becomes a disease. Hence, the epidemic of various diagnoses I've alluded to elsewhere on this blog. Telling people that their problems are all diseases and what they really need is the latest heavily advertised drug is disempowering and disenfranchising. People are taught and then believe that they have little influence and power over how they feel, act, and relate - it's "my bipolar," "my depression," "my anxiety," etc., making me feel or act this way. This ignores the science and defeats the spirit, creating an even greater need for more medication. And we wonder why health care costs are spiraling out of control!

Psychotherapy vs Second Generation Anti-depressants

Talk Doesn't Pay So Psychiatry Turns to Drugs

Denying Care to Brain Injured Vets

It's easy to put a Support Our Troops bumper sticker on the back of your car. It feels good and costs nothing. Here's what costs: paying for the long term treatment and care for service members suffering from traumatic brain injury. That requires - brace yourselves - taxes. In the frenzy undertaken by House Republicans to make the world safe for corporate socialism, lots of people suffer. The poor. The middle class. And the men and women we send into harm's way. Tricare, the mangled care - oops, managed care - organization that insures military personnel, veterans, and their families is refusing to provide the kind of care that has been repeatedly shown to bring about the best recovery for brain injured vets, cognitive rehabilitation therapy. Why? Well, it's expensive so they contracted with a private consultant to say more study is needed despite the overwhelming evidence for its efficacy. Want to do something to really support our troops? Write or call your Congressional Representative and US Senators and urge them to demand that Tricare provide the treatment our service members need and deserve! Please pass this on.

Denying The Best Care to Our Troops

Antidepressants Not Effective for Minor Depression

Most people who are depressed experience minor depression (though it never feels "minor" to the individual.) Minor depression is a dysphoric mood that leaves the person unhappy most of the time but does not significantly impair day to day functioning. The vast majority of prescriptions for antidepressants are written for minor depression, costing the health care system and, ultimately, all of us billions of dollars. As this review indicates, antidepressants are no better than placebo for minor depression. i.e., they don't help. They do enrich the pharmaceutical companies so don't expect the science to change the practice.

Antidepressants Not Effective with Minor Depression

Drug Cocktails - Easy, Cheap, and Fatal

The incidence of PTSD and other mental health disorders in the armed forces is extremely high for a number of reasons: a ten year war, multiple tours, and repeated exposure to intense violence and fear are some. Two additional reasons: a shortage of mental health professionals and the over-reliance on prescription medications. Sometimes troops are given drug cocktails and sometimes these prove fatal. More soldiers are now dying from suicide than from combat. As Congress looks to the most vulnerable to cut the budget to preserve tax cuts for the wealthy and the corporations, please put some pressure on them to at least give our troops what we promised - first rate care during and after their service.

Drug Cocktails

Antipsychotics' Effect on the Brain

I've written previously about the potential negative impact of long term use of psychotropic medication on the brain. This new article in the Archives of General Psychiatry provides further evidence. Antipsychotics used to treat schizophrenia appear to cause a loss of brain tissue over time. Subtle but important cognitive impairments have long been noted in schizophrenics but were thought to be a result of the disorder itself. Now it is becoming increasingly clear that these effects are due to the drugs used to treat schizophrenia. Robert Whitaker has written extensively about this phenomenon in Anatomy of An Epidemic. Antipsychotics are not the only psychiatric drug that cause significant problems for people. However, the antipsychotics are of particular concern for two reasons. The first is the change in the brain itself, as described in the article linked below. The second reason is the widespread prescription of anti-psychotics for non-psychotic reasons. Antipsychotics are heavily marketed for other symptoms including depression and mood lability. And, as I've written previously, they are increasingly used with children. Psychiatry and BigPharma have invested very heavily in the notion of every human problem as a "brain disease" due to "chemical imbalances" that can only be remedied with drugs prescribed, of course, by psychiatrists. We are beginning to see the results of this overly simplistic, reductionistic model of human behavior.

Antipsychotics for schizophrenia associated with subtle loss in brain volume

Of the Corporation, by the Corporation, and for the Corporation!

When will people wake up to the fact that we have become a country of the corporation, by the corporation, and for the corporation? That both parties are complicit in policies explicitly designed to facilitate the massive accumulation of wealth by the very few and a rapid race to the bottom by the rest of us? That attacks on government and public employees for so-called sweet benefits and pensions are nothing but a cover for the corporate plundering of benefits and pensions in the private sector while profits and bonuses for executives go through the roof?

