High initial doses of antidepressants may double suicide risk in teens

first_img Read Full Story Young people who start taking antidepressants at higher-than-average doses may be twice as likely to commit suicide, especially in the first three months of treatment, as those who begin treatment with customary doses, according to a new study led by Harvard School of Public Health (HSPH).Earlier studies found that taking selective serotonin reuptake inhibitor antidepressants (SSRIs) increased suicidal thinking and behavior in young people, which prompted the U.S. Food and Drug Administration to issue warnings about the drugs 10 years ago. The new study suggests that it may be the initial dose of such drugs that matters most.The study, “Antidepressant Dose, Age, and the Risk of Deliberate Self-harm,” published online April 28, 2014 in JAMA Internal Medicine, was led by injury prevention expert Matthew Miller, associate professor of health policy and management at HSPH. Looking at data from 162,625 young people treated for depression with SSRIs between 1998 and 2010, Miller and colleagues found that there was roughly one additional suicide attempt for every 150 young people who started with higher doses of antidepressants.last_img read more

Lawmakers ask about Bar lawyer regulation system

first_imgLawmakers ask about Bar lawyer regulation system Lawmakers ask about Bar lawyer regulation system Senior EditorAfter a day debunking many of the claims made about medical malpractice, a Florida Senate committee questioned Florida Bar President Miles McGrane about Bar prosecutions for frivolous lawsuits and the Bar grievance process generally.McGrane was one of about 20 people invited to give sworn testimony to the Senate Judiciary Committee on July 14-15 during the second legislative special session on medical malpractice.The Senate has been under fire from Gov. Jeb Bush and the House for refusing to agree to a $250,000 cap on noneconomic damages in medical malpractice cases. But senators said they had been getting conflicting information, so the upper chamber took the unusual step of inviting witnesses to the Judiciary Committee, and then putting them under oath. That makes them liable to a perjury charge if they lie.McGrane testified after the committee had quizzed state employees involved in regulating insurance companies and the medical profession. They testified that the state largely relies on information from insurance companies and their accountants on the number of claims made and other actuarial information. Other employees testified that although claims have been made that high malpractice rates are driving doctors out of the state, there are more doctors in Florida than five years ago, and the number of doctors applying to practice in Florida is increasing.Witnesses also said, contrary to much of the talk about medical malpractice, that there is no flood of frivolous malpractice suits driving up rates.Against that backdrop, committee Chair Sen. Alex Villalobos, R-Miami, asked McGrane for general information about the Bar’s grievance process and specifically how many cases had been investigated for filing frivolous malpractice suits.McGrane replied that there had been three malpractice related investigations. One was referred by a judge who ruled a defense lawyer did a filing without reasonable investigation. That case was dropped when an appellate court overturned the judge.On the other two cases, a lawyer sued the wrong doctor who had the identical name as the intended defendant, and a lawyer sued the wrong partner in a P.A., he said.In recent years, the Bar has averaged about 9,000 complaints a year involving 4,500 to 5,000 lawyers, McGrane reported. Total disciplines have ranged from 391 to 472, including between 20 and 38 annual disbarments. Other disciplines include suspensions, reprimands, voluntary resignations, and probations. The numbers do not include those who opt to attend the Bar’s ethics school in lieu of facing a minor misconduct charge.Asked by Sen. Durrell Peadon, R-Crestview, how the Bar process worked, McGrane answered that local grievance committees, made up of lawyers and nonlawyers, investigate complaints. If a committee finds probable cause, then a referee holds a hearing and makes a recommendation. That is reviewed by the Bar Board of Governors, which decides whether to agree to make a different recommendation when the case goes to the Supreme Court, which has final authority over all grievance cases, he said.Sen. Dave Aronberg, D-West Palm Beach, asked about cases under F.S. 57.105, which allows judges to award the opposing side attorneys’ fees in costs when an attorney brings a frivolous action. McGrane replied that rarely happens. He also noted that some had suggested a provision that an attorney who brings three frivolous actions within five years be barred from filing medical malpractice, and added he doubts that will ever happen.Sen. Skip Campbell, D-Tamarac, a former member of the Bar Board of Governors, spent much of the meeting asking tough questions of insurance and medical representatives. He asked McGrane about lawyer advertising, saying, “I think the doctors have a legitimate gripe about that.”McGrane said the U.S. Supreme Court in the 1970s ruled that lawyers have a right to advertise, but that The Florida Bar has enacted — and has been upheld by the U.S. Supreme Court — the toughest regulations of any state bar.“Personally, I find it repulsive, repugnant, whatever word you want to use. But as president of The Florida Bar, I have to enforce the rules on what the courts will let us do,” he said.Ironically, no one asked McGrane about his personal practice, which is largely made up of defending doctors in medical malpractice cases.Questioning of McGrane was mild compared to some witnesses. Robert White, president of First Professionals Insurance, the state’s largest medical malpractice insurance company, and Jeff Scott, an attorney with the Florida Medical Association, conceded there was no problem with frivolous lawsuits, or even that there is a large number of them. White said past legislation had fixed that problem, but added bad faith laws make it difficult for insurance companies.That was contrary to much of the rhetoric earlier this year, when frivolous lawsuits were frequently blamed for skyrocketing medical malpractice rates. White also estimated that 10 percent of rate hikes were caused by low interest rates on investments and other economic factors, not related to lawsuits. August 1, 2003 Gary Blankenship Senior Editor Regular Newslast_img read more

Newcastle will fight to keep Coloccini

first_img Press Association Newcastle boss Alan Pardew is gearing up for a fight to hold on to skipper Fabricio Coloccini for the second time in five months. However, Press Association Sport understands there has been no contact between the two clubs, and that any approach from the South Americans would not be welcomed. Pardew has repeatedly spoken of his desire to keep Coloccini, although he admits the decision ultimately lies with the former Deportivo La Coruna man. However, any deal would be fraught with difficulties with the player still under contract and San Lorenzo having admitted they will not be able to come anywhere near Newcastle’s valuation of a man who cost them £10.3million in August 2008. Coloccini is a fans’ favourite and his influence during the tense final few weeks of a difficult season was key, and central defensive partner Steven Taylor is as keen as Pardew to see him stay. Taylor told the Shields Gazette: “The lads love playing with him and we hope he stays. “Colo and I have had a great partnership over the past few seasons. We have a good understanding. We know each other’s strengths and weaknesses. We seem to be able to mix it up. “He’s very composed and he’s not shy of a tackle as well. He’s been great a guy in training. You can learn a lot from him. I’ve got a fantastic partnership with him, and hopefully that will continue.” center_img The 31-year-old asked to leave the club for personal reasons in January, but was persuaded to stay on Tyneside, with Pardew determined to retain the services of a man who signed a four-year contract extension in March last year. Argentinian club San Lorenzo, who employ Coloccini’s father as a youth coach, are desperate to recruit the central defender, and president Matias Lammens has already indicated he is planning to fly to England in a bid to prise the player away from the Magpies. last_img read more