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May 11, 2006

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Convicted Child Molester Claims Bipolar Disorder
NBC 11 Bay Area
SAN JOSE, Calif. -- Convicted child molester Frederick Everts testified Wednesday that he suffers from bipolar disorder, and in his manic stage he has no control over his impulses to sexually molest pre-pubescent boys.

L.A. Woman's Fall Probed in Chicago
Los Angeles Times
She is critical after her plunge from a project high-rise. She had been released from police custody after her family said she was bipolar.

Mentally ill inmate needs more than just jail
Sun-Sentinel
What will it take for a mentally ill jail inmate named Cory Itson to get the medical treatment he needs? Strongly worded orders from two Broward judges to the Department of Children & Families haven't worked.

Group illuminates dark puzzle of disorders: A student's bipolar disorder or other illness can baffle parents and teachers.

Orlando Sentinel (Orlando, FL); 5/9/2006

Byline: Kelly Griffith

May 9--GROVELAND -- The lighting in Steven Roy's room isn't so good.

A medium-sized fluorescent bulb shines near the bookcase where his collection of 300 DVDs grows with occasional trips to the pawnshop. The other source of light -- his computer monitor -- glows almost constantly.

The computer is his hobby, his companion, his best friend. Roy, 20, is plagued by bipolar and panic disorders, two mental illnesses that helped drive him from South Lake High School and into his room, where he has spent weeks at a time since dropping out of high school his senior year. Roy and his family say they often felt alone navigating school issues and bureaucracy, not realizing help was available through a Clearwater nonprofit, which offers not only volunteer mentors but also a bevy of online resources and in-person workshops. The Family Network on Disabilities of Florida Inc.'s Parent Education Network will host workshops Thursday in Leesburg and May 16 in Lakeland on topics aimed at Central Florida parents who have a child with a disability or other condition that may impair learning. Much of what they will teach is information Roy's mother, Cheryl Grieb, learned by doing.

It wasn't easy, and it still isn't. Sometimes, Roy never leaves his dimly lit safe haven, where a few cigarettes keep him company while he mixes music on his computer. He slows the tempo slightly, giving a new sound to an old song. He makes Prince's "Purple Rain" or an Isley Brothers tune slow down a notch. "Like it?" he asks, the mellow sound purring through the speakers. In some ways, Roy is among the fortunate ones. Many young people with mental disorders often struggle in school, and wind up not in their rooms -- but in jail. No one knows how many students have illnesses such as bipolar disorder or learning disabilities such as attention deficit disorder because no one in the school district asks. Still, researchers have long known that juvenile-justice facilities are full of kids with such problems. Educators only track students with disabilities if they reach thresholds that result in labels such as "emotionally disturbed." Roy moved to Florida with his mother after she divorced when he was 7. He was bright and made straight As in school. By fourth grade, the Lake County School District discharged him from its exceptional student education program, the track for children with learning disabilities, saying he no longer needed it based on his performance. But by age 12, Roy was diagnosed as depressed and prescribed his first medication. He hadn't seen his father in years; a man he says still suffers ups-and-downs in similar fashion. Mental illness is sometimes hereditary. The years that followed brought deep depressions, numerous medications, side effects that included vomiting and shakes, short unpredictable manic episodes sparked by something as simple as a friend telling a joke. Panic attacks came a bit later. Missed school days added up, as did the letters from school-district officials. Finally, at the beginning of his senior year, Roy quit. Each day, he would sit in the parking lot, afraid to go inside the school, and eventually drive off. After two or three weeks of the same sitting-panic-drive ritual, he withdrew from school and went home for good. Today, Roy has no high school diploma, no job and is afraid his handwriting will look bad on an application. Talking openly, he says, has taken extreme courage and, for him, a huge move out of a two-year-long depression that kept him mostly in his darkened room. "I plan to get my GED and get a job," he said. " And college. I want to start saving up for that." The Individuals with Disabilities Education Act, known as IDEA, is the government's way of ensuring that students like Roy have equal opportunity to make it through school and into a job. Roy, for instance, will be allowed to take the GED test in parts and in a private room. He plans to take the first section next week. The act, however, can be confusing or leave parents not knowing where their child's rights start and stop if they do get in trouble or have problems with school officials. Years of research connects mental illness and disabilities with poor educational outcomes and higher incidence of juvenile-justice problems. Research shows that a disproportionate number of children with mental disorders are incarcerated, compared with the general population.

