Psych suspended for interfering with other doctor's patients

A follow up to the strange case of Dr Patrick Cosgrove, as published in the British Medical Journal. It seems he was trying to interfere with other doctors, pushing his own agendas ....

A consultant child psychiatrist who sent letters to GPs questioning other psychiatrists’ competence, and forwarded copies to their patients, has been suspended for 12 months by the General Medical Council for serious professional misconduct.

Dr Patrick Cosgrove was one of the pioneers of the use of methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The Citizens’ Commission on Human Rights and Overload Network, the Scottish based advocacy group for patients with the condition, have both complained to the GMC about Dr Cosgrove, saying he was too ready to prescribe off label drugs.

But Professor Norman Mackay, chairman of the Professional Conduct Committee, said: "Throughout the course of this inquiry there has been no criticism of Dr Cosgrove’s prescribing practice ... Instead this case has been centred around Dr Cosgrove’s monitoring of those patients whom he diagnosed as suffering from ADHD and the letters he subsequently sent to other practitioners."

In four letters Dr Cosgrove criticised five other psychiatrists who had seen his patients, some of whom disagreed with his opinions on the subject of the condition. Copies were sent to the psychiatrists themselves, to the patients’ general practitioners, and to adult patients or the patients’ parents. In one letter he suggested that two psychiatrists at the Cardiff and Vale NHS Trust were arguably guilty of medical negligence in knowing less about attention deficit hyperactivity disorder in adults than the patient himself did.

In another letter, written last summer, he wrote that a psychiatrist who had treated the patient might not believe in the existence of attention deficit hyperactivity disorder and might therefore have trouble being revalidated by the GMC’s Fitness to Practice Committee.

Finding Dr Cosgrove guilty of serious professional misconduct, Professor Mackay said he had contravened the GMC’s code of practice, which states that: "You must not undermine patients’ trust in the care or treatment they receive, or in the judgement of those treating them, by making malicious or unfounded criticisms of colleagues."

Professor Mackay added: "The nature of this correspondence goes far beyond what amounts to robust criticism ... Further similar incidents occurred after 2002 despite Dr Cosgrove being notified of these matters by the GMC." Dr Cosgrove "considered he had the best interests of his patients at the forefront of his mind," but had "not demonstrated any remorse or insight into his behaviour."

The case, which began in January but was adjourned, ended in a 12 month suspension for Dr Cosgrove, who has been retired since closing his private practice, the Bath Priority Clinic, in February. In a statement he denied the closure was linked to the GMC case, but said that registering with the National Care Standards Commission "would not be meeting the needs" of his patients.

Psychiatry: the social and criminal implications

Given the all-encompassing expertise on mental health apparently possessed by psychiatry, it would follow that psychiatrists and psychologists should be among the sanest, wisest and most stable of all the population, especially in light of the fact that they are responsible for our 'mental health' and constantly advise the public on what is best for us. It would follow that they would be paragons of mental stability, have great marriages, and set an enduring example to society which would prove that the tenets of psychiatry can stand the tests of pressure and time.

The truth is very different. A very extensive documentation of their statistics as an occupation.

Tidbits include:

1. In America, psychiatrists commit suicide twice as often as doctors in general. This figure is five times the rate of the general population
   
2. When the physician membership of Alcoholics Anonymous in the United States was studied, it was found that 17% were psychiatrists, even though psychiatrists in America make up only 8% of the medical profession.
   
3. Psychiatrists have much higher rates for all types of [psychotropic drug] use at any time than do other groups of physicians."
   
4. Psychiatrists also lead other branches of medicine in marriage difficulties - including sexual problems.
   
5. A 1988 American study discovered that a higher incidence of sexual abuse existed among prominent doctors in psychiatry - tenured professors and chairmen of ethics committees - than among the rank and file.

Woman Accuses Psychiatrist Of Improper Relationship

As reported on the Iowa Channel Website

West Des Moines police are investigating a psychiatrist after a female patient claimed the two had an intimate relationship. According to court documents obtained by KCCI in Iowa, Dr. Gaylord Nordine hired a longtime patient to work in his office.

The woman reported that their relationship became intimate in late 2002. In May, after the relationship apparently soured, the woman turned evidence over to police, including clothing, love letters, vacation pictures and a taped phone call. She said the items prove her intimacy with Nordine.

Court documents show police searched the doctor's office at 2700 Westown Parkway in West Des Moines. Investigators seized the patient's medical records and took a DNA sample from the doctor. Court documents show Dr. Nordine had prescribed drugs, including an antidepressant for the female patient as recently as April. No charges have been filed, but police said the investigation is continuing. Nordine would not comment to KCCI.

