Psychiatric Drugs Are False Prophets With Big Profits - Psychiatry has been hijacked

From a column in Psychiatry Today by Robert Berezin M.D. While I do not think that psychotherapy is very workable, his criticism of psychiatry is spot on.

Once again, I just finished another consultation with someone from out of state who was desperate to find a therapist who he could talk to. He didn’t want to be pigeon holed into some DSM-5 reductionistic diagnosis. He didn’t want psychiatric drugs. He was desperate to find a psychiatrist who would understand him, who he could relate to, and could treat him with real psychotherapy. There should never have been a reason for me to consult with anyone from out of state. Unfortunately, the cynical and fraudulent takeover of psychiatry is all but complete. How many real psychiatrists are left?

How did this happen? Over the course of my career, I kept my head down and devoted myself to my craft, psychotherapy. I was certainly aware of the collusion between the APA and the drug companies. But as recently as ten years ago, I honestly did not know that things had really deteriorated this far.

Apparently, Dr. Jeffrey Lieberman and other like-minded psychiatrists, decided that psychoanalysis had too much power, and they wanted to transform the APA once again to the tenets of somatic psychiatry. The underling theory of somatic psychiatry is that the source of human struggle is considered to be the brain itself, rather than the person.

Treatments that follow from this simplistic, mechanistic, and reductionist notion have been to act directly on the brain, always with violating and destructive outcomes.

Somatic psychiatry originated with seizure therapy, or its first modern incarnation, insulin shock therapy (IST). It actually had its roots in the sixteenth century and was used psychiatrically around the time of the American Revolution. It was refined in 1927 into insulin shock therapy, when insulin was used to induce seizures as a treatment for drug addiction, psychopathy, and schizophrenia, with claims of a 50 percent remission rate. Papers were published in the American Journal of Psychiatry, starting in 1937. IST was widely used through the 1940s and 1950s. Its founding etiological principle was the (false) idea that seizures were the opposite of schizophrenia. Induce a seizure, and you balance out psychosis. In the 1930s, a more refined scientific explanation was developed for the (phantom) curative power of seizures. Its science proclaimed that psychiatric problems came from the autonomic nervous system. IST was said to work by blocking the nerve cells of the parasympathetic nervous system, thereby intensifying their tonus and strengthening their anabolic force. This restored the nerve cell, and the patient recovered. The corollary theory was that patients were jolted out of their psychiatric condition.

Next, we have lobotomies, originally called leucotomies. Lobotomies came onto the scene in the 1930s, having been invented and promoted by Antonio Egas Moniz. When I was a psychiatric resident, lobotomies were still fresh in psychiatric memory. The practice had only ceased in the early 1960s, after over twenty thousand people received this “treatment.” Let’s see … what was the science? The source of psychiatric problems was located in the brain, specifically the prefrontal cortex. The treatment of choice, then, was to ream out the prefrontal cortex with an ice pick. Respected MDs had a miracle cure and were the vanguard of the field. Science proved that lobotomies cured not only schizophrenia but anxiety, depression, low self-esteem, obsessive/compulsive disorder, and the unwanted behavioral problems associated with mental retardation (this is code for sexual behaviors). It was respected and celebrated in the psychiatric literature and validated in journals with documented studies and peer-reviewed scientific evidence. Lest you think this is an exaggeration, Moniz won a Nobel Prize in 1949 for his great and wonderful discovery.

Eventually, the validating follow-ups were shown to be fabricated and deluded, with self-promoting lies and half truths. Only after a great deal of harm were they debunked. And the ice picks were thrown into the trash heap of psychiatric history. We need to add that after lobotomies gradually attenuated, no one stopped and said, “What in the world did we just do?” How could sticking an ice pick in someone’s brain ever have been even a remote consideration? What was going on that such a grotesque medieval mutilation was actually adopted as a good thing to do? And how could it have been publicly and professionally embraced? However, as always seems to happen, amnesia quickly set in, and we forgot the brutal inhumanity that was so recently celebrated. And the considerable body of discredited scientific validation was never scrutinized for its contribution to and for having promoted such harm. Instead, science moved on to support the next somatic treatment in exactly the same way.

Next, we have electroconvulsive therapy (ECT), which came along soon after IST, in 1938. ECT was still a part of the curriculum in my own psychiatric residency in 1971. Entire psychiatric hospitals, built exclusively for ECT, were still operating, with no empty beds. Scientific studies and respected journals provided documented validation for placing electrodes on patients’ heads and applying huge jolts of electricity to generate seizures. Apparently, the jolt theory had gained traction. So we shocked the brain, instead of reaming it out. How humane. In addition to everything else, ECT also was touted as a cure for depression. It was allegedly proved that ECT was a safe, effective cure, with few, if any, drawbacks. The resultant memory loss not only was initially downplayed but was trumpeted as being therapeutic. (By the way, drugs are being developed today to chemically erase memories with the idea that this is therapeutic for trauma—same thing.) Later, under public pressure, ECT was refined to cut down on memory loss. The history of electroconvulsive therapy followed the same trajectory as lobotomies. Eventually, ECT showed itself to be the ineffective and violating practice that it is. But don’t get overconfident. Incredibly, in recent years, ECT has made a comeback and is being promoted once again, when its progeny treatments, antidepressants, don’t work.