A 2002 study of one juvenile-justice facility, for instance, found that 90 percent of its population had been diagnosed with one or more mental illnesses. Only a handful of law-enforcement personnel in most counties have specific training on how to deal with the mentally ill despite sometimes having violent encounters. A 21-year-old man diagnosed with bipolar disorder died at the Polk County Jail on March 19 after more than a half-dozen deputies subdued him during a violent outburst. The cause of death awaits toxicology reports. The Clearwater-based Parent Education Network travels the state and offers workshops on topics such as what parents can expect if their child winds up in the juvenile-justice system and what an individual education plan is. The experiences can be sobering for parents, particularly those who have coddled their "disabled" child, said Tara Bremer, co-director of the network, who had experiences with her son in the juvenile-justice system. She now helps teach other parents and recently spoke in Polk County. Roy, meanwhile, is preparing for his first one-hour GED test, the social-studies portion, on May 17.

Said his mother, Cheryl Grieb: "He is scared but determined."

Kelly Griffith can be reached at kgriffith@orlandosentinel.com or 863-422-5908.

Copyright (c) 2006, The Orlando Sentinel, Fla.

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.),

(213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

COPYRIGHT 2006 The Orlando Sentinel

This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

Dead suspect had pellet gun: Harold Leon Sherrod was shot after a series of crimes and confrontations with officers Sunday.

Orlando Sentinel (Orlando, FL); 5/9/2006

Byline: Willoughby Mariano and Amy C. Rippel

May 9--A man shot dead by deputies on Interstate 4 after a crime spree across Orange County was armed with a pellet gun that looked like a handgun, a Sheriff's Office spokesman said Monday. Harold Leon Sherrod, 32, also had recent arrests on charges that he attempted to kill and rape a woman with a knife and for violating probation, according to Seminole County Sheriff's Office records. Department spokesman Sgt. Carlos Torres gave few details on what prompted deputies to shoot Sherrod on Sunday evening other than that Deputy Ravindra Khargie, a six-year department veteran, fired after another deputy's car was rammed by Sherrod, and that Khargie feared for his life. The shooting was the culmination of a crime spree that began on Santa Cruz Court at about 5 p.m. Sunday and ended about an hour later on I-4 near Lake Buena Vista, Torres said. Within that time, Sherrod carjacked an Acura, crashed into a Chevrolet, held a family at gunpoint and hit a Jaguar -- all in the Santa Cruz Court area, south of Silver Star Road. Then he drove to a gas station at South Kirkman and Vineland roads in Orlando and stole a Cadillac, according to sheriff's reports.

The chase ended near the State Road 535 exit of I-4, where Sherrod rammed the car of Deputy Angel Cirino, who was taken to Florida Hospital Celebration Health with minor injuries. Khargie fired as he was trying to take Sherrod into custody, the Sheriff's Office said. Sherrod's mother, Jennifer Butler, said Monday that her son had bipolar disorder. A blood vessel also was wrapped around his brain stem, she said, causing him to slowly die. Sherrod lived at home with his mother on San Jose Boulevard. On Sunday, her son seemed fine, she said. He had been taking his medicine regularly to control the disorder, but she wondered if the blood vessel in his brain burst and caused his erratic behavior. Her son was diagnosed with the blood-vessel problem at age 21 and was told there was nothing doctors could do to help him, Butler said. He was slowly losing control over his left side, his mother said. He was blind in the left eye, forcing him to wear an eye patch. "The doctors said he could die any day," she said.

She said he lived for his four children -- three girls and a 1-year-old boy. He was a "humble, sweet, sweet person," she said. Witnesses at one of the earlier incidents told deputies that Sherrod fired shots, according to reports. But the only weapon found at the I-4 scene was a pellet gun designed to look like a handgun, Torres said. Khargie will perform administrative duties for two weeks in keeping with department policy on officer-involved shootings, Torres said. Sunday wasn't the first time Sherrod had been held at gunpoint by a deputy. On Nov. 11, a Seminole County deputy found him holding a woman at knifepoint in an Oviedo-area apartment, according to a sheriff's report. The deputy drew his gun and ordered Sherrod to let the knife go, then switched to his Taser once Sherrod disarmed himself. That's when Sherrod pointed his right index finger to his forehead and made a request.

"Shoot me," Sherrod told the deputy, the report states. He was arrested on charges of attempted sexual assault, attempted homicide, aggravated battery and cruelty toward a child, according to the report.

