Opinion: When my child is in psychosis, the pediatric health care system can’t help us

I am sitting in a firm recliner with a wipeable surface during a two-day hospital admission for testing at our local children’s hospital. The chair is designed for durability, not sleep. The pillow beneath my head is flat and smells faintly of disinfectant. A thin hospital blanket scratches against my arms as I shift, unsuccessfully, trying to rest. The room is dim but never quiet. Monitors beep. Machines hum. Footsteps pass the door. Hospital noise does not fade. It embeds itself in the nervous system.

My 13-year-old is finally asleep. His thin body is curled beneath a blanket identical to mine. One shoulder peeks out, bruised from repeated injections of calming medication. A neon orange bandage marks the most recent one, given about an hour ago. I watch his chest rise and fall and allow myself a brief moment of relief.

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What the peptide craze reveals about Americans’ relationship with risk

Robert F. Kennedy Jr. tends to favor health choices he sees as natural — whether that means eating “real food” like meat and vegetables instead of ultra-processed food or suggesting, falsely, that nutrition and vitamins are a good alternative for fighting off measles instead of vaccines.

But there’s at least one area where the health secretary breaks with his own tradition. He’s among the many influential voices in health and wellness in favor of people injecting themselves with experimental drugs known as peptides — much to the concern of mainstream public health experts, who warn that these drugs haven’t been sufficiently studied for efficacy or potential side effects, including higher cancer risk.

With demand for peptides on the rise and would-be self-optimizers seeking out the drugs on gray and black markets, Kennedy said on Joe Rogan’s podcast in February that he thought the Food and Drug Administration would take action within a couple of weeks to make them more accessible. That means reclassifying around 14 drugs so that compounding pharmacies can once again offer them after a 2023 rule change under the Biden administration. “I’m a big fan of peptides,” Kennedy said, having “used them myself to really good effect on a couple of injuries.” 

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STAT+: How a four-month FDA delay forced a small biotech company to close its doors

In February, a small biotech company called Kezar Life Sciences reached a breakthrough with the Food and Drug Administration, agreeing to a plan for a clinical trial it hoped could lead to the approval of its treatment for a rare, debilitating liver disease called autoimmune hepatitis. The problem: The agreement came four months too late.

The meeting to discuss trial design, a critical step in the drug development process, had been scheduled for last October. But the FDA abruptly canceled it without explanation. The company could no longer proceed as planned and, without clarity from regulators, its path forward was unclear. Kezar’s investors wanted out, and the biotech was forced to start the process of winding down.

It laid off most of its staff of about 60 people. Then, it auctioned off its lab equipment and sold much of its office furniture, except for the table and chairs in one conference room it kept in case the company got its meeting with FDA staff.

Last week — after the meeting and the breakthrough happened — the company said it would be sold. Kezar hopes the buyer, Aurinia Pharmaceuticals, will take the drug forward, though how quickly that can happen, if at all, is not guaranteed.

It’s also not clear why Kezar’s initial meeting was canceled. But to CEO Chris Kirk, the chain of events fits a pattern over the past year in which volatility at the FDA — including staff departures and decision-making seen as inconsistent — has ricocheted across the industry, impacting drugmakers. Those impacts can fall disproportionately on small companies, which, unlike major drugmakers, often operate on one financing to the next. 

“In my career, I’ve often not agreed with what the FDA has said, but I’ve at least relied on their consistency,” said Kirk, who’s worked in biotech for more than two decades. “That doesn’t appear to be what’s happening now. It feels more stochastic and maybe even capricious, what’s going on at the FDA. And this isn’t good for patients. It’s definitely not good for the biotech ecosystem as a whole.”

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Home tDCS for the Treatment of Major Depression.

Conditions: Major Depression Disorder

Interventions: Device: Accelerated protocol of home Transcranial direct current stimulation; Device: Conventional protocol of home Transcranial direct current stimulation; Device: Conventional protocol of in person Transcranial direct current stimulation

Sponsors: Ionclinics & Deionic SL; Hospital Universitari de Bellvitge; Consorci Sanitari del Maresme. Hospital Universitari de Mataró; Parc Taulí Hospital Universitari

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