Re: Call for reporting of Sudden
Unexplained Deaths/Sudden Cardiac Deaths
in all on Stimulants or Antipsychotics
Dear Dr. Preston,
01/21/10
I agree with Centers for Disease Control and
Prevention (CDC) and the American
Academy of Neurology's (AAN) call
for reporting cases of Guillain-Barre
Syndrome regardless of their vaccination
status.
However, just as important or moreso, it was
recently reported by Gould et al (2009) that
(a) the rate of sudden cardiac deaths in
children on amphetamines/psychostimulants
is 7.4 times as prevalent as in children
taking no such medication, and by Ray et al
(2009), (b) that the rate of sudden cardiac
deaths in adults on antipsychotics is twice
the rate in a normal control population.
Therefore, I would also urge the reporting of
all child and adult deaths associated with
amphetamines or amphetamine-like,
Schedule II stimulants, and with
antipsychotics whether in children or adults
and whether the use of such drugs is as
monotherapy or part of a drug cocktail-polypharmacy! For such reporting to truly
comprehensive, the cooperation of the
American Psychiatric Association (APA),
American Academy of Child and
Adolescent Psychiatry (AACAP), American
Academy of Neurology (AAN), Child
Neurology Society (CNS), American
Academy of Pediatrics (AAP) and the
American Academy of Family Physicians
(AAFP) should be sought.
Highlighting the urgency of such reporting,
there is a still-unacknowledged 'outbreak' of
sudden unexplained (probably cardiac)
deaths among those serving or having served
in Afghanistan and Iraq who have been
psychiatrically diagnosed PTSD, major
depressive disorder or otherwise and who
are on psychiatric polypharmacy regimens
including an antipsychotic and one or more
antidepressants. The Surgeon General of the
Army and the House and Senate Veteran's
Affairs Committees should be asked to
provide what information they have on this
'outbreak' of sudden unexplained deaths as
well.
Fred A. Baughman Jr., MD, Fellow, AAN,
Member, CNS
----- Original Message ----From: William G. Preston, MD, FAAN
To: fredbaughmanmd@cox.net
Sent: Thursday, January 21, 2010 8:25 AM
Subject: Important: GBS Reporting Requirements
The Centers for Disease Control and Prevention
(CDC) and the American Academy of Neurology
continue to ask neurologists and other health care
professionals nationwide to report on any possible
new cases of Guillain-Barré syndrome (GBS)
following H1N1 flu vaccination.
Your Active Involvement Is Essential
As a neurologist practicing in one of the CDC’s
Emerging Infections Program states (CT, MD, MN,
NM, TN, CA, and selected regions of CO, GA, NY,
and OR), your continued active participation in
reporting new cases of GBS identified in your practice
is extremely important. Practitioners in these states
are asked to report ANY newly diagnosed case of
GBS, regardless of vaccination status. Physician
reporting of all GBS cases diagnosed in the EIP sites
is a strategy for increased detection. Visit the EIP
resource page for information on how to report in
your state. Also available at the AAN’s GBS Toolkit
webpage are other important tools and resources,
such as AAN guidelines, multimedia resources, payer
policies, and more.
Watch for regular updates on AAN.com, designed to
keep you informed with the latest news of the
national monitoring campaign.
Best Regards,
William G. Preston, MD, FAAN
President, Association of California Neurologists