As an increasing number of kids are prescribed powerful antipsychotics, a new study finds that many doctors are deviating from established medical guidelines when they dole out the scripts.
In nearly half of cases, physicians failed to conduct lab tests to measure cholesterol and blood-glucose levels in patients before and after they began taking antipsychotics, according to findings published this month in the journal Pediatrics.
Such lab tests are recommended to mitigate the elevated risk of conditions like high cholesterol and diabetes associated with such medications, researchers said.
Nonetheless, the study found that physicians were generally prescribing antipsychotics to the right patients. In 92 percent of cases, doctors were using the drugs to address situations where they were warranted, most commonly as a secondary treatment for aggression or mood instability.
For the study, researchers sent surveys to every physician in Vermont who prescribed antipsychotics to children covered by Medicaid between July and October 2012. Ultimately, 147 of the doctors — who accounted for prescriptions for 647 patients — responded to questions about their prescribing habits.
The findings suggest that more needs to be done to ensure that doctors follow established protocols when they prescribe antipsychotics, researchers said. Specifically, better training, greater sharing of records and use of electronic medical records to remind providers about blood work could help, they said.
“I’m not anti-antipsychotics; I just want to make sure they’re used very carefully,” said David Rettew of the University of Vermont who led the study. “These findings could help us design a game plan for measures to improve best-practice prescribing.”
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Everyone is worried about the man in the house.
His ex-wife, his mother, his father, his neighbors, the psychiatrists he has seen and no longer sees, they are all concerned because he has been alone in the house in suburban Maryland for two years.
No one knows what he is doing. No one knows what he is thinking, what he is eating or how he is surviving. In two years, since his frightened wife took their three young boys and left him there alone, he has not spoken to anyone for more than a few minutes. He has not let anyone beyond the front door, which he has fortified with a new lock, a piece of plastic bolted over the window, and a piece of plywood bolted below that, all of which he has painted a bright shade of yellow. He keeps the living room curtains shut.
The man in the house, a 42-year-old who once earned six figures working on Capitol Hill and was a devoted husband and father, tells his family that he is not sick, even though a psychological evaluation found he had “a schizoaffective disorder, depressive type with persecutory delusions.”
As far as they know, he has stopped taking the psychiatric medication prescribed after he told police that God was speaking through his 3-year-old son. He has quit his job and stopped paying bills. His family doesn’t know what to do.
His mother leaves bags of groceries on the porch. His ex-wife sends text messages, and his responses are increasingly worrying, such as when he refers to his sons as his “suns.” His father is always leaving a version of the same phone message — “Hey, this is dad. Let me know if you want to come out and talk. We love you. We care about you.” — which his son never answers.
Continue reading WashPost: Behind the yellow door, a man’s mental illness worsens