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Psychiatry

Marijuana for ADHD

Marijuana for ADHD – what’s the evidence?

Those of you who follow this website know that I frequently take down myths about the medical usefulness of marijuana. Let’s just say the evidence barely reaches the level of “sparse.” Recently, Tara Haelle pointed me to an article that trumpeted using marijuana for ADHD, attention deficit hyperactivity disorder.

ADHD is a psychological disorder in which the individual is unable to focus, is overactive, is unable to control behavior, or a combination of these, not appropriate for the age of the individual. Diagnosing ADHD is often difficult, because the differential diagnosis for the condition can be confused with or related to other emotional, psychiatric or neurodevelopmental disorders such as anxiety, major depressive disorder, and bipolar disorder.

There are some treatments available for ADHD, including stimulants such as the well-known medications, methylphenidate, or better known by its trademarked name, Ritalin, and Adderall, a mixture of two amphetamines. These stimulants are very effective for treating ADHD, but there are some risks to its use, and the effectiveness appears to lower over time.

So let’s look at marijuana for ADHD – it’s pretty weak, but let’s give it a good scientific skeptical analysis.

Read More »Marijuana for ADHD – what’s the evidence?

Pseudoscience and psychopathy

psychopath-lecterGuest post by Matthew Facciani

There has been a news story creating some buzz lately regarding recent claims made by neuroscientist James Fallon, a Professor of Psychiatry at the University of California-Irvine School of Medicine. Dr. Fallon studied the brains of psychopaths for a few years and later saw that his brain was just like those of the psychopaths he studied. Many news outlets are picking up on this story as Dr. Fallon has just released a new book about it as well.

To summarize, Dr. Fallon had received a PET scan of his brain in conjunction with an Alzheimer’s disease study, and subsequently noticed that his PET scan image was eerily similar to PET scan images from those of the psychopaths he researched. These articles then reported how both the psychopaths and  Dr. Fallon had less activity in the frontal and temporal lobes which he claimed are linked to empathy, self-control, and morality. Beyond the PET scan results, Dr. Fallon mentions how he his family has the “Warrior Gene” which is associated with aggressive behavior.Read More »Pseudoscience and psychopathy

Treating depression with acupuncture-evidence is lacking

hellraiser-pinheadLet’s start out with a basic point–acupuncture does not work. For anything in medicine. And because there is a small, but significant, risk associated with the “procedure,” the risk to benefit ratio is huge (if not infinity, since there is no benefit). 

Just in case you don’t believe me, Steven Novella, MD, of the Science Based Medicine blog, clarifies why acupuncture does not work:

Clinical research can never prove that an intervention has an effect size of zero. Rather, clinical research assumes the null hypothesis, that the treatment does not work, and the burden of proof lies with demonstrating adequate evidence to reject the null hypothesis. So, when being technical, researchers will conclude that a negative study “fails to reject the null hypothesis.”

Further, negative studies do not demonstrate an effect size of zero, but rather that any possible effect is likely to be smaller than the power of existing research to detect. The greater the number and power of such studies, however, the closer this remaining possible effect size gets to zero. At some point the remaining possible effect becomes clinically insignificant.

In other words, clinical research may not be able to detect the difference between zero effect and a tiny effect, but at some point it becomes irrelevant.Read More »Treating depression with acupuncture-evidence is lacking

Flu during pregnancy is associated with bipolar disorder in children

pregnant-flu-vaccineA recent article published in a leading psychiatry journal, JAMA Psychiatry, has shown that pregnant mothers’ exposure to the influenza (flu) was associated with a nearly 4X increase in risk to their child eventually developing bipolar disorder in adulthood. These findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza. Bipolar disorder, historically called manic depressive disorder, is a mood disorder where the sufferer can experience episodes of a frenzied state known as mania (or hypomania), typically alternating with episodes of depression. It can be treated with medications and psychotherapy (especially cognitive therapy), but more difficult cases require the individual to be voluntarily or involuntarily institutionalized until the mood changes can be reduced or eliminated.

