Psychiatrists represent the second largest prescriber of sleep aids, accounting for 11% of total prescriptions in the US. While primary care physicians prescribe over half of sleep aids, psychiatrists and primary care physicians have similar prescribing patterns for individual sleep aids such as Ambien, Lunesta, and Sonata. Neurologists, who are considered sleep specialists, only account for 2% of sleep aid prescriptions. The study found no significant differences between psychiatrists, primary care physicians, and neurologists in their use of specific sleep medications.
William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. LaVelle Henricks, Texas A&M University-Commerce and colleagues published in national refereed journal.
Dr. William Allan Kritsonis, Distinguished Alumnus, Central Washington University, College of Education and Professional Studies, Ellensburg, Washington; Invited Guest Lecturer, Oxford Round Table, University of Oxford, United Kingdom; Hall of Honor, Prairie View A&M University/Member of the Texas A&M University System.
This article applies a critical flaw analysis to psychiatric drugs for children and concludes the evidence does not support drugs as a first line choice.
Trends in Psychotropic Medication Costsfor Children and Adol.docxwillcoxjanay
Trends in Psychotropic Medication Costs
for Children and Adolescents, 1997-2000
Andrés Martin, MD, MPH; Douglas Leslie, PhD
Objective: To examine trends in psychotropic medi-
cation utilization and costs for children and adolescents
between January 1, 1997, and December 31, 2000.
Methods: Pharmacy claims were analyzed for mental
health users 17 years and younger (N = 83 039) from a
national database covering 1.74 million privately in-
sured youths. Utilization rates and costs for dispensed
medications were compared across psychotropic drug cat-
egories and individual agents over time.
Results: Overall use of psychotropic drugs increased from
59.5% of mental health outpatients in 1997 (a 1-year
prevalence of 28.7 per 1000) to 62.3% in 2000 (33.7 per
1000), a 4.7% increase. The largest changes in utiliza-
tion were seen for atypical antipsychotics (138.4%), atypi-
cal antidepressants (42.8%), and selective serotonin re-
uptake inhibitors (18.8%). The average prescription price
increased by 17.6% ($7.90 per prescription), a change
in turn attributed to a shift toward costlier medications
within the same category (55.1% of the increase, or $4.35)
and to pure inflation (44.9% of the increase, or $3.55;
P for trend �.001 for all comparisons). Almost half
(46.7%) of the $2.7 million gross sales differential was
accounted for by only 3 of the 39 drugs identified (am-
phetamine compound, risperidone, and sertraline), and
75% was accounted for by 7 drugs (the previous 3 and
bupropion, paroxetine, venlafaxine, and citalopram).
Conclusions: Psychotropic drug expenditure increases
during the late 1990s resulted from more youths being
prescribed drugs, a preference for newer and costlier medi-
cations, and the net effects of inflation. The impact of man-
aged care and pharmaceutical marketing effects on these
trends warrants further study.
Arch Pediatr Adolesc Med. 2003;157:997-1004
T
HE USE of psychotropic
medications in children has
become a highly visible is-
sue, receiving regular at-
tention from academics (for
a recent summary, see Jensen et al1), poli-
cymakers,2,3 and the lay press alike.4-6 In
contrast to the controversial and at times
charged reactions that the topic can en-
gender, reliable national estimates of the
extent of pediatric use of psychotropic
drugs have only recently started to be-
come available.7-9 Previous studies10,11 have
documented that most psychotropic medi-
cations are not prescribed by mental health
specialists but rather by general practi-
tioners, a pattern that is certainly appli-
cable to stimulants, the most widely used
psychotropic drug class for children: in
1995, pediatricians prescribed 50% of
stimulants, family practitioners 20%, and
psychiatrists only 13%.8
The financial implications of pediat-
ric pharmacotherapy have gone largely un-
examined, an important shortcoming given
that in the US expenditures for prescrip-
tion drugs have continued to be the fastest
growing component of health care across
a ...
This is the summary text of a presentation at the Vatican addressing: "The Question of the Use of Pharmaceuticals in Pediatrics." This presentation covers the clinical trial evidence and offers prescription guidelines
Virtual Visits by THREAD (www.THREADresearch.com)John Reites
The hybrid virtual approach: replacing on-site clinic visits with Virtual Visits using THREAD. Presented at DPharm on 24Sep2018 for Mobile in Clinical Trials.
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Similar to Current Status of Hypnotic Prescribing Habits in the United States
William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. LaVelle Henricks, Texas A&M University-Commerce and colleagues published in national refereed journal.
Dr. William Allan Kritsonis, Distinguished Alumnus, Central Washington University, College of Education and Professional Studies, Ellensburg, Washington; Invited Guest Lecturer, Oxford Round Table, University of Oxford, United Kingdom; Hall of Honor, Prairie View A&M University/Member of the Texas A&M University System.
This article applies a critical flaw analysis to psychiatric drugs for children and concludes the evidence does not support drugs as a first line choice.
Trends in Psychotropic Medication Costsfor Children and Adol.docxwillcoxjanay
Trends in Psychotropic Medication Costs
for Children and Adolescents, 1997-2000
Andrés Martin, MD, MPH; Douglas Leslie, PhD
Objective: To examine trends in psychotropic medi-
cation utilization and costs for children and adolescents
between January 1, 1997, and December 31, 2000.
