The Wall Street Journal (8/27, A6, Lagnado, Subscription Publication) reports that a two-year effort by nursing homes and Medicare to reduce use of antipsychotic medications has been unsuccessful. Centers for Medicare and Medicaid officials witnessed a 9% decrease in antipsychotic usage from 2011 to 2013, far from the goal of a 15% decrease by the end of 2012. Officials now hope to reach the 15% rate decrease by the end of the year. According to nursing home officials, instead of addressing the issue of hiring more staff, many nursing homes instead resort to antipsychotics to pacify their residents.

Related Links:

— “Nursing Homes’ Drug Use Falls,The Wall Street Journal, August 26, 2013.

Medscape (8/27, Cassels) reports that, according to a study published online Aug. 21 in the BMJ, “antidepressant use by pregnant women around the time of delivery is linked to an increased risk for postpartum hemorrhage.” The study of 106,000 pregnant women of childbearing age diagnosed with either anxiety or a mood disorder revealed “a 1.5-fold increased risk for postpartum hemorrhage associated with all classes of antidepressants and not just selective serotonin reuptake inhibitors.” An accompanying editorial called the increased risk a “cause for concern.”

Related Links:

— “Antidepressants and postpartum haemorrhage,BMJ, August 21, 2013.

The Wall Street Journal (8/26, A4, Winslow, Subscription Publication) reports that, according to a clinical guidance report by the American Academy of Pediatrics (AAP) and published in the September issue of Pediatrics, the majority of vaccines and medications appear to be safe for nursing mothers. Still, breastfeeding women are cautioned against taking certain psychiatric medications, as well as herbal medicines and some painkillers, including oxycodone, hydrocodone and codeine.

MedPage Today (8/26, Phend) reports that the AAP report urges caution “for the small proportion of drugs that are concentrated in human milk, have a long half-life, have known toxicity to mother or child, or expose the infant to relatively high doses or detectable serum concentrations.” Pediatrician Hari Cheryl Sachs, MD, of the Food and Drug Administration, and colleagues suggested that healthcare professionals “look up safety of specific medications on the National Library of Medicine’s peer-reviewed LactMed database online.” “The report also addressed common concerns about antidepressants, anxiolytics, and antipsychotics, many of which show up in low concentrations in breast milk.
Clinically significant levels of drug have been reported in breast milk for bupropion (Wellbutrin), diazepam (Valium), fluoxetine (Prozac), citalopram (Celexa), lithium (Eskalith), lamotrigine (Lamictal), and venlafaxine (Effexor).”

Related Links:

— “Many Drugs Found Safe for Breast-Feeding Mothers, “Ron Winslow, The Wall Street Journal, August 26, 2013.

HealthDay (8/24, Gordon) reported that most children “with autism will grow up to be adults with autism.” According to autism researcher Paul Shattuck, PhD, of the Washington University in St. Louis, an estimated “45,000 to 50,000 kids with autism turn 18 each year.” A number of experts have noted that “a shortage of necessary programs for adults with autism already exists and is likely to worsen” as more youngsters with autism become adults. Higher education and employment for these young adults with autism may be difficult or even impossible, and many young adults with autism are forced to continue living at home with their families.

Related Links:

— “Who Will Care for Children With Autism When They’re Adults?, “Serena Gordon, HealthDay, August 23, 2013.

In a segment on the NBC Nightly News, NBC News correspondent Mark Potter reported, “To prevent more violence in classrooms, teachers, counselors and other workers in the Miami-Dade County [FL] schools are now being trained to spot the warning signs of student mental illness.” Those warning signs “include talk of suicide, high risk or odd behavior, withdrawal, increased anger, bizarre thoughts and persistent sadness.” Potter added, “The program is paid for by the American Psychiatric Foundation and…is currently used in 21 states,” as well as in the District of Columbia.