Business Doesn't Need American Workers

Little Pharma: Read It and Weep

Maggie Kozel, M.D. reveals a very frightening statistic: One in four American kids take chronic prescription meds. That's right, 25% of our children are taking daily medication for chronic conditions. Over 40 million kids are taking stimulants, anti-depressants, and anti-psychotics. The science behind this prescription epidemic? To put it kindly, it's poor. Poor diagnostic criteria, poor clinical studies establishing efficacy and safety, and extremely poor long term understanding of what happens in a child's brain when you disturb it with pharmaceuticals designed for adults and, e.g., fundamentally alter the serotonin system. Our health care system is way off track. It's bad enough when it hurts adults. What the pharmaceutical industry is doing to our children is criminal.

Little Pharma: One in Four Kids Medicated

Brain Changer

Marketing has convinced people that mood disturbances like depression and anxiety are due to "chemical imbalance" in the brain. There's little evidence for this causal explanation. Our brain chemistry may change as a result of many things, including depression, anxiety, stress, joy, positive or negative thinking, and as indicated in this article, meditation.  Meditation has been very helpful in improving mood disorders, stress, attention, insomnia, and a host of other conditions. More importantly, it seems to enhance one's ability to be a fully present and active participant in one's own life. 

How Meditation May Change the Brain

The Truth About Psychotropics

Despite the 5 Billion dollar marketing campaign by Big Pharma, the science underlying the widespread and long term use of psychotropic medication is woefully inadequate. These medications are expensive, have sometimes very serious side effects, may create the very problems they purport to cure, and their long term safety has not really been established. Are they useful for some patients in some circumstances? Yes. Are they useful for most patients in most circumstances? No. Should they be used as a first line and exclusive treatment for the complicated life circumstances that lead to emotional and behavioral disorders? Never.

The Truth About Psychotropics

Big Pharma Rip Offs

"Even during a two-year recession with people losing their homes and jobs, pharma is still the nation's third most profitable sector. How does it do that? In part by cheating the government, misrepresenting science, bribing doctors, patients and pharmacies, and squeezing the FDA. Other than that, the industry plays completely fair."  

Check this out if you want to see one reason why health care costs are so high. 

Big Pharma Rip-Offs

Epidemic or Marketing?

Robert Whitaker's "Anatomy of An Epidemic" discusses the so-called biological psychiatry revolution of the past 30 years. In essence, there has been an explosion of psychiatric disability coinciding with the widespread adoption of the antipsychotics, mood stabilizers, anxiolytics, and stimulants. These drugs have resulted in more disability rather than less and, Whitaker argues, do more harm than good, often creating the very disturbance in brain chemistry they purport to treat. The diagnostic criteria for "mental illnesses" have broadened to the point where a wide variety of human experience has been medicalized and pathologized. It is no coincidence that this has occurred in the context of multi-billion dollar marketing campaigns by the big pharmaceutical companies. Formerly rare disorders have now become, quite literally, epidemics. Bipolar disorder is, perhaps, the best example. Prior to the marketing of the mood stabilizers and anti-psychotics, this was a disorder that occurred infrequently and a had a brief, limited and often non-recurring course. Now, if you have anger issues or are moody, especially if you are female, or if you abuse alcohol or drugs, the odds are you will be diagnosed bipolar. The criteria for the disorder have been broadened so much as to be meaningless. Worst of all, if you believe the marketing hype, there is now an epidemic of bipolar disorder among children. We are now medicating children as young as three or four for a condition that, prior to the introduction of these drugs, was thought not to occur in children. The biological psychiatry revolution has, in essence, expanded the profits of the drug companies by creating disease and disorder. More insidiously, the drug companies have promoted the belief that the individual can do nothing to change his or her life.  Their pitch is that for every human discomfort or distress, well, "there's an app for that" in the form of an expensive medication.

Anatomy of An Epidemic

Better Living Through Chemistry?