Family psychiatrist Dr. David Drake is a former Iowa Psychiatric Society ethics committee chairman. Drake said even if a psychiatrist's relationship with a patient or former patient is consensual, it's at least unethical and can be illegal.

Number of US Citizens at Suicide Risk due to SSRI Psych Drugs

This letter is to advise you that there is a new and accurate method for calculating the number of patients that have taken SSRIs in the US since introduction of these drugs. Neither the FDA, nor Pharma have been able to make this calculation. This method enables the extent of the harm, induced suicide and dependency caused by SSRIs in the US since 1988 to be quantified in both human and financial terms. [...]

It has been known by Pharma since1985 and now sadly by many thousands of victims, that every person, healthy or depressed, adult or child, who starts an SSRI, faces a finite risk of drug induced suicide and other harm in the first weeks of use. (Teicher and Cole, 1993)

Since 1988, 68 million Americans have used Paxil, Prozac and Zoloft. Using a most conservative excess suicide rate, at least 21 thousand avoidable suicides may have been induced, without any warnings to the victims or their families. [...]

There is a simple analogy with another industry that demands two questions. Assuming the lowest rate (32/100K) would the FAA support an airworthiness certificate for a certain aircraft type, that for 10 years consistently crashed and killed 300 to 1000 passengers per year and injured many others? How would the FAA react if the aircraft manufacturer consistently blamed the crashes on the passengers but not the aircraft?

As seen in this report

74% of children and adolescents suffered an adverse [bad] event during their treatment with SSRI Psych Drugs

As found on the net from another overlooked report

A report in the Journal of Child and Adolescent Psychopharmacology Dr. Timothy Wilens, Dr. Joseph Biederman, et al, child psychiatrists at Harvard's teaching hospital, Massachusetts General, found that 22% of children and adolescents who had been prescribed any one of the selective serotonin reuptake inhibitor (SSRI) antidepressants suffered drug-induced psychiatric adverse effects within three months. Furthermore, the authors, who have long advocated prescribing psychotropic drugs for children, reported: "Overall, 74% of children and adolescents experienced [i.e., suffered] an adverse event to an SSRI over the course of their treatment."

The SSRI drugs prescribed for these children were: Prozac, Paxil (Seroxat), Zoloft, Luvox and Celexa. Proof that the adverse effects were drug-induced is borne out by the fact that after the drugs were withdrawn and the children were re-exposed to an SSRI, 44% suffered another psychiatric adverse effect.

This report validates what critics--who are not receiving financial support from drug companies--have been pointing out for some time: Antidepression drugs are not the solution for troubled children. The documented evidence consistently shows that the drugs are causing children mental distress that can only aggravate their problems.

Of particular concern: According to the authors, the most frequent adverse effects induced by SSRI drugs are sleep disturbance (35%) and agitation. That combination is a prescription for violent outbursts--such as, self injury, suicide attempts, and / or violent outbursts toward others.

It is scandalous that the National Institute of Mental Health has remained absolutely silent about mounting evidence that these drugs pose hazards for children's health and lives. NIMH officials disregard the evidence of suicidal acts by children in clinical trials. The same evidence led the medical authorities in Great Britain to ban the use of an SSRI in children under 18. See documents at: www.ahrp.org

Despite evidence of harm, NIMH continues to promote the use of SSRIs and sponsors clinical trials that expose little children and adolescents to the hazards of these drugs.

The Law Project for Psychiatric Rights

The Law Project for Psychiatric Rights is a non-profit, tax exempt 501(c)(3) organization. It has a mission to bring fairness and reason into the administration of legal aspects of the mental health system, particularly unwarranted court ordered psychiatric drugging. The public mental health system is creating a huge class of chronic mental patients through forcing them to take ineffective, yet extremely harmful drugs. The purpose of the Law Project for Psychiatric rights is to promote and implement a legal campaign in support of psychiatric rights and against unwarranted court ordered psychiatric medication akin to what Thurgood Marshall and the NAACP mounted in the 40's and 50's on behalf of African American civil rights. Help us prevent unwarranted forced drugging with a secure on-line tax-deductible donation.

Excellent site, good references.