Finally, we come the current incarnation of somatic psychiatry - neurobiological psychiatry, and its so-called treatment—drugs. Psychiatric drugs are next in the lineage of “treatments” whose focus is to act upon the physical brain. History is repeating itself.

Our contemporary science has now apparently proven that human problems come from genetic or developmental neurobiological disorders of the physical, anatomical, biochemical brain. The somatic treatments for these neurobiological, genetic, synaptic hormonal neurotransmitter diseases are brain drugs—psychoactive drugs.

In one generation, the APA, in collusion with the drug companies have destroyed psychiatry. The American Public has been sold a bill of goods.

People actually believe that human struggle is a brain disease. It is now taken as fact that there is a chemical imbalance in the brain and psychoactive drugs is just what the doctor ordered. We can now cure biological depression with antidepressants; biological anxiety with benzodiazepines; the fictitious ADHD with, of all things, amphetamines; insomnia with benzodiazepines, and other bizarre psychoactive drugs; Likewise the belief is that schizophrenia and manic-depression should be treated with drugs [...]

Psychiatric diagnosis of schizophrenia is not compatible with the facts of modern science

A Few thoughts prompted by this article in Psychology Today

The Oct 16 issue of the Scientific American has a short piece on “Massive Study Reveals Schizophrenia’s Genetic Roots.” These roots are, we learn, incredibly complicated. A huge consortium involving more than 300 scientists from 35 countries found “128 gene variants associated with schizophrenia, in 108 distinct locations in the human genome.”

Wow, eh?

This “genome-wide association study” found so many mutations in the molecular pairs of the 113,000 people it studied that . . . I can’t tell you. The mind boggles at how complicated “schizophrenia” must be.

Unless there is no such thing as schizophrenia.

The obvious conclusion seems not to have occurred to the Scientific American commentators: It is not that schizophrenia is “incredibly complicated,” but that there are several different diseases buried under the term “schizophrenia,” each with a genetics of its own.

[...]

It is a sign of the diminished American interest in psychopathology that all of these symptoms, which are highly diverse, each pointing in a different direction, have all been lumped together as “schizophrenia,” which makes as much sense as lumping measles, syphilis, and gangrene together as “skin diseases.”

[...] it was all dumped together in the same cauldron. Catatonia, adolescent insanity, psychosis at midlife, paranoia, who cares? It was all “schizophrenia.”

And this is the inheritance we’re now living with, as the geneticists take the phenotypes they’ve inherited from psychiatry and try to make sense of the anomalies they find on the DNA – which up to now, after billions of dollars and decades of research – have been indecipherable.

So, hunting for schizophrenia’s “genetic roots,” are we? Good luck with that.

But it all gets worse. As seen in this blog article "Biology and Genetics are Irrelevant Once True Causes are Recognized"

As superbly reviewed by psychologist John Read in the 2013 second edition of Models of Madness: Psychological, Social and Biological Approaches to Psychosis, since the turn of the 21st century many studies have linked schizophrenia and other psychotic conditions to childhood adversities such as having experienced bullying, emotional abuse, incest, neglect, parental loss, physical abuse, or sexual abuse—findings that are well known to clinicians who work with people diagnosed with psychotic disorders.

Read reviewed research linking schizophrenia and other psychotic disorders to social environments such as poverty, racism, migratory stress, and urbanicity. He concluded, “There is ample evidence that inequality, deprivation and discrimination, filtered through their social and personal meanings, are key causal factors in psychosis.” Psychological processes identified by Read and his colleagues, through which childhood adversities may lead to symptoms of psychosis later in life, include attachment, dissociation, dysfunctional cognitive processes, psychodynamic defenses, problematic coping responses, impaired access to social support, behavioral sensitization, and revictimization. A biologically oriented commentator might object that even if these factors play a role in causing schizophrenia and psychosis, only people who are genetically predisposed will develop them, and it is therefore important to understand and study hereditary factors. Aside from the fact that the evidence in support of genetics is weak, a clear understanding of the environmental causes of a condition frequently renders potential genetic factors irrelevant.

For example, 33 miners were trapped underground for 69 days in a copper mine near Copiapó, Chile in 2010. Although the miners were finally rescued and were treated as heroes, and in some cases as celebrities, many subsequently developed severe psychological symptoms caused by their ordeal, such as depression, anxiety, nightmares, and avoidant behavior. Because the causes of these symptoms are obvious and recognized, no one to my knowledge has suggested that the miners have genetically based brain disorders or “chemical imbalances.” It is clear that the miners’ experiences caused their symptoms, and the symptoms of most psychiatric conditions can also be seen in this way.

Simply, psychiatric diagnoses are not compatible with the facts of modern science

Anti-psychotic drug use soars in USA children, and in UK children, too

Report seen on Yahoo! News, from the AP

American children take anti-psychotic medicines at about six times the rate of children in the United Kingdom, according to a comparison based on a new U.K. study.

