F.D.A. Approves a New Antipsychotic Drug

Available antipsychotic treatments work by blocking dopamine receptors. The new drug, Cobenfy, takes a different approach.The Food and Drug Administration on Thursday approved the first novel antipsychotic treatment in decades, a drug developed to treat schizophrenia without disabling side effects like weight gain.Until now, all available antipsychotics have worked by blocking a dopamine receptor. In most patients with schizophrenia, they can reduce symptoms like hallucinations and paranoia to a manageable level.But they have serious flaws. Weight gain, a common side effect, contributes to a high rate of cardiac disease and early death among people with schizophrenia. And many patients stop taking the medications, complaining that they leave them sluggish and unmotivated.The new drug, Cobenfy, also influences dopamine levels, but it does so indirectly, by changing levels of another neurotransmitter, acetylcholine. The new approach, researchers hope, will address some of the most intractable aspects of the disease, like lack of motivation and inability to feel pleasure.“This is the first time, really since the advent of these medicines, that a new mechanism has come out, so there is really a lot of excitement that maybe we have something new to treat patients with,” said Dr. Frederick C. Nucifora, director of the Adult Schizophrenia Clinic at the Johns Hopkins School of Medicine.Still, there are unanswered questions about the new drug.Only three controlled studies of the drug’s efficacy have been published, and all three lasted for only five weeks. So it is not clear how effective Cobenfy will be over longer periods, or whether it has long-term neurological side effects, like movement disorders, said Dr. David Rind, the medical director of the Institute for Clinical and Economic Review, which reviews new drugs arriving on the market.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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Acadia Hospitals Reach $20 Million Settlement With Justice Dept.

The F.B.I. is also investigating the large chain of psychiatric hospitals for holding patients longer than what is medically necessary.Acadia Healthcare, one of the country’s largest for-profit chains of psychiatric hospitals, has agreed to pay nearly $20 million to settle a federal investigation accusing the company of defrauding taxpayer-funded health insurance programs like Medicare and Medicaid, the Justice Department said on Thursday.Prosecutors said that Acadia had held patients for longer than necessary and admitted people who didn’t need to be there. Once patients entered its facilities, the government said, Acadia failed to provide therapy and kept staffing dangerously low, leading to assaults and suicides.Under the settlement, Acadia has agreed to pay the federal government as well as four states — Florida, Georgia, Michigan and Nevada — to resolve allegations that the company had violated state laws.Tim Blair, an Acadia spokesman, said that the company had been cooperating with the government and did not admit any wrongdoing. He said that resolving the investigation “allows us to ensure our focus remains on providing quality care to our patients and their families.”Acadia operates more than 50 psychiatric hospitals nationwide, and more than half of its revenue comes from government insurance programs.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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The Global Threat of Antibiotic Resistance

International health experts have begun to shift their focus to try to provide access to basic drugs in countries where preventable deaths from infections occur too frequently.An impoverished family in Africa is unable to afford a 50-cent course of antibiotics to save the life of a child with a simple bacterial infection. Is such a tragedy best described as a case of antimicrobial resistance, the slow-motion health emergency caused by the misuse of lifesaving antibiotics?For more than a decade, antimicrobial resistance has been framed as a problem of excess. The willy-nilly consumption of antibiotics, scientists said, have rendered the drugs less effective, leading to the unnecessary death of millions, many of them poor.But as global health officials gathered at the United Nations on Thursday to discuss the challenges posed by antimicrobial resistance, many have been promoting a more expansive understanding of the problem. It’s one based on preventing treatable infections through improved sanitation, higher vaccination rates and increased access to anti-infective drugs in lower-income countries.“Millions of people around the world have never even taken an antibiotic because they can’t afford them,” said Dr. Ramanan Laxminarayan, an economist and epidemiologist who has been promoting this new approach to antimicrobial resistance, much of it detailed in a recent series of journal articles in The Lancet. “We’re trying to move away from the issue of resistance, which is hard for the public to understand, and more to entitlement, which is that everyone should have access to an effective antibiotic.”Threading that needle — promoting greater access to antibiotics in some places while seeking to limit their use in others — won’t be easy.In the eight years since the U.N. held its first high-level meeting on antimicrobial resistance, the world has become increasingly familiar with the threats posed by untreatable infections.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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A Patchwork of Cannabis Laws Creates Health Risks, Study Finds

A new report calls for public education and closing of legal loopholes to keep the public safe.The NewsAs more states have legalized the sale of cannabis, a fractured and inconsistent legal framework has emerged across the country that has prioritized sales income and tax revenue over public health, a new report finds.The report, issued Thursday by the National Academies of Sciences, Engineering and Medicine, describes an “urgent need for a coordinated public health response.” The academies, a nonprofit advisory group of the nation’s leading scientists, said that such a response should include a federally led campaign to educate parents, children and others about the risks of a drug that is increasingly potent.Among the other suggestions, the report also calls for a lifting of research restrictions on cannabis. In recent years, many claims have been made about the medicinal and other health effects of the drug but often without substantiation from science.Even as a patchwork of laws and regulations have emerged, the potency of cannabis products has surged.Cindy Schultz for The New York TimesPotencyCurrently 24 states, the District of Columbia and two U.S. territories have legalized the sale of cannabis for recreational use, according to the National Conference on State Legislatures. In 13 other states, cannabis is legal for medicinal use.Even as a patchwork of laws and regulations have emerged, the potency of cannabis products has surged, as measured by the growing concentration of THC, the main psychoactive compound in cannabis. The rapid increases have left the public unaware of the health risks, particularly to young people, pregnant women and seniors, according to Yasmin Hurd, director of the Addiction Institute at the Icahn School of Medicine and the vice chair of the committee that issued the latest report.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

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