Bush plans to screen whole US population for mental illness

As reported in the British medical Journal

A sweeping mental health initiative will be unveiled by President George W Bush in July. The plan promises to integrate mentally ill patients fully into the community by providing "services in the community, rather than institutions," according to a March 2004 progress report entitled the New Freedom Initiative. While some praise the plan's goals, others say it protects the profits of drug companies at the expense of the public. Bush established the New Freedom Commission on Mental Health in April 2002 to conduct a "comprehensive study of the United States mental health service delivery system." The commission issued its recommendations in July 2003. Bush instructed more than 25 federal agencies to develop an implementation plan based on those recommendations. The commission commended the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan that "illustrates an evidence-based practice that results in better consumer outcomes." [...]

But the Texas project, which promotes the use of newer, more expensive antidepressants and antipsychotic drugs, sparked off controversy when Allen Jones, an employee of the Pennsylvania Office of the Inspector General, revealed that key officials with influence over the medication plan in his state received money and perks from drug companies with a stake in the medication algorithm (15 May, p1153). He was sacked this week for speaking to the BMJ and the New York Times. The Texas project started in 1995 as an alliance of individuals from the pharmaceutical industry, the University of Texas, and the mental health and corrections systems of Texas. The project was funded by a Robert Wood Johnson grant—and by several drug companies. Mr Jones told the BMJ that the same "political/pharmaceutical alliance" that generated the Texas project was behind the recommendations of the New Freedom Commission, which, according to his whistleblower report, were "poised to consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects, and to force private insurers to pick up more of the tab"

It is gratifying to observe the many negative reactions of readers of the BMJ to this crazy plan.

The above Whitehouse link goes to the 2004 Progress Report report on The President's New Freedom Initiative for People with Disabilities, which includes some information on the New Freedom Commission on Mental Health, starting on page 32. You can also see their final report here. It is this report that gives some details regarding proposed screening programs.

The actual range of the proposed programs are unclear, although obviously broad due to the promise of federal money. These reports do not provide actual details on pending proposals. Hopefully the BMJ report is not jumping the gun.

Happiness as a Psychiatric Disorder

As reported in the NY Times Magazine, we come up with this little tidbit.

... the British psychologist Richard P. Bentall has observed, ''There is consistent evidence that happy people overestimate their control over environmental events (often to the point of perceiving completely random events as subject to their will), give unrealistically positive evaluations of their own achievements, believe that others share their unrealistic opinions about themselves and show a general lack of evenhandedness when comparing themselves to others.'' Indeed, Bentall has proposed that happiness be classified as a psychiatric disorder.

Of course, the article also notes that happy people can also be bigoted and spiteful, and so somehow Happiness could be the cause of this.

Researchers found that angry people are more likely to make negative evaluations when judging members of other social groups. That, perhaps, will not come as a great surprise. But the same seems to be true of happy people, the researchers noted. The happier your mood, the more liable you are to make bigoted judgments -- like deciding that someone is guilty of a crime simply because he's a member of a minority group. Why? Nobody's sure.

Fortunately the journalist has a skeptical attitude.

Licensed Child Psychologist Convicted on Child Porn Charges

A former youth counselor has been convicted on child pornography charges. Donald Leonard Keys, 59, of St. Paul, was convicted of two felony counts for 26 pictures he took in 2001 of a 16-year-old boy in sexually explicit poses. The jury deliberated for about six hours following a three-day trial before U.S. District Judge David Doty, and returned its verdict Thursday.

According to statements made in court, Keys was working as a crisis counselor for a teen suicide hot line. Federal prosecutors said he met his 16-year-old victim in an Internet chat room where he was pretending to be a young, attractive homosexual male. The boy informed the Minnesota Internet Crimes Against Children Task Force of the photographs last year. He told investigators he believed he was manipulated into posing and was worried that Keys may have sent the images over the Internet.

Keys was once a licensed social worker in Minnesota and Wisconsin. He obtained the license after hiding a 1971 conviction for attempted sodomy that would have disqualified him, officials said. He forfeited the social worker license in 1996 after his role in a scheme to defraud an elderly man of his money became public. Federal authorities say Keys still is licensed as a child psychologist in Minnesota and Wisconsin.

A sentencing date has not been scheduled. Keys faces a mandatory minimum sentence of 15 years in prison and up to 30 years for producing child pornography and a mandatory two years and up to 10 years for possession of child pornography.

Mother wants to know how son died at NZ Psych Hospital

As seen in this report

Clement Matthews' mother wants the police to get to the truth about his death in Kingseat mental hospital 36 years ago. Rebecca Matthews, 63, said yesterday that she first learned of the police re-opening their investigation into the 1968 death of 11-year-old Clement in last week's Weekend Herald.

