Excerpts from chapter 4 regarding CTE
I explained that I strongly felt all football players, to a degree, have experienced CTE. My comment was based on the nature of the sport and the 4-22-15 article in USA Today; “Judge Approves Potential $1 Billion Settlement To Resolve NFL Concussion Lawsuit”, which reported that 6000 retired NFL players will receive an average of $190K for concussion injuries. This is a significant number comprised of approximately 1/3rd of all retired players. This number accounts only for those experiencing problems while the other 2/3rds have yet to see problems or they are minimal based on the degree of CTE experienced.(http://www.usatoday.com/story/sports/nfl/2015/04/22/nfl-concussion-lawsuit-settlement-judge-1-billion/26192827/)
Since anyone with a TBI or CTE has an increased risk of suicide four times more than someone without this injury combining narcotic pain relievers with brain-altering psychiatric medications sets up a perfect storm for sudden death, suicide, and other physical and psychological reactions.
After viewing the movie Concussion, I noticed that although mention was made to the deceased players using medication for pain relief, as well as psychiatric medications, there was no direct reference to these medications contributing to the actual behave- ior of the players being discussed. Therefore, I feel strongly that anyone having potential CTE or TBI should be aware that the first black box warning on most psychiatric medications is suicide. As this book states, there are multiple integrative treatment modalities that can be utilized for what is a very physical (not psychiatric) impairment of CTE or TBI.
Concussion also neglects to explore the relationship between psychiatric medication and dangerous physical side effects. For example, there is a scene in which a football player (Webster), who is later diagnosed post-mortem with CTE, was given an injection of Haldol (also known as Haloperidol) after he visits the NFL team physician in a very agitated state (which is not uncommon with a brain injury). Soon after, Webster has a heart attack and dies.
“Haloperidol, is also commonly used, both intramuscularly and intravenously, to control agitated patients in the emergency room. In September 2007, the FDA released a warning that torsades de pointes and QT prolongation (Heart rhythm) might occur in patients receiving haloperidol, particularly when the drug is administered intravenously or at doses higher than recommended. The FDA notes that haloperidol is not approved for intravenous use”. This information can be seen in the Summary and Comment of the 10/12/07 issue of Emergency Medicine titled “FDA Warning: Haloperidol Joins Droperidol” by Diane M. Birnbaumer, MD, FACEP.74
Also an article in the Journal Of Hospital Medicine in 2010; 5(4): E8-E16 (PubMed: 20394022) titled, “The FDA extended warning for intravenous haloperidol and torsades de pointes: how should institutions respond” reveals some patients experiencing sudden cardiac arrest after given IV haloperidol, as well as other potential risk factors.75
The movie suggests that the football player had CTE but died from heart failure; the injection of Haldol was never addressed.
What I have been stating publically for several years and also in my book “Invisible Scars”, is that 100% of all National Football League (NFL) players have Chronic Traumatic Encephalopathy (CTE), based on the nature of the game itself. Now my clinical observations have been scientifically confirmed by a study presented in the Journal of the American Medical Association (JAMA), JAMA. 2017;318(4):360-370. doi:10.1001/jama.2017.8334
The article is:
Original Investigation — July 25, 2017
“Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football”
“Findings: In a convenience sample of 202 deceased players of American football from a brain donation program, CTE was neuropathologically diagnosed in 177 players across all levels of play (87%), including 110 of 111 former National Football League players (99%)”.
Also, extensive newspaper articles can be found on this study:
The New York Times on July 25, 2017 titled: 110 NFL brains by Joe Ward, Josh Williams and Sam Manchester.
USA Today reports: “Study: CTE diagnosed in 99% of former NFL players studied by Researchers”
A.J. Perez, USA TODAY Sports Published 11:02 a.m. ET July 25, 2017, Updated 11:45 a.m. ET July 25, 2017