He was booked into jail again Feb. 7 on one count of violating the terms of his probation or community control. He was released later that month. Willoughby Mariano can be reached at wmariano@orlandosentinel.com or 407-420-5171. Amy C. Rippel can be reached at arippel@orlandosentinel.com or 407-420-5736.

Copyright (c) 2006, The Orlando Sentinel, Fla.

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.),

(213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

COPYRIGHT 2006 The Orlando Sentinel

This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

Putnam County man given 4-year term in '04 crash: Driver ran stop sign, killed 2 people in van.

Blade (Toledo, OH); 5/9/2006

Byline: Jennifer Feehan

May 9--BOWLING GREEN - A Putnam County man who was intoxicated when he ran a stop sign at U.S. 6 and struck a van, killing two people, was sent to prison yesterday for four years. Lucas Horstman, 22, of Ottawa pleaded no contest in March to two counts of aggravated vehicular homicide and two counts of aggravated vehicular assault stemming from the Oct. 17, 2004, crash that killed Lawrence Campbell. 57, of Sandusky and Douglas Fishbaugh, 26, of Huntington, Ind. Two other passengers in Mr. Campbell's vehicle, Trenda Dingus, 27, and her daughter, Hanna Jones, 4, were badly injured. Judge Reeve Kelsey of Wood County Common Pleas Court said that once Horstman is released from prison, he is to be on community control for five years, during which time he must perform 300 hours of community service, get evaluated and treated for substance abuse and anger management, and pay $4,285 in restitution.

Judge Kelsey also suspended Horstman's driver's license for 10 years. Before he was sentenced, Horstman said he was "extremely sorry" for the incident. "There's a debt that I'll never be able to repay," he said. "I can only try and turn my life around." Horstman was northbound on Pemberville Road about 4 a.m. when he ran the stop sign and collided with Mr. Campbell's eastbound van. Horstman and his passenger, Cruz Castillo, 18, of Ottawa were thrown from the vehicle and investigators were initially unsure who was driving. One of the passengers injured in the crash and her mother told the court they did not want to see Horstman go to prison. "I know neither Larry or Doug would want to see this boy go to jail," said Marie Dingus, who said she was the mother of Trenda Dingus, the grandmother of Hanna Jones, and fiance of Lawrence "Larry" Campbell. "There was another party involved in this and [Horstman] has taken responsibility. I'm begging you judge, I don't want to see him go to jail. He has to live with this for the rest of his life." Trenda Dingus, who was engaged to Douglas Fishbaugh, said much the same. "I don't want to see him rot in prison. What's prison going to do?" she asked. Assistant Wood County Prosecutor Gwen Howe-Gebers said Horstman had to be punished. "There has to be some message sent that you cannot drink and drive," she said. She said Horstman had tested positive for marijuana use twice while the probation department was preparing his presentence investigation. She said he became so angry when questioned about it that he had to leave the interview. While the prosecution and defense had disagreed over who was behind the wheel when the crash occurred, Ms. Howe-Gebers said Horstman was culpable whether he was driving or whether he allowed his drunken friend to drive. Bill Kluge, attorney for Horstman, said an accident reconstructionist he hired felt certain Horstman was not driving, but his client agreed to plead no contest because he decided to take responsibility for his actions. "Lucas has been a troubled young man for many years, including bouts of depression, diagnosis of bipolar disorder, and his inability to stay with treatment," Mr. Kluge said. Contact Jennifer Feehan

at jfeehan@theblade.com

or 419-353-5972.

Copyright (c) 2006, The Blade, Toledo, Ohio

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.),

(213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

COPYRIGHT 2006 The Blade

This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

Doctors Widely Prescribe Drugs Without Adequate Scrutiny, Stanford Scientist Finds.

Business Wire; 5/8/2006

STANFORD, Calif. -- In choosing which drugs to prescribe, doctors often select medications for patients despite a lack of conclusive medical evidence of their effects and safety, according to a new study led by a researcher at the Stanford University School of Medicine.

Of a wide sampling of prescriptions dispensed to patients in 2001, 21 percent were intended to treat medical conditions for which the drugs lacked specific approval from the U.S. Food and Drug Administration, though other published research suggested possible benefits. Furthermore, about three of every four of those prescriptions were for conditions for which there were little or no evidence of the drugs' effectiveness.