While investigating some of the flood of complaints over treatment of ex-patients of former mental hospitals, the newspaper found that the police were looking again at Clement's case after another former Kingseat patient, Stephen Lindsay, said he saw a male nurse kick him in the back. Ms Matthews, who has 17 grandchildren, four great-grandchildren and works in a car-polish factory, wants to speak to the police.

Ex-patients who were put into mental hospitals in the 1960s and 1970s have continued to come forward this week alleging mistreatment. They follow nearly 200 people, mostly aged 8 to 16 at the time of hospital treatment, who have lodged complaints with Wellington lawyers whose request for an inquiry is being considered by the Government. Their allegations include beatings and sexual assault by staff and patients, inappropriate use of electric-shock therapy and drugs such as paraldehyde as punishment, and excessive use of other drugs and solitary confinement. The claims initially centred on Porirua Hospital but now encompass most of the former asylums, including Oakley, Kingseat, Tokanui and Lake Alice hospitals.

See also this report: Abuse inquiries flow in

There has been a steady stream of inquiries from former employees and patients over abuse allegations at psychiatric hospitals. Almost 200 official complaints have been made by people who allege they were physically and sexually abused in state mental health hospitals in the 1960s and 1970s. Wellington lawyer Roger Chapman says recent publicity about the litigation has encouraged more people to come forward. He says it seems like an indication that abuse happened quite a bit in New Zealand's psychiatric hospitals in the past. However Mr Chapman says it is likely the majority of patients in psychiatric care were treated well by the psychiatric standards of the day. Lawyers are poring over the claims and inquiries. The abuse allegations include electric shock therapy, solitary confinement and the misuse of medication to keep people quiet. Mr Chapman says the allegations vary from hospital to hospital.

Sound like the standards of the day are horrific.

See also this report: Abuse complaints mount against psychiatric hospital

Military commander wanted torture whistle blower designated as 'mentally unfit'

As reported in the Guardian

A National Guard commander told a mental health counselor to change an evaluation to show that a serviceman who accused fellow soldiers of abusing Iraqi prisoners was mentally unfit, another soldier says. The commander has refused to comment on the allegation.

Sgt. Greg Ford of the 223rd Military Intelligence Battalion has said he was stripped of his duties and ordered to see combat-stress counselors after reporting that three fellow soldiers in the California National Guard unit brazenly abused Iraqi detainees during interrogations in Samarra last year. He said the soldiers choked detainees, threatened them with guns and stuck lit cigarettes in their ears.

Ford was placed under the supervision of Sgt. 1st Class Michael Marciello, a team leader in the battalion. In an interview this week, Marciello said he was ordered to watch Ford's behavior at all times. He said unit commanders believed something must have been wrong with Ford for making such ``wild'' claims against his fellow soldiers.

Marciello said that after a mental health evaluation came back saying Ford was OK, he witnessed a company commander in the 223rd, Capt. Vic Artiga, ask a counselor to change her evaluation. ``The company commander requested that this woman reconsider the end result of her analysis,'' Marciello said. He said he did not know what the final report said.

``Something happened for them to take Greg away,'' Marciello said. ``After a short discussion, they agreed to refer him to Germany for further evaluation. Then the following day, Greg was gone.'' Ford has said that he underwent psychiatric evaluations at military installations in Germany and San Antonio, Texas, and that those evaluations found nothing wrong with him.

Ford said the counselor who evaluated him in Iraq was Capt. Merle Madera of the 113th Medical Company. She did not return a call seeking comment Wednesday. Artiga would not say whether he influenced Ford's mental evaluation. And he defended his soldiers against Ford's abuse accusations. ``I know they conducted all their obligations legally, morally and ethically,'' he said.

Marciello said he had never worked with Ford until after the sergeant made the allegations, and could not corroborate his claims of abuse. Ford, 49, said he was a state prison guard for 18 years. He has since returned home to the Sacramento suburb of Fair Oaks. His unit, the San Francisco-based 223rd, returned home in March.

Sort of like the old days in the Gulag, no?

Bristol-Myers Squibb pulls psych drug Serzone from market

As seen in this report

Bristol-Myers Squibb (BMS) announced that this month it would stop manufacturing and shipping its Serzone brand of the combined serotonin-norepinephrine reuptake inhibitor and 5-HT2 antagonist nefazodone.

The announcement brings to a close a rocky nine-and-a-half-year run for the antidepressant, which has been tied to serious adverse effects on the liver and played a part in documented medication errors, due to name confusion.