Read More »Flu during pregnancy is associated with bipolar disorder in children

Placebos cannot replace antipsychotics

As I’ve discussed previously, placebo effects are mostly a myth, and if a new drug has an effect barely above that of a mythical placebo effect, it’s considered a failure. In a recent article in Reuters Health, Rising placebo response seen in schizophrenia trials, Amy Norton states that clinical trials of anti-schizophrenia drugs, in a class of drugs called antipsychotics, are finding lesser effects because patients are responding positively to placebos (that presumably does not contain anything but sugar).

Treating schizophrenia or any psychosis is difficult because different patients respond in different ways to each drug. For some individuals, these drugs can treat many of the symptoms of schizophrenia, including hallucinations and delusions, which allows them to live relatively normal lives. But for some individuals these same drugs have significant side effects, including sedation, weight gain, and hyperglycemia (which can be serious for a diabetic). Eventually, individuals stop using the drugs because of the side effects and their psychotic symptoms return.Read More »Placebos cannot replace antipsychotics

LeRoy neurological illness mystery–update 3–is it conversion disorder?

Since I last wrote about the group of individuals suffering from some neurological issues in LeRoy, NY (outside of Rochester), very little new information has come to light.  The junk science purveyors, such as the Age of Autism, is still trying to insinuate that vaccines have something to do with the “outbreak”, although they provide not one tiny bit of evidence supporting such a belief.

A few individuals still claim it is PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, but I am highly skeptical of physicians who self-promote their ideas outside of the standard peer-review process, and that a lot of reviews of the research into PANDAS has come out negative.  As I’ve mentioned before, a recent review of research in PANDAS came to this conclusion: “Despite continued research in the field, the relationship between GAS and specific neuropsychiatric disorders (PANDAS) remains elusive. It is possible that GAS infection may be but one of the many stressors that can exacerbate tic/Tourette’s or OCD in a subset of such patients.”  If there’s not even agreement that PANDAS exists, then a self-serving promotor of this particular diagnosis should be met with a high level of skepticism.  Even researchers who accept PANDAS as a legitimate diagnosis, such as Susan Swedo of the NIMH, are skeptical of such a diagnosis.Read More »LeRoy neurological illness mystery–update 3–is it conversion disorder?

LeRoy neurological illness mystery–junk science–update

(Updated to add more information about the anti-vaccination lunatics weighing in.)

When I write postings here, I never search google for information or sources, I always go to trusted locations for my information.  For example, if I read a news article on some interesting subject, I check with the original source, usually at PubMed, for medical articles, and the original abstract (at least) for other science articles.  I click on nearly every outlink in postings that I read, to confirm whether the information presented is accurate.  A google search is practically useless, especially for medical articles, because the amount of cruft and junk science makes it a challenge to sort.Read More »LeRoy neurological illness mystery–junk science–update

LeRoy teenage neurological illness mystery–junk science everywhere

When I write postings here, I never search google for information or sources, I always go to trusted locations for my information.  For example, if I read a news article on some interesting subject, I check with the original source, usually at PubMed, for medical articles, and the original abstract (at least) for other science articles.  I click on nearly every outlink in postings that I read, to confirm whether the information presented is accurate.  A google search is practically useless, especially for medical articles, because the amount of cruft and junk science makes it a challenge to sort.

WordPress blogs (which I use) tells the user if a blog posting was searched on google (or Yahoo…does anyone use that anymore?)  Apparently, my postings about the LeRoy (NY) neurological show up on google (but not that far up the list, so people must be digging), and I was kind of surprised.  This led me to do something that I just vowed I wouldn’t do, I googled it.Read More »LeRoy teenage neurological illness mystery–junk science everywhere

The newest cause for the LeRoy neurological issues

I’ve published a few posts over the past month about a group of teenagers and one adult who are experiencing some neurological symptoms in LeRoy, NY, a small town outside of Rochester, NY.  Those symptoms seem to mimic Tourette Syndrome (TS), a neuropsychiatric disorder that is characterized by multiple physical or motor tics plus at least one vocal tic.  It is probably inherited, although a gene for it has not been identified.  Since most of the teenagers who exhibit the symptoms attend LeRoy High School, the New York State Department of Health has carefully examined the school for any environmental issues, and have found none.  Erin Brokovich, of the eponymous movie, has gotten involved and has postulated that a train wreck over 40 years ago spilled toxic chemicals, such as arsenic and trichloroethylene, which may be the cause.Read More »The newest cause for the LeRoy neurological issues