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We narrowly escaped yet another black-box warning on yet another commonly class of drugs prescribed by psychiatrists - antiepileptics.
From APA Headlines:
I don't have the numbers in front of me, but I have to believe that there are many more psychotropics with prohibiting warnings and black boxes than any other system-class of drug. Another example of JCAHO-esque "everyone believing they can understand psychiatry?"
From APA Headlines:
FDA panel votes against adding black-box warning to epilepsy drugs.
In continuing coverage from previous editions of Headlines, the Wall Street Journal (7/11, B6, Favole) reports, "A Food and Drug Administration (FDA) panel has recommended against adding the agency's toughest warnings to labels of epilepsy drugs, saying studies didn't show a high-enough risk for suicidal behavior to warrant such warnings." Fourteen of the FDA "panel members voted against adding the toughest warning, known as a black-box warning, while four voted in favor, and three abstained."
According to the AP (7/11, Perrone), some panel members said that "they worried the warning labels could inadvertently cause doctors and patients to abandon the treatments." Panel member Rochelle Caplan, M.D., a professor of psychiatry at University of California-Los Angeles, stated, "If we have good drugs that are working, we have to be very careful about scaring patients into not taking" these medications. And, "[p]hysician groups told panelists that patients experiencing seizures are already at risk for depression, making it difficult to tell whether drugs aggravate those problems." The AP quoted Jacqueline French, M.D., of the American Psychiatric Association, as asking, "Why put a black-box warning on, when you're not yet sure of the impact these drugs have?"
Bloomberg (7/11, Larkin) notes that drugmaker Pfizer also echoed the panel's concern, saying that "warnings may make patients reluctant to seek treatment they need." Christopher Wohlberg, M.D., Pfizer's medical team leader, told the panel that "[o]ver-warning has the potential to negatively impact patient care." And, psychiatrist Stefan Kruszewski, M.D., "who has reviewed cases for private insurance companies and the state of Pennsylvania," explained that some epilepsy drugs are used off-label "to treat psychiatric conditions, such as depression, anxiety, or dementia," or to control weight or manage headaches.
In a separate story, Bloomberg (7/11, Larkin, Waters) points out that the panel voted against the stronger warnings, but still "voted 20-0 that all epilepsy drugs increase the chance patients will consider suicide." Bloomberg adds that "[t]he panel also voted 18-3 that all 11 epilepsy medicines studied pose the suicide risk, and 15-5 that the danger also applies to 14 older treatments that weren't part of the review." HealthDay (7/10, Reinberg) and WebMD (7/10, Zwillich) also covered the story, as did USA Today's (7/10, Rubin) A Better Life blog, and ABC News (7/10, Cox) on its website.
I don't have the numbers in front of me, but I have to believe that there are many more psychotropics with prohibiting warnings and black boxes than any other system-class of drug. Another example of JCAHO-esque "everyone believing they can understand psychiatry?"
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