BMS cited financial and business concerns for the decision, noting declining sales since the introduction of generic formulations in September 2003. Most industry analysts said the company pulled the drug in the face of numerous lawsuits and increasing pressure from regulators to remove the product voluntarily rather than being ordered to do so. With a voluntary removal, BMS is protected from the impact of an official FDA determination that the drug was removed from the market for safety reasons. Such a determination could have seriously damaged the company's position in legal proceedings.

Generic formulations of nefazodone are available from nine manufacturers, and at press time there was no immediate indication of any similar action by any of the nine companies.

Approved by the FDA in December 1994, nefazodone soon became associated with severe and possibly irreversible liver failure, leading to the necessity of a liver transplant and/or death. By early 2002 the FDA had told BMS to add a black-box warning to nefazodone's label and produce a new patient-information packet to be dispensed with each prescription. At that time, the FDA based its order on postmarketing experience of prescriptions to more than 7 million patients and cited a "rate of 3-4 times the estimated background rate of liver failure" (Psychiatric News, February 1, 2002). Generic nefazodone also carries the warning.

A year later, in January 2003, BMS voluntarily removed Serzone from the European market after regulators there expressed concern over the liver effects. In May 2003 the FDA requested a label change warning prescribers of 23 medication-error reports in which Serzone had been confused with AstraZeneca's second-generation antipsychotic Seroquel.

Then, on November 27, 2003, Health Canada ordered the product removed from the Canadian market, citing "51 cases of serious liver damage, including cirrhosis leading to transplant and death." That left the drug on the market only in the United States, Australia, and New Zealand. (BMS announced the simultaneous withdrawal of the product from those markets as well.)

Last year the consumer advocacy group Public Citizen sued the FDA, seeking to force the agency to remove Serzone and generic equivalents for safety reasons. That suit will continue, Public Citizen said, to force the removal of all nefazodone products from the market.

To date the FDA's Adverse Events Reporting System has received at least 55 reports of fulminant liver failure tied to the drug, including 20 deaths. In addition, another 39 cases of less-severe liver injury have been reported

Top UK Child Psychiatrist Suspended after Misconduct Hearing

One of the UK’s top child psychiatrists was today suspended for 12 months after he was found guilty of serious professional misconduct. Dr Patrick Cosgrove fired off a series of letters criticising the actions of fellow doctors and alleging a hospital inquiry whitewash, the General Medical Council was told.

The two-week inquiry in Manchester heard Cosgrove was one of the country’s leading experts in the field of Attention Deficit Hyperactivity Disorder (ADHD). He wrote the letters between 1996 and 2003 while working as a consultant child and adolescent psychiatrist at the private health centre, the Bristol Priority Clinic.

Outlining the committee’s judgment, Chairman Professor Norman Mackay said the comments made in the letters were “unprofessional, unsustainable and likely to cause the reader to doubt the knowledge and skills” of the doctors. He said: “The committee have found that the nature of this correspondence goes far beyond what amounts to robust criticism and that he acted in a wholly unprofessional manner in sending those letters. “(We) consider that Dr Cosgrove has not demonstrated any remorse or insight into his behaviour.”

He was also criticised for failing to monitor patients to whom he had prescribed powerful drugs such as Ritalin and Risperidone, used in the treatment of ADHD. Prof Mackay added: “Dr Cosgrove prescribed drugs to these patients but did not take appropriate steps to monitor the patients whilst they were taking the drugs prescribed and as such acted irresponsibly and not in the best interests of the patients.”

The committee also found his allegations of a hospital whitewash, which related to an inquiry following the treatment of a young boy by Oxfordshire Mental Healthcare Trust, to be “unsustainable”.

Prof Mackay said: “The committee have considered all the matters and judge Dr Cosgrove’s behaviour to be a serious departure from the standards of care and conduct expected of a registered medical practitioner. “The committee find Dr Cosgrove guilty of serious professional misconduct.” The GMC ruled that despite having retired from medical practice, Cosgrove should be suspended for 12 months, effective immediately.

This is very odd. Was he suspended for abuse, or for trying to blow the whistle?

See also this BBC Report. It reports that "Dr Cosgrove prescribed drugs to patients but did not take appropriate steps to monitor the patients whilst they were taking the drugs prescribed. As such, he acted irresponsibly and not in the best interests of the patients."