Methods: Pharmacy claims were analyzed for mental
health users 17 years and younger (N = 83 039) from a
national database covering 1.74 million privately in-
sured youths. Utilization rates and costs for dispensed
medications were compared across psychotropic drug cat-
egories and individual agents over time.
Results: Overall use of psychotropic drugs increased from
59.5% of mental health outpatients in 1997 (a 1-year
prevalence of 28.7 per 1000) to 62.3% in 2000 (33.7 per
1000), a 4.7% increase. The largest changes in utiliza-
tion were seen for atypical antipsychotics (138.4%), atypi-
cal antidepressants (42.8%), and selective serotonin re-
uptake inhibitors (18.8%). The average prescription price
increased by 17.6% ($7.90 per prescription), a change
in turn attributed to a shift toward costlier medications
within the same category (55.1% of the increase, or $4.35)
and to pure inflation (44.9% of the increase, or $3.55;
P for trend �.001 for all comparisons). Almost half
(46.7%) of the $2.7 million gross sales differential was
accounted for by only 3 of the 39 drugs identified (am-
phetamine compound, risperidone, and sertraline), and
75% was accounted for by 7 drugs (the previous 3 and
bupropion, paroxetine, venlafaxine, and citalopram).
Conclusions: Psychotropic drug expenditure increases
during the late 1990s resulted from more youths being
prescribed drugs, a preference for newer and costlier medi-
cations, and the net effects of inflation. The impact of man-
aged care and pharmaceutical marketing effects on these
trends warrants further study.
Arch Pediatr Adolesc Med. 2003;157:997-1004
T
HE USE of psychotropic
medications in children has
become a highly visible is-
sue, receiving regular at-
tention from academics (for
a recent summary, see Jensen et al1), poli-
cymakers,2,3 and the lay press alike.4-6 In
contrast to the controversial and at times
charged reactions that the topic can en-
gender, reliable national estimates of the
extent of pediatric use of psychotropic
drugs have only recently started to be-
come available.7-9 Previous studies10,11 have
documented that most psychotropic medi-
cations are not prescribed by mental health
specialists but rather by general practi-
tioners, a pattern that is certainly appli-
cable to stimulants, the most widely used
psychotropic drug class for children: in
1995, pediatricians prescribed 50% of
stimulants, family practitioners 20%, and
psychiatrists only 13%.8
The financial implications of pediat-
ric pharmacotherapy have gone largely un-
examined, an important shortcoming given
that in the US expenditures for prescrip-
tion drugs have continued to be the fastest
growing component of health care across
a ...
This is the summary text of a presentation at the Vatican addressing: "The Question of the Use of Pharmaceuticals in Pediatrics." This presentation covers the clinical trial evidence and offers prescription guidelines
Virtual Visits by THREAD (www.THREADresearch.com)John Reites
The hybrid virtual approach: replacing on-site clinic visits with Virtual Visits using THREAD. Presented at DPharm on 24Sep2018 for Mobile in Clinical Trials.
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• Set proper expectations from the start for all teams involved
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mortality, and public health costs than all illicit drugs combined. The
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disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
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pharmacotherapies for AUD.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Current Status of Hypnotic Prescribing Habits in the United States
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Psychiatry (Edgmont). 2007 September; 4(9): 24–25. PMCID: PMC2880939
Current Status of Hypnotic Prescribing Habits in the United States
Elisa F. Cascade, Amir H. Kalali, MD, and John Reites
Author information ► Copyright and License information ►
This article has been cited by other articles in PMC.
Abstract
Prescription data suggests that outside of primary care physicians, psychiatrists represent the second largest
prescriber of sleep aids, accounting for 11 percent of total prescriptions. Use of individual agents do not differ
between psychiatrists, primary care physicians, and neurologists.
Keywords: sleep aid, hypnotic, neurologist, psychiatrist, primary care physician, prescriptions
Introduction
In this article, we examine use of specific sleep aids by psychiatrists, primary care physicians, and
neurologists to determine if there are similarities or differences in sleep aid use.
Methods
To investigate the use of sleep aids by prescriber specialty, we took a snapshot of prescription data from
Verispan's Vector One National (VONA) database in July 2007. At present, Verispan's VONA captures nearly
half of all prescription activity in the US.
Results
As seen in Figure 1, primary care physicians represent over half of all prescriptions for sleep aids in the US.
Outside of primary care physicians, psychiatrists represent the second largest prescriber specialty with 11
percent of prescriptions. Perhaps what is most interesting about this data is that neurologists, who are often
referred to as sleep specialists, represent only two percent of the prescriptions.
Figure 1
Sleep aid total prescriptions, by specialty
The data in Figure 2 summarize use of specific sleep aids in primary care physicians, psychiatrists, and
neurologists. As seen in Figure 2, individual sleep aid use did not differ significantly between specialties.
Figure 2
Product share of total prescriptions, by specialty
Contributor Information
2. Elisa F. Cascade, Ms. Cascade is Vice President, Strategic Research and Safety, Quintiles Inc., Falls Church,
Virginia.
Amir H. Kalali, Dr. Kalali is Vice President, Global Therapeutic Group Leader CNS, Quintiles Inc., San Diego,
California, and Professor of Psychiatry, University of California, San Diego.
John Reites, Mr. Reites is Senior Project Manager, Strategic Research and Safety, Quintiles, Research
Triangle Park, North Carolina.
Articles from Psychiatry (Edgmont) are provided here courtesy of Matrix Medical Communications