Citizen Cartwright

Diagnosis: Caffeine withdrawal

Have you ever missed your morning coffee, only to be surprised by a pretty nasty headache?

The new mental health diagnostic manual released last month includes caffeine withdrawal and intoxication as mental disorders when they impair a person's ability to function in daily life.

The designations are controversial.

"Caffeine intoxication and withdrawal both occur fairly frequently but only rarely cause enough clinically significant impairment to be considered a mental disorder," says Allen Frances, who chaired the task force that developed the previous version of the manual and has been a vocal critic of the latest version. "We shouldn't medicalize every aspect of life and turn everyone into a patient," he says.

For people who don't want to completely give up caffeine, but don't want to be dependent on it, Dr. Laura Juliano of American University recommends drinking it at irregular intervals, and limiting it to as close to 100 milligrams as possible.

Dr. Roland Griffiths, of Johns Hopkins, says he has caffeine perhaps once a week, in relatively small doses. "If I'm sleep deprived, it's a really effective drug. It's very useful if you're not dependent on it because then it's more powerful and more effective and you don't have any withdrawal," he says.

Excitement over possible new cancer drugs

The drugs work in an entirely new way — unleashing the immune system to attack cancer cells much as it attacks bacteria — and are being seen as a possible alternative to chemotherapy.

Why so many suicides among baby boomers?

Reasons for the trend — which started a decade before the 2008 recession — aren't yet clear. But analysts say the generation came of age at a time of limitless possibilities, with "an illusion of choice" that has ended up in inevitable disappointment for some people.

Sunscreen as a way to look younger

If concern about skin cancer doesn't make you slather on the sunscreen, perhaps vanity will, says The Associated Press.

What AP calls "some of the strongest evidence to date that near-daily sunscreen use can slow the aging of your skin" — even if you're already middle-aged — comes from an Australian study published in the journal Annals of Internal Medicine.

New moves against superbugs

It's amazed me that more hasn't been done to come up with new antibiotics, after older ones became ineffective because of overuse in humans and farm animals.

After all, tens of thousands of Americans die every year from infections — mainly picked up in hospitals — that are resistant to antibiotics, according to experts.

But last month the Health and Human Services Department announced an agreement to pay $40 million to drugmaker GlaxoSmithKline to help it develop medications to fight antibiotic resistance and biological agents that terrorists might use.

And some government officials, drug companies and medical experts are pushing for quicker testing of new antibiotics, which could have a special label specifying that their use be limited to very sick patients.

But critics worry that a new antibiotic with special approval for limited use would end up being overused itself.

“The big problem is controlling the marketing,” says Dr. Steven Nissen, a cardiologist at the Cleveland Clinic and a frequent critic of the Food and Drug Administration. “Companies can get a drug on the market for a narrow indication and before you know it, it is being used in everybody.”

Why the U.S. leads the world in medical costs

The New York Times is starting a series on how the economic incentives in the U.S. health care market have driven up costs.

The Congressional Budget Office has said that if medical costs continue to rise at this rate, “total spending on health care would eventually account for all of the country’s economic output.”

Concerns about blood pressure, diabetes drugs

Bucking his bosses at the Food and Drug Administration, senior regulator Thomas Marciniak is seeking stronger warnings about blood pressure drugs known as angiotensin receptor blockers, or ARBs, according to internal documents reviewed by The Wall Street Journal.

The drugs, taken by millions of people and generating $7.6 billion in U.S. sales in 2012, may be linked to higher cancer rates, Marciniak says.

Meanwhile, Dr. Peter Butler, head of endocrinology at UCLA and a former editor of Diabetes, the American Diabetes Association journal, has raised cancer concerns about diabetes drugs such as Januvia, which have sales of more than $9 billion a year and are used by hundreds of thousands of people with Type 2 diabetes.

No link between ADHD meds, drug use

Medications like Adderall and Ritalin have no effect one way or the other on whether children abuse alcohol, marijuana, nicotine or cocaine later in life, according to an analysis published Wednesday by the American Medical Association.

A 2003 study in the journal Pediatrics had concluded that the introduction of stimulant medication to children with ADHD — attention deficit hyperactivity disorder — reduced the risk of such abuse later.

That finding has been repeated by doctors and pharmaceutical companies to ease parents’ concerns about putting their children on the medication.

Hospitals' 'struggle' to get staff to wash their hands

Hospital-acquired infections lead to nearly 100,000 patient deaths a year and cost $30 billion.

And under new federal rules, hospitals will lose Medicare funds when patients get preventable infections.

Key to preventing the spread of these infections: washing hands.

And yet hospital workers wash their hands as little as 30 percent of the time they interact with patients, according to studies.

So hospitals nationwide are using everything from video surveillance to carrots (okay, pizzas) and sticks (red cards) to get staff to wash their hands.

Why are health care workers so bad at it? Among the explanations studies have found: dry skin, pressures of an emergency environment, tedium of hand washing and resistance to authority. Doctors tend to be the most resistant, according to studies.

What can you do? If the person who comes in to examine you or your loved one doesn't wash their hands, ask them to.

Pfizer is leading in race for superbug vaccine

MRSA (methicillin-resistant Staphylococcus aureus) kills 20,000 Americans each year, exceeding annual deaths from AIDS.

And the market for a vaccine is estimated to be worth $3 billion to $4 billion a year.

But critics say companies may be risking costly failure with so much work on a bacterium that still is barely understood.