No Psychs Dot Org

No Psychs is not a highly polished site. But it does have a lot of good resources. No Psychs is a project created by the Foundation for Religious Freedom for:

• people seeking viable alternatives to mainstream mental health
  
• people requiring support after suffering from fraud, malpractice or physical harm
  
• people studying modern psycho-therapy and other conventional treatments for psychiatrically diagnosed mental disorders ---including the use of drugs
  
• a down-to-earth educational resource for the general public

Lots of reasonably informed articles on a variety of subjects. See for example, this article which provocatively attacks psychiatry as a dangerous cult

The REAL recipe for a mind-altering, debilitating, anxiety-inducing, Dangerous Cult:

1. Set up a system where all of society is forced, by weight of government arms, to be in awe of that system and any of its members;
   
2. Make them above much of the law by having it be practically self-regulating;
   
3. Allow such varying and dangerous use of substances that it becomes difficult to tell when it's appropriate usage;
   
4. Place or allow people to place themselves unquestioningly into one of these members' care without any checks and balances at all;
   
5. Make it very, very cumbersome and stressful for a legitimate threat of a highly dangerous nature, which clearly breaks with law, to be investigated at all.

What's the cult? Psychiatry....

Read their mission statement here

Paxil Ineffective

As Reported in The Seattle Post Intelligence

GlaxoSmithKline PLC, which is being sued for allegedly concealing negative information on the effects of its Paxil anti-depressant on children, admitted this week that the drug didn't show a benefit over a sugar pill when treating depression in children. Glaxo also published on its Web site a comprehensive list of the studies it's conducted on children who used the drug.

The British company said that Paxil led to a few more incidents possibly linked to suicidal behavior than a placebo did, though none of the children in its studies actually committed suicide.

The move to release the results of the past trials at one time and in one place comes after New York Attorney General Eliot Spitzer filed a consumer-fraud lawsuit last Wednesday accusing Glaxo of "repeated and persistent fraud" for concealing details on how well the drug works and its side effects. "We feel like we've acted appropriately in communicating the data from the (Paxil) trials," Glaxo spokeswoman Mary Anne Rhyne said. "Posting the information was in the interest of full disclosure."

Eli Lilly & Co.'s Prozac is the only anti-depressant approved for pediatric use. However, physicians commonly prescribe other antidepressants like Paxil. On Friday, the FDA admonished Glaxo for running a TV ad for Paxil CR, the controlled release version of Paxil, that was "false or misleading" because it suggests the drug can be used by a broader range of patients than it is actually approved for.

Prison Psychiatrist accused of Sexual Misconduct

A prison psychiatrist who allegedly asked a man to obtain an erection during an office visit and then rewarded his efforts with $10 and a bottle of Coke is being accused of sexual misconduct with a patient by the Medical Board of California.

Robert Clayton Bright Jr. of Pasadena was issued his license in October 1997, and worked in the L.A. County Men's Central Jail when the incident took place, according to the May 24 accusation. Bright is accused of misconduct with Preston S., an inmate who was acting in an undercover capacity and having his conversation electronically recorded by the L.A. County Sheriff's Department during a June 6, 2003, visit with Bright, the accusation said. Bright's attorney, Carl Simons, denies all allegations against his client.

Ending Psych Treatment Does Not Close Door on Malpractice Lawsuits

Problems arising from beginning and ending treatment with some patients can place psychiatrists at risk of being named defendants in malpractice suits, according to David Cash, J.D., an attorney and senior risk manager with Professional Risk Management Services Inc. (PRMS), the company that manages the APA-endorsed Psychiatrists' Professional Liability Insurance Program. They recently held a seminar to brief Pyschs on how to avoid legal problems. Psychiatrists should avoid prescribing large quantities of medication to the patient before terminating treatment, Cash said, and should never terminate treatment with a patient who has become a danger to himself or herself or others.

How about getting out of the Business?

Father Threatened with Child Abuse Charge for Taking Son Off Ritalin

When Chad Taylor noticed his son was apparently experiencing serious side effects from Ritalin prescribed for attention deficit hyperactivity disorder, he decided to take the boy off the medication. Now, he says he may be accused of child abuse.

In February, 12-year-old Daniel began displaying some symptoms that his father suspected were related to the use of Ritalin. "He was losing weight, wasn't sleeping, wasn't eating," Taylor told ABC News affiliate KOAT-TV in New Mexico. "[He] just wasn't Daniel."

So Taylor took Daniel off Ritalin, against his doctor's wishes. And though Taylor noticed Daniel was sleeping better and his appetite had returned, his teachers complained about the return of his disruptive behavior. Daniel seemed unable to sit still and was inattentive. His teachers ultimately learned that he was no longer taking Ritalin. School officials reported Daniel's parents to New Mexico's Department of Children, Youth and Families.Then a detective and social worker made a home visit.

