Risk of Suicide Highest

At Start of Drug Therapy

Patients on antidepressant drugs run a higher risk of suicide in the first few days of therapy, but the risk is similar with any of the most popular mood-lifting drugs and may be rooted in the underlying depression, a study said yesterday.

The report, published in this week's Journal of the American Medical Association, was designed to find out if drugs called selective serotonin reuptake inhibitors -- such as GlaxoSmithKline's Paxil and Eli Lilly and Co.'s Prozac -- were associated with a higher suicide risk than other mood lifters.

Researchers at Boston University said they looked at data on nearly 160,000 users of four antidepressants in England from 1993 to 1999. The four drugs were fluoxetine (Prozac), paroxetine (Paxil), amitriptyline and dothiepin, the latter two being from an older class of antidepressants called tricyclic drugs.

The researchers reported nonfatal suicidal behavior was four times as likely within 10 days of when any of the drugs was first prescribed -- and three times as likely in the next 19 days -- than was the case after the patient had been on a drug for three months.

Private Reviewers Miss

Many Faults in Hospitals

The private organization that clears hospitals to receive Medicare payments missed most problems later identified by state inspectors, potentially compromising patient safety, congressional investigators said yesterday.

The Joint Commission on Accreditation of Healthcare Organizations failed to find 167 of 241 "serious deficiencies" in a survey of 500 hospitals reviewed between 2000 and 2002, the Government Accountability Office said.

Many of the overlooked problems related to fire safety, but others involved substandard care.

The commission accredited 82 percent of U.S. hospitals in 2002.

FDA Approves Botox

For Heavy Sweating

It's now official: Wrinkle-smoothing Botox can be injected in the armpits to curb excessive sweating.

Yesterday, the Food and Drug Administration approved the long-expected new use of Botox, the weakened form of the food-poisoning toxin that causes botulism.

People with a condition called primary axillary hyperhidrosis produce four or five times the normal amount of underarm sweat. There are other treatments, including powerful antiperspirants, drugs to prevent sweat gland stimulation, and surgery.

Botox apparently temporarily paralyzes a nerve that stimulates sweat glands. In one study, 91 percent of patients who received Botox underarm injections saw their sweating cut in half in a month, compared with 36 percent of patients given saltwater injections.

Patients can get additional Botox injections every few months.

-- From News Reports