Haloperidol And Other Antipsychotics No Better Than Placebo For ICU Delirium, Study Finds

Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine.

Antipsychotic medications, such as haloperidol (brand name, Haldol), are widely used in intensive care units, emergency rooms, hospital wards and nursing homes.

“In some surveys up to 70 percent of patients [in the ICU] get these antipsychotics.”

…But the drugs can have serious side effects.

…”There’s not a shred of evidence in this entire investigation that this aggressive approach to treating delirium with antipsychotics, which is commonplace and usual care, did anything for the patients,” he concludes.

…Both she and Ely advocate for a more holistic approach to treating delirium — getting patients off drugs and off breathing machines as soon as possible and getting them up and about as soon as they’re able.

Haloperidol And Other Antipsychotics No Better Than Placebo For ICU Delirium, Study Finds : Shots – Health News : NPR

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Quote from Ford’s testimony spray-painted on Yale Law School entrance

A quote from Christine Blasey Ford’s Senate testimony against Supreme Court Justice Brett Kavanaugh was spray-painted outside the entrance to Yale Law School before being removed later on Monday.

…“Indelible in the hippocampus is the laughter …” was written on the concrete in paint.

Quote from Ford’s testimony spray-painted on Yale Law School entrance | TheHill

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Everyone saw the French Quarter attack. Few saw the mental health care failures behind it.

A review of Paul’s UMC medical records by NOLA.com | The Times-Picayune raised significant questions. Four hours after he was admitted, a doctor wrote that Paul was “having auditory hallucinations” and that he was “a potential threat to himself and other people as well as gravely disabled.” 

This assessment gave the hospital a legal right to involuntarily commit Paul for up to three days for observation and treatment, with the possibility of holding him an additional 12 days following a re-examination by the coroner. And yet doctors still chose to discharge him, just one day later.

Behavioral health experts said this is not uncommon, that people in need of psychiatric treatment are released on a regular basis, a result of the state’s gutting of its mental health care funding and infrastructure.

…Paul is one of hundreds of homeless kids who cycle through Covenant House and other outreach programs every year, Foots said, many suffering from the same mental health disorders as him, some more severe. If the level of care doesn’t improve, and if hospitals continue to turn away people in need because they lack the necessary beds and funding, she fears what happened to Paul and the men he injured could become more commonplace.

“I work with these kids every day and I know they are all very troubled,” Foots said. “I see their mental illness, but they rarely get the help they need. Just like Dejuan. Those damn voices in his head got ahold of him and he just lost it.” 

…He paced frantically while hitting himself and repeating, over and over again, that he needed his medicine. 

Then, as if someone pulled a string, he slumped to the floor near the kitchen. 

Foots knelt down, her face inches from Paul’s, and locked eyes with him. She said he needed to focus, that he was in control of his mind, no one else. Ignore the people in your head, she instructed him. Staff members told Foots to keep her distance. She refused. 

…“The police told me when they got him, ‘At least he’s going to emergency. They’re going to give him some medicine. He’s going to be better and everything is going to be good,’” Foots said. “And that’s what I told Dejuan, but that’s not what happened.”

…Paul was given 10 mg of Zyprexa, an antipsychotic typically prescribed to people with bipolar disorder or schizophrenia. A toxicology screen came back positive for marijuana. Paul confessed that he smoked marijuana every day since he was 15 and that over the past several weeks he had rarely slept more than four hours a night. 

…According to his medical records, Paul told the doctors at UMC he had “racing thoughts about everything and feels stuck in his own head.” If he could get some Vyvanse, a drug prescribed to people with attention deficit hyperactivity disorder, he said he would feel “much better and everything would be OK.”

…In this case, however, despite receiving confirmation of Paul’s diagnosis and prior care, UMC doctors refused to give him his medication, his medical records show. There was no explanation provided in the records. 

…Warden Perry Stagg, who was seated nearby, interjected to ask Paul if he had been given his medication at the prison. When Paul said no, that the nurse said they can’t prescribe it, Stagg said they would try to figure out potential substitutes “to get him back where he needs to be.”

Since former Gov. Bobby Jindal gutted the mental health care system, taking care of people like Paul has become part of the prison’s job, Stagg said. 

“Unfortunately, the Department of Corrections has become the de facto mental health hospital for the state,” he said. “We need to get these mental health services back available on the street and try to catch some of these guys before they commit a crime.”

…“I’m an old, conservative Republican, a lock‘em up and throw away the key kind of guy. Until I came to the Department of Corrections and realized that, hey, that’s not always the answer. There are reasons for some of this stuff and some of this stuff can be corrected.”

Everyone saw the French Quarter attack. Few saw the mental health care failures behind it. | NOLA.com

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