"The detective told me if I did not medicate my son, I would be arrested for child abuse and neglect," Taylor said. A spokesman for New Mexico's Department of Children, Youth and Families told KOAT-TV that they could not comment on the case because of state confidentiality laws. John Francis, a detective for the Rio Rancho Department of Public Safety, said that Taylor was not threatened but told KOAT-TV that parents could be charged in situations like his.

Pills and kids may not mix

At least five teenagers in Canada have died, four of suicide, while being treated with the most widely prescribed antidepressants in Canada and at least 100 other children as young as 18 months old have experienced serious suspected adverse reactions to the pills, CanWest News Service has learned. The most recent reported suicide involves a 14-year-old boy who killed himself after 25 days on Paxil, one of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

The antidepressants are at the centre of a growing storm over whether SSRIs, blockbuster drugs that have become among the most popular medicines in history, cause some children to become suicidal or trigger other severe emotional or behavioural changes within weeks of the commencement of treatment or a change in dose.

Health Canada was notified of the boy's suicide on July 22, 2003, nearly two weeks after the government and GlaxoSmithKline, the makers of Paxil, warned doctors not to prescribe the drug to children and teens because of a possible increased risk of suicidal thinking, suicide attempts or self-harm. Health Canada learned in October 1996 of a 17-year-old boy who committed suicide while he was being treated with Zoloft. A suicide involving a male 18-year-old who had been taking Prozac was reported to the government in 1992.

In all three suicides, the antidepressants might have contributed to the deaths, according to adverse-drug-reaction reports contained in an edited, online Health Canada database. It's estimated only one to 10 per cent of all adverse drug reactions are reported to Health Canada.

Working Against Mind Control in Advertising

As seen here and as published on the PR Newswire

A public interest advocacy organization urged the Federal Trade Commission today to review and analyze the interactive marketing and branding technologies and techniques used by advertisers to target the country's children, "tweens," and teens.

In a letter to FTC Chairman Muris and the other four commissioners, the nonprofit Center for Digital Democracy (CDD) wrote that the "immersive, relational, and ubiquitous nature of such marketing raises serious questions about the ability of existing safeguards and rules to protect our nation's children and young people." The letter urged the commission to use its subpoena power to obtain any needed documents, including proprietary research studies. CDD also called on the ad industry to adopt a moratorium on all interactive techniques that -- in the absence of independent research suggesting otherwise -- could potentially harm or negatively affect children and youth.

CDD Executive Director Jeffrey Chester said that the nation's parents, educators, and health professionals should be concerned about the impact that such digital technologies have on the psychosocial development of children. "We know that the advertising industry is wielding powerful new tools that track and target the 'behavior' of the online and interactive audience (such as those for video games)," Chester explained. "How this marketing affects such critical developmental issues as cognition/brain development, identity formation, and the emotional system must be well understand prior to its use on the child-to-teen audience," he added.

Chester noted that "the architecture of our nation's electronic media system is in a critical transition," with the widespread deployment of new data collection, profiling, and "personalization" marketing techniques. "The advertising industry is engaged in multiple research efforts designed to perfect their ability to pinpoint consumers online and to ensure that they can be both tracked and measured. The government -- through the FTC and other appropriate bodies -- must step in to determine what other research is necessary to safeguard the welfare of our nation's young population," declared Chester. "That's why we are asking the FTC to engage in the kind of study that will lead to meaningful recommendations to the public -- including policymakers -- on how to ensure that interactive marketing does not detract from the healthy development of children."

CDD called for a moratorium on such advertising until its effects on children and youth could be further assessed. The group also urged Chairman Muris to have the FTC issue a similar call for an interactive marketing moratorium.

"Interactive marketing to children exploits their cognitive weaknesses, and is a deceptive and shameful misuse of child development principals," declared Michael Brody, MD, chair of the Television and Media Committee of the American Academy of Child and Adolescent Psychiatry. Brody (available for comment at 301-585-1703) personally supported CDD's letter to the FTC, including the call for a moratorium on such advertising until its effects on children could be further assessed.

Chester will be speaking at the National Press Club on Wednesday, June 9, on the need for the FCC to strengthen its policies on advertising and children in the digital television era. The event is sponsored by Children Now, the American Academy of Pediatrics, and the American Psychological Association.

CDD is a national public interest group devoted to ensuring that the digital media fulfill its democratic potential. Its staff led the effort to protect children's privacy online through the passage of the 1998 Children's Online Privacy Protection Act.

A copy of the FTC letter is available at http://www.democraticmedia.org/resources/filings/FTCletter.html.