This practice of "off-label prescribing" offers doctors flexibility and innovation in treating patients but also carries unknown risks. The findings, which will be published May 8 in the Archives of Internal Medicine, are believed to be the first estimate based on a sizeable data base of the actual number of off-label prescriptions among the 100 most-used drugs and 60 other randomly-selected, commonly used medications.

The results show scientific evidence plays only a partial role in a physician's treatment decisions, said Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center and senior author of the study. Indeed, many doctors might be unaware if a drug has been FDA-approved for a specific use or how much research supports its use, he added.

"Many doctors prescribed a drug when there is little or no evidence supporting its efficacy and safety," Stafford said. "The study can't tell us why doctors prescribe drugs off label. Some uses are more reasonable than others, but, by definition, off-label uses receive less scrutiny than FDA-approved indications."

It is unclear how off-label uses become established within the medical community in cases where limited or no scientific evidence backs up their use. Informal communication between physicians, promising or preliminary scientific studies, and marketing by the pharmaceutical industry could play roles, Stafford commented.

Of course, just because a drug is unapproved by the FDA doesn't mean it's ineffective. The FDA approves drugs for treating specific indications only, and there are many reasons why a drug might not have been approved for treating a particular condition, Stafford said. Undergoing the trials necessary for approval, for instance, can be time-consuming and expensive. If a drug's patent has expired, a pharmaceutical company is unlikely to pursue approval for another indication.

What's more, many drugs belong to classes of pharmaceuticals that work in similar ways, though each might have different side effects. It would be logical to assume that a drug in a particular class would have the same effect as others in that class. Other off-label use may represent an extension of labeled uses or evolving new uses that have not been evaluated stringently. Greater caution is advised in such circumstances, Stafford said.

"These off-label uses have not been scrutinized the way FDA-approved uses have been," Stafford explained. "While this situation is more risky, some patients might have conditions where taking such risks might be warranted."

For patients with severe medical conditions, the potential benefits of treatment might outweigh the increased risk associated with off-label use. A physician might choose to prescribe a drug off-label to adjust for a patient's sensitivities, to avoid interactions with other drugs or to try a different approach if FDA-approved drugs haven't worked. While nothing prevents a doctor's prescribing a drug off-label, pharmaceutical companies are prohibited from directly promoting such uses.

With colleague and first author David C. Radley, MPH, of Dartmouth Medical School's Center for Evaluative Clinical Sciences, and collaborator Stan N. Finkelstein, MD, of the Massachusetts Institute of Technology, Stafford compiled data taken from the 2001 National Disease Therapeutic Index, a continuing survey of U.S. physicians conducted by IMS Health, a pharmaceutical and health-care marketing company based in Plymouth Meeting, Pa. The survey compiles data from 3,500 physicians who report information about patient care during two randomly selected, consecutive workdays every quarter. The data represents 403,957 encounters between doctors and patients.

According to the IMS Health data, the 160 drugs selected for the study accounted for an estimated 725 million in annual prescriptions. About 575 million, or 79 percent of the total, were prescribed for a condition approved by the FDA. Off-label prescriptions accounted for 150 million, or 21 percent of the total number. Of those, 27 percent were for indications supported by scientific evidence, while the remaining 73 percent, or 109 million prescriptions, had little or no evidence.

The team considered a drug's use scientifically supported if the indication appeared with an evidence rating of good or excellent in DRUGDEX, a nationally recognized pharmaceutical compendium. Rigorous observations in clinical settings and controlled trials must determine the drug's efficacy before such a rating is assigned.

The medication gabapentin was prescribed off-label most frequently -- about 83 percent of the total prescriptions for that drug. In 66 percent of these instances, the drug had little or no scientific evidence for its efficacy in treating the indication. As of 2001, the FDA had approved gabapentin as an anticonvulsant and as a pain-reliever for patients with shingles. Scientific evidence supported its use for social anxiety, migraine prevention and certain diabetic conditions. But doctors commonly prescribed it to treat bipolar disorder and chronic pain, uses not evidenced by adequate scientific scrutiny.

Stafford said better communication and education for both the physician and patient about off-label use is crucial to good health care.

"Patients as well as physicians need to ask what's the level of evidence for using a specific drug for a specific condition," Stafford said. "Empowering patients to ask about the level of supporting evidence and to have the physicians adequately respond to these questions will improve patient care."

This study was funded by a grant from the Agency for Healthcare Research and Quality.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions -- Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

COPYRIGHT 2006 Business Wire

This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

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