Ms. Burton’s own experience of therapy convinces her, for example, that trauma survivors don’t always make the best trauma therapists. This is especially true if they never completed their own therapy. She has seen them react with fear and dissociation in response to traumatic material or negative emotions expressed in a session.

While we don’t learn who her current therapist is, it is clear that they are working together toward healing. She writes with clarity and maturity; and without a chip on her shoulder. It is a privilege to publish an article from a guest author who is such an articulate therapy client. This article will help me be a better therapist.

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Researchers studying survivors of the September 11, 2001 World Trade Center attack have been surprised to find many of them to be free of PTSD symptoms. Resilience was less common among people who were actually in the buildings or in the immediate area, but the researchers report that even for “highly exposed individuals” the frequency of resilience never fell below one third.

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Drug companies come out with new versions of their medications just before the patent on the existing version expires, but Seroquel’s patent does not expire until 2011. Israel’s Teva Pharmaceuticals filed an FDA request to produce a generic version of quetiapine last year and they were promptly sued by AstraZenica. Was this a factor in the early request for a sustained-release version?

A sustained release version of quetiapine may be a good thing for patients. It’s easier to take a medication once a day than twice a day – and a sustained release version may insure a more steady blood level of the medication. Risperdal (risperidone) is actually available in a version that can be given every two weeks – by injection. Patients who can’t afford the new formulation of Seroquel (if it is approved) may save money by continuing to take the current version twice a day. They will certainly save money once a generic quetiapine is available.

Read the announcement from AstraZeneca

Serotonin syndrome occurs when the body has too much of serotonin, a chemical found in the nervous system. Serotonin syndrome may be more likely to occur when starting or increasing the dose of a triptan, SSRI or SNRI. Symptoms of serotonin syndrome may include:

• restlessness
• hallucinations
• loss of coordination
• fast heart beat
• rapid changes in blood pressure
• increased body temperature
• overactive reflexes
• nausea
• vomiting
• diarrhea

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We seem to be better able to hold multiple options in our unconscious mind and process them “in the background.” Our consious mind can only attend to one or two things at a time.

Source: Source: Dijksterhuis, A. and Nordgren, L. “A Theory of Unconscious Thought”. Perspectives on Psychological Science, June 2006.

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The irony is that those with limited access to treatment are often those with lower incomes. In effect lower income people pay more for their depression treatment. The study also found that:

• People with depression are not being fully diagnosed
• Only a small minority of people with depression are receiving dual therapy (prescription medication and talk therapy)
• The shortage of mental health care professionals is impacting care
• People with depression who live in states with no mental health parity law may have more limited access to treatment
• Self-reported depression among minority groups may be on the rise

Together these findings suggest that changes are needed in health care coverage for Americans. At the very least mental disorders need to be covered at the same level as physical disorders in health insurance plans. The study is also a persuasive argument for universal health coverage.

For the purposes of this study, limited access was defined as “either having no health insurance, being in a health savings account-qualified health plan where costs are not reimbursed until a high minimum deductible is met (at least $1,050 for individuals and at least $2,100 for a family), being enrolled in a pharmacy benefit plan that provides no coverage for certain brand-name pharmaceutical agents (self-reported data), or being enrolled in a health plan which, respondents claim, either provides no coverage for physician visits, or no coverage for prescription medication. ”

Read more about the study at NAMI.org

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Researchers are studying a potential new drug that works on the same pathway as nicotine. The drug may improve these patients’ ability to think clearly, a symptom poorly treated by existing medications. Will it also help them stop smoking?

Read more in this Reuters story.

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The Pennsylvania bill will limit insurerers and managed care companies to a single authorization per treatment episode. A “new episode” will start if the person has not been in treatment for 6 months.

Source: The National Psychologist, July/August 2006.

Read more about mental health medications