Post Traumatic Slave Syndrome

As reported in The Oregonian

A Portland lawyer says suffering by African Americans at the hands of slave owners is to blame in the death of a 2-year-old Beaverton boy. Randall Vogt is offering the untested theory, called post traumatic slave syndrome, in his defense of Isaac Cortez Bynum, who is charged with murder by abuse in the June 30 death of his son, Ryshawn Lamar Bynum. Vogt says he will argue -- "in a general way" -- that masters beat slaves, so Bynum was justified in beating his son.

The slave theory is the work of Joy DeGruy-Leary, an assistant professor in the Portland State University Graduate School of Social Work. It is not listed by psychiatrists or the courts as an accepted disorder, and some experts said they had never heard of it.

DeGruy-Leary testified this month in Washington County Circuit Court that African Americans today are affected by past centuries of U.S. slavery because the original slaves were never treated for the trauma of losing their homes; seeing relatives whipped, raped and killed; and being subjugated by whites.

Because African Americans as a class never got a chance to heal and today still face racism, oppression and societal inequality, they suffer from multigenerational trauma, says DeGruy-Leary, who is African American. Self-destructive, violent or aggressive behavior often results, she says.

Noting the theory has not been proven or ever offered in court, Washington County Circuit Judge Nancy W. Campbell recently threw out DeGruy-Leary's pretrial testimony. But the judge said she would reconsider the defense for Bynum's September trial if his lawyer can show the slave theory is an accepted mental disorder with a valid scientific basis and specifically applies to this case.

[...]

Experts disagree on whether post traumatic slave syndrome can be proven, much less accepted in legal arenas. It took 50 years for society and the courts to accept post traumatic stress syndrome, a diagnosis for someone who has experienced or witnessed an extraordinary event that involves actual or threatened death or serious injury. It is only diagnosed when functioning is severely impaired.

The judge also said the defense would have to show Bynum, who grew up in Mississippi, has slave syndrome. At the time of her testimony, DeGruy-Leary had not interviewed him. Besides a doctorate in social work research, DeGruy-Leary has a master's degree in clinical psychology. She said she can offer counseling but is not licensed to diagnose anyone.

Somehow this is a bit off the mark.

Glaxo accused of Drug Fraud

GlaxoSmithKline PLC committed fraud by withholding negative information and misrepresenting data on prescribing its anti-depressant Paxil to children, according to a lawsuit filed Wednesday by New York Attorney General Eliot Spitzer. The lawsuit highlights two pharmaceutical and medical controversies: whether anti-depressants increase suicidal tendencies in children, and whether drug companies skew information on their products either by not publicizing all the studies conducted on medicines or editing information on published trials.

The most detailed reports can be seen in the NYT, which has details on two drug trials, known within SmithKline Beecham as Study 329 and Study 377. Study 329 suggested that the company's popular drug Paxil might help depressed adolescents. Study 377, completed later, indicated that Paxil provided no more benefit than a sugar pill in treating depressed young people. This later study was recommended to be "buried"

As noted in Bloomberg<, the cost to insure GlaxoSmithKline Plc debt has doubled after New York Attorney General Eliot Spitzer filed the lawsuit against the company.

Forbes also notes that GlaxoSmithKline Plc has agreed to compensate Japan's Otsuka Pharmaceutical Co Ltd for withdrawing an antibiotic from the market five years ago.

Psychiatric Drug Mix disapproved for treatment of Migraine headaches

Pozen Inc. (POZN) on Tuesday said U.S. regulators rejected its experimental migraine drug because it was not more effective than an existing treatment, sending the company's stock down 40 percent. Pozen said the Food and Drug Administration issued a non-approval letter on its experimental drug MT100, a combination of naproxen and another treatment, because it did not prove substantially more effective than naproxen alone at sustaining pain relief.

The FDA was also concerned with the risk that patients could suffer from tardive dyskinesia, a neurological syndrome caused by the long-term use of certain medicines used for psychiatric disorders. The drug that Pozen combined with naproxen in MT100, called metoclopramide, has been associated with uncontrollable motions characteristic of tardive dyskinesia patients.

Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements, such as grimacing, tongue protrusion, lip smacking, puckering and pursing, rapid eye blinking and rapid movements of the arms, legs, and trunk. The FDA did not observe any raised risk of tardive dyskinesia in clinical trials of MT100, but was apparently still concerned by it.

``Given the number of patients exposed to MT 100 for at least one year in your database (about 300), the absence of any detected cases is consistent with a true rate of TD of about 1 percent, an unacceptably high risk in the absence of any demonstrated advantage of the product,'' the FDA said in its letter to the company.