The Yeardley Love murder trial has started in Charlottesville, VA this week. I was invited by Fox TV (WBFF) in Baltimore to speak to the defense’s position that alcohol and adderall were the cause of death, not the head injury. My interview excerpts will likely be aired sometime over the next 2 weeks.
In reviewing the specific information on alcohol and adderall in this tragic murder, I share below public information (NBC29.com) on autopsy findings.
“Through testimony from Dr. William Gormley, the man who performed Love’s autopsy, we learned that she had a blood alcohol content of 0.14; nearly twice the legal limit if she had been driving. He also said there were no fractures to Love’s skull but her brain was riddled with contusions, and the alcohol in her system was not sufficient to cause death.”
“Love also had a trace of a prescription amphetamine in her system (0.05ng/ml this I added from another source) consistent with the Adderall she took to help with her ADHD. Gormley testified that he did not believe the amphetamines were a contributing factor to her death.”
In regards to adderall, Yeardley was prescribed adderall under medical care. Adderall can be detected in blood up to 24 hours later so it is difficult to know when she had taken her dose of medication. Very likely it was taken much earlier in the day. The level is so low as to be relatively inconsequential in regards to clinical impact.
Two recently published studies reviewing the serious cardiovascular risks of stimulants in children, adolescents and adults found no association between stimulants and risk of myocardial infarction (heart attack), stroke, or sudden death. These two studies (NEJM, JAMA) represent the largest databases ever reviewed on stimulants and serious cardiovascular risks. There is additional study underway by the NIMH that is not yet published.
In my opinion, given that Yeardley was a seasoned athlete who would have had a pre-sports cardiogram and her heart was subjected to extreme athletic conditions without symptoms, the likelihood that alcohol and adderall provoked a cardiac arrthymia and sudden death is almost non-existent and wouldn’t rise to the level of consideration, especially in light of the more obvious cause of death determined by the medical examiner, “blunt force head trauma”.
We’ll await the presentation of additional facts in court and the jury’s conclusion.
ADHD Stimulant Shortage Video Maryland Public Television Jan 30, 2012 David W. Goodman, M.D. Feb 01, 2012 23:23 pm
Watch my interview from Maryland Public Television live 15 minute interview by Jeff Salkin on Direct Connection with Jeff Salkin on January 30, 2012 Monday at 7:30 pm discussing the recent problematic shortage of ADHD stimulant medications. I offered explanations for the shortages and “work arounds” for patients. Let me know what you think.
FDA, Pharmaceutical Companies, and Stimulant Shortages David W. Goodman, M.D. Jan 28, 2012 16:45 pm
Maryland Public Television has invited me to a live interview by Jeff Salkin on Direct Connection with Jeff Salkin on January 30, 2012 Monday at 7:30 pm to discuss the recent problematic shortage of ADHD stimulant medications. I will review the possible causes and make suggestions to “work around” the shortages for parents and patients.
As a preview to the show and for those who read my blogs, I have provided the FDA’s recent tables highlighting the manufacturers explanations for shortages. You will notice there are several companies making the medications so no one company can be held to blame. This is an industry issue entailing regulatory, manufacturing and economic factors.
Join us Monday night for my detailed explanations. Following the program, I will blog the detailed information I offered in the interview with further links.
30 mg tablets, 100 count (NDC 00555-0768-02)
API supply issues
Teva continue to release product as it becomes available.
Dextroamphetamine Tablets (1/12/2012)
Company/Products
Reason
Related Information
Teva Pharmaceuticals
1-800-545-88005 mg tablets, 100 count (NDC 00555-0952-02)
10 mg tablets, 100 count (NDC 00555-0953-02)
Manufacturing delays
Teva has dextroamphetamine 5 mg and 10 mg, 100 count tablets, will be on intermittent back order through mid-2012. Product will be released as it becomes available.
Methylphenidate HCl (updated 1/12/2012)
Company/Products
Reason
Related Information
Sandoz Customer Service:
1-609-627-85005 mg (100s – NDC 00781-8840-01 & 00781-5748-01; 1000s – NDC 00781-8840-10), 10 mg (100s – NDC 00781-5749-01 & 00781-8841-01; 1000s – NDC 00781-1749-10), 20 mg (100s – NDC 00781-8842-01 & 00781-5753-01; 1000s – NDC 00781-1753-10)20 mg (100s – NDC 00781-8843-01 & 00781-5754-01)
Capacity constraints and receiving API orders.
Expect sporadic backorders for the next couple of months.
Mallinckrodt Customer Service:
(800) 325-88885 mg (100s – NDC 00406-1121-01; 1000s – NDC 00406-1121-10), 10 mg (100s – NDC 00406-1122-01; 1000s – NDC 00406-1122-10), 20 mg (100s – NDC 00406-1124-01; 1000s – NDC 00406-1124-10) Methylin ER, 10 mg (100s – NDC 00406-1423-01) and 20 mg (100s – NDC 00406-1451-01)
Continued recovery as a result of previously unavailable raw material
All strengths of methylphenidate IR and ER tablets will be increasingly available as supply recovery continues, with most contracted orders being met.
UCB Customer Service:
1-800-477-78775 mg (100s – NDC 53014-0531-07), 10 mg (100s – NDC 53014-0530-07), and 20 mg (100s – NDC 53014-0532-07)Metadate ER Tablets, 20 mg (100s – NDC 53014-0594-07)
ADHD Drug Shortage on Maryland Public TV Jan 30 7:30pm David W. Goodman, M.D. Jan 26, 2012 09:20 am
With the increasing shortage of ADHD stimulant medications, Maryland Public Television invited me to a live interview by Jeff Salkin on Direct Connection with Jeff Salkin on January 30, 2012 Monday at 7:30 pm. I had been invited on his show a few years ago about adults with ADHD.
I will discuss the possible explanations for these shortages in addition to the large picture of drug shortages across all medication categories. As is frequently the case, there is no one cause. I hope to lay out the explanations. More importantly, I’ll offer suggestions to work around these shortages for you and your family members.
Join us this Monday night. I want to thank my patients who have offered their stories about the impact of the shortages.
ADHD Stimulant Shortage on Maryland Public Television Jan 30, 2012 7:30 pm David W. Goodman, M.D. Jan 18, 2012 09:36 am
Because of my recognized expertise in ADHD, I’m honored to have been invited to speak as a featured quest on Maryland Public Television’s program, Direct Connection with Jeff Salkin on January 30, 2012 Monday at 7:30 pm.
I will be addressing the stimulant shortage over the past several months-possible causes, the routes of manufacturing medications, the distribution of medications across the country, the sporadic availability of these medications, suggestions to physicians and patients on how to avoid shortages or alternative medications when shortages occur.
This problem now plagues those patients and family who use these medications in order to function at their highest level. The absence of medication may severely compromise ones ability to perform consistently thus increasing anxiety.
Join us and listen to my commentary and suggestions.
