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Monday, August 14, 2006

Veterans Issues: VA RESEARCH ON BIPOLAR DISORDER

New treatment model used on veterans shows promise.

VA Watchdog/Larry Scott
emaxhealth dot com
August 12, 2006

A new treatment model for bipolar disorder tested in veterans across the nation reduced their manic episodes and improved their quality of life, according to research led by a psychiatrist with the Providence Veterans Affairs Medical Center and Brown Medical School.

The randomized, controlled trial also showed that the model did not add to the treatment costs for bipolar disorder, which affects nearly 6 million American adults a year. Results appear in two reports published in Psychiatric Services, a journal of the American Psychiatric Association.

"We applied the same symptom management approaches found in the interventions for diabetes and asthmas to the treatment of bipolar disorder and found that people with serious mental illness can help take control of their care," said Mark S. Bauer, M.D., staff psychiatrist with the Providence VA Medical Center and professor of psychiatry and human behavior at Brown Medical School. "The finding should reduce the stigma of helplessness that so often is associated with these disorders, and it will open new avenues for the treatment of bipolar disorder."

Bauer oversaw the clinical trial and is the lead author of both journal articles.

The new model was developed and tested in veterans with bipolar disorder at the Providence VA Medical Center. During the trial, 306 veterans were enrolled at 11 VA centers located in Arizona, California, Colorado, Georgia, Indiana, Maryland, Ohio, Pennsylvania, Tennessee and Texas. Each veteran was randomly assigned to a study group. One group got usual care through their psychiatrist. The other group received treatment for bipolar disorder under the new model.

Developed by Bauer and colleagues, the model brings together psychiatrists and nurses as a team to treat the patients. Psychiatrists monitored symptoms and handled medications. Nurse care coordinators worked with veterans during group education sessions.

During the weekly group sessions, nurses discussed topics such as medication side effects and early warning signs for symptoms, which in bipolar range from racing speech, bursts of optimism and impulsive behavior during manic episodes to fatigue, social withdrawal and suicidal thoughts during depressive episodes. During the sessions, patients discussed coping skills, got feedback from the group and created personal action plans.

The intervention was tested for three years. The results: Under the new model: patients saw a significant reduction in symptoms, including five fewer weeks experiencing mania during the three-year study period. Patients also felt happier and healthier, reporting more productive time at work, better relationships with family, and more satisfaction with their care.

The new model was less expensive---an average of $61,398 for three years of direct bipolar disorder treatment costs compared with $64,379 for usual care---although the difference was not statistically significant.

"The bottom line is that we saw improvements in patients' symptoms, function and quality of life with no change in net costs," Bauer said.

The results mirror those from a simultaneous trial tesing a similar team-based treatment approach for bipolar disorder that Bauer also helped to develop. That approach was tested in 441 patients enrolled in a Washington state mental health maintenance organization. Results from that trial were published in May in the Archives of General Psychiatry.

"We now have results from more than 700 patients, cared for in very different health systems, that show this collaborative approach works," Bauer said. "Just like anyone with a chronic illness, people with bipolar disorder can work with medical professionals to manage their symptoms and manage their lives."

3 Comments:

  • At 10:31 AM, Anonymous Daniel Haszard said…

    I took zyprexa which was ineffective for my condition and gave me diabetes.

    Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

    Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

    Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?

    Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

    I was prescribed Zyprexa from 1996 until 2000.
    In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.
    ----
    Daniel Haszard http://www.zyprexa-victims.com

     
  • At 10:32 AM, Anonymous Daniel Haszard said…

    I took zyprexa which was ineffective for my condition and gave me diabetes.

    Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

    Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

    Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?

    Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

    I was prescribed Zyprexa from 1996 until 2000.
    In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.
    ----
    Daniel Haszard http://www.zyprexa-victims.com

     
  • At 10:32 AM, Anonymous Daniel Haszard said…

    I took zyprexa which was ineffective for my condition and gave me diabetes.

    Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

    Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

    Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?

    Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

    I was prescribed Zyprexa from 1996 until 2000.
    In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.
    ----
    Daniel Haszard http://www.zyprexa-victims.com

     

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