Monthly Archives: April 2014

Interesting Article: Antipsychotic Efficacy

I ran across a quite interesting article this past week that had been recently published in the Lancet.

Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Leucht S, et.al., Lancet. 2013 Sep 14;382(9896):951-62. doi: 10.1016/S0140-6736(13)60733-3.

This is a meta-analysis of randomized trials comparing 15 different anti-psychotics and asking the questions:

1. Which is the most effective antipsychotic in treating schizophrenia?
2. Which antipsychotic has the most (and least) number of side effects?

The answers are quite interesting. Unless you are a psychiatrist, you may not have intuitively known this information before. Continue reading

Verbal Aikido: A Guest Column by Dr. Bill Wright

Dr. Bill Wright

Dr. Bill Wright

Today on JailMedicine, I am happy to present a guest post by Dr. Bill Wright.  As you may remember, Dr. Wright is the author of Maximum Insecurity: A Doctor in the Supermax, which I reviewed here and which you can purchase here.

VERBAL AIKIDO

Correctional medicine attracts more than its share of argumentative and demanding patients. We all feel the tightening in our stomachs when finding certain names on the clinic schedule, anticipating the disputes that are almost certain to follow. It doesn’t need to be that way. Continue reading

More CFOAM

Today, I am adding more sites to the CFOAM page found at the top of the blog. Remember that FOAM stands for Free Online Access to Medicine and is a movement that seeks to utilize the full potential of the internet for medical education. In order to make it as FOAM, a web site must be free, provide useful education on a medical topic, and be easily accessible online. This can (and does) include audio podcasts, video lectures, and written articles and blogs. If the content is relevant to correctional medicine, well, that’s CFOAM: Correctional Free Online Access to Medicine. Today, I am adding three more CFAOM websites to the list. Continue reading

Skeletal Muscle Relaxers Do Not Relax Skeletal Muscles!

Today’s post is an opinion piece. Personally, I think that skeletal muscle relaxers like cyclobenzaprine, methocarbamol and chlorzoxazone are over prescribed for acute and chronic musculoskeletal pain, both in the outside world but especially in corrections. The main reason for this, I think, is that prescribers misunderstand what muscle relaxers do. Contrary to their name, muscle relaxers do not relax muscles, at least as they are commonly prescribed. Muscle relaxers are sedatives, pure and simple, and should be prescribed with that fact in mind. Instead of telling patients (and ourselves) that “I am prescribing a muscle relaxer for you,” in the interest of full disclosure, we should be saying “I am prescribing a sedative for you.”  Continue reading