The last half-century and, in particular, the last 20 years have witnessed the marketing of scores of psychiatric drugs. It seems there's now a pill for every human dilemma and difficulty. Are you shy? You must suffer from the disease of Social Anxiety Disorder! Zoloft will help that! Your anti-depressant not improving your satisfaction with life? Well, have no fear! The anti-psychotic Abilify will do the trick! Your marriage, finances, kids, and job got you worried? You have Generalized Anxiety Disorder! Take Xanax and all your worries will go away!  Have difficulty getting things done? You must have the disease of Attention Deficit Hyperactivity Disorder and, you guessed it, you need Ritalin, Concerta, Strattera, or Adderall for that! Moody, irritable, and angry some of the time (especially while female all of the time?) You must have Bipolar Disorder and need Abilify, Risperdal, Zyprexa, or Geodon for that! Experiencing side effects from all your meds? Not to worry, there are other meds to counteract the side effects!

Here's the question. Has the widespread promotion and use of these medications been beneficial? Or, have they caused as much or more harm than benefit? This is a complicated issue and I will be writing about it a lot on this blog. My basic position is as follows. In some instances and usually for the short term, some of these medications can be very helpful. In most instances and for the long term, they are more likely to harm than help, both psychologically and physically. The expansion of psychiatric diagnostic categories to cover just about every discomfort encourages the belief that every problem is a disease and the only solution is a drug. It also disempowers people and discourages them from taking control of their own lives. 

This is not in any way to minimize the suffering caused by emotional and behavioral problems! My argument is that people, if they know how, can often solve these problems themselves or with professional help. And they can do so without perturbing their brains. Much more to come.

It's Insane to Let Crazy People Purchase Guns

Jared Loughner

Virginia Tech Shooter and his first gun, a Glock 9

The Arizona gunman is, unfortunately, not the first and most certainly won't be the last example of a crazy person with easy access to weapons causing havoc and grief. I've written about de-institutionalization previously in this blog. Nobody really gives a damn about the seriously mentally ill until something like this happens, and the current concern will pass in a few weeks. And you can't even bring up the issue of reasonable gun regulations - the gun lobby and the Republican Party have made that the true third rail of American politics.

The closing of the psychiatric centers was due to several factors, primarily financial. The promise was that de-institutionalization was supposed to be accompanied by shifting resources to MH services in the communities. That didn't happen, in part because societal and political pressures favored tough "law and order" policies that were and are extremely expensive – and the mentally ill don’t vote in large numbers. The mental health disaster is not strictly a Republican or Democratic problem; there is plenty of blame to go around. As for mental patients getting guns, I'm afraid that's on conservative politicians and the all powerful NRA. The Clinton era laws that restricted access to semi-automatic weapons expired in 2004 when the Bush Administration and Republican Congress refused to renew them largely due to the NRA. Thus, Jared Loughner could walk into a store and legally purchase a Glock 9. Those are the facts.

  

What Next?

This is a very thoughtful analysis in the Sunday NY Times by Matt Bai of the political rhetoric and the Arizona shootings. The question is what's next. I'm afraid nothing will change. There's too much money in flame-throwing.

The end or the beginning?

Health Care in America is a Disaster

Health care in America is a disaster. We spend more money on health care than any other developed country and get less for it. Consider this:

• Medicare is the single largest Federal spending program and if it isn't reined in will consume almost all federal tax revenues in another few years.
• Medicaid is bankrupting the states (New York, for example, spends $1,000,000,000 per week on Medicaid, that's right, a billion dollars every seven days.) 
• Big Pharma and Big Insurance lobbies dominate health care policy in this country and they are making us sicker and poorer. The new Congress will be no different. Just this week high ranking staff appointments to the committees that regulate insurance and health care came directly from, you guessed it, the insurance and health care companies they are to regulate. 
• Patients pressure their physicians for the newest - and most expensive - drugs in response to Big Pharma's $10 billion advertising campaign even though there is little evidence that these drugs are better than the generics they compete against.
• More money is spent on psychiatric drugs than almost any other category. Yet the rate of psychiatric disability has exploded in the last twenty years, the era when psychiatric "wonder drugs" have been promoted for just about every conceivable problem people might experience. (Much more to come on this topic.)

I'll be writing more about this and other topics as we go along. What are your thoughts about the state of health care and what needs to be done about it?

My Broken-Down Upstate City

This site will be about health care, behavioral health care in particular, and politics, local, state, and national. First, though, I'd like to call your attention to another blog.

My wife, Cindy Day Bepko, has started a blog about Upstate New York and Utica in particular.  It's called My Broken-Down Upstate City. Check it out! 

http://mybroken-downupstatecity.blogspot.com/