Does it mean U.S. kids are being over-treated? Or that U.K. children are being under-treated?

Experts say that's almost beside the point, because use is rising on both sides of the Atlantic. And with scant long-term safety data, it's likely the drugs are being over-prescribed for both U.S. and U.K. children, research suggests.

Among the most commonly used drugs were those to treat autism and hyperactivity.

In the U.K. study, anti-psychotics were prescribed for 595 children at a rate of less than four per 10,000 children in 1992. By 2005, 2,917 children were prescribed the drugs at a rate of seven per 10,000 — a near-doubling, said lead author Fariz Rani, a researcher at the University of London's pharmacy school.

The study is being released Monday in the May edition of the journal Pediatrics.

By contrast, an earlier U.S. study found that nearly 45 American children out of 10,000 used the drugs in 2001 versus more than 23 per 10,000 in 1996.

There are big differences that could help explain the vastly higher U.S. rate.

A recent report in The Lancet suggested that the U.K.'s universal health care system limits prescribing practices there. The report also said direct-to-consumer ads are more common in the United States. These ads raise consumer awareness and demand for medication.

While drug company ties with doctors are common in both the U.S. and U.K., Vanderbilt University researcher Wayne Ray said U.K. physicians generally are more conservative about prescribing psychiatric drugs. Ray co-authored the U.S. study, published in 2004.

The new U.K. study, involving 1992-2005 health records of more than 16,000 children, is the first large examination of these drugs in U.K. children. It found the increase was mostly in medicines that haven't been officially approved for kids. They were most commonly prescribed for behavior and conduct disorders, which include attention deficit disorder.

Side effects including weight gain, nervous-system problems and heart trouble have been reported in children using these drugs and there's little long-term evidence about whether they're safe for them, the study authors said.

"This highlights the need for long-term safety investigations and ongoing clinical monitoring," they said, "particularly if the prescribing rate of these medicines continues to rise."

One of the most commonly used anti-psychotics in the U.K. study was Risperdal, a schizophrenia drug that is sometimes used to treat irritability and aggression in autism. Its side effects include drowsiness and weight gain.

Thioridazine, sometimes used to treat hyperactivity in attention deficit disorder, was frequently used early on. Its use decreased after 2000 when a U.K. safety committee warned of heart-related side effects, the authors said.

Reasons for the increases are uncertain but may be similar to those in the United States, such as an increase in autism cases and drug industry influence.

In both countries, the issue isn't simply how many children are getting these drugs, said Dr. David Fassler, a University of Vermont psychiatry professor. "The more important question is whether or not the right kids are getting the most appropriate and effective treatment possible," he said. Fassler wasn't involved in the study.

Dr. William Cooper, a Vanderbilt pediatrician, said the study shows the drugs are being used "without full understanding about the risks."

"I find it really interesting that we're now seeing increases in other countries besides the U.S., which suggests that the magnitude of this issue is global," said Cooper, also an author of the 2004 U.S. study.

Half of Americans are in some way mentally ill, and one-quarter of the population has taken anti-depressants, not including that one time at a rave

Another person is waking up to the fraud the is Modern Psychiatry. An Editorial in the NY Sun, by Christoper Lane

America has reached a point where almost half its population is described as being in some way mentally ill, and nearly a quarter of its citizens - 67.5 million - have taken antidepressants.

These statistics have sparked a widespread, sometimes rancorous debate about whether people are taking far more medication than is needed for problems that may not even be mental disorders. Studies indicate that 40% of all patients fall short of the diagnoses that doctors and psychiatrists give them, yet 200 million prescriptions are written annually in America to treat depression and anxiety.

Those who defend such widespread use of prescription drugs insist that a significant part of the population is under-treated and, by inference, under-medicated. Those opposed to such rampant use of drugs note that diagnostic rates for bipolar disorder, in particular, have skyrocketed by 4,000% and that overmedication is impossible without over-diagnosis.

To help settle this long-standing dispute, I studied why the number of recognized psychiatric disorders has ballooned so dramatically in recent decades. In 1980, the Diagnostic and Statistical Manual of Mental Disorders added 112 new mental disorders to its third edition, DSM-III. Fifty-eight more disorders appeared in the revised third edition in 1987 and fourth edition in 1994.

With over a million copies in print, the manual is known as the bible of American psychiatry; certainly it is an invoked chapter and verse in schools, prisons, courts, and by mental-health professionals around the world. The addition of even one new diagnostic code has serious practical consequences. What, then, was the rationale for adding so many in 1980?

After several requests to the American Psychiatric Association, I was granted complete access to the hundreds of unpublished memos, letters, and even votes from the period between 1973 and 1979, when the DSM-III task force debated each new and existing disorder. Some of the work was meticulous and commendable.

But the overall approval process was more capricious than scientific.

DSM-III grew out of meetings that many participants described as chaotic. One observer later remarked that the small amount of research drawn upon was "really a hodgepodge - scattered, inconsistent, and ambiguous." The interest and expertise of the task force was limited to one branch of psychiatry: neuropsychiatry. That group met for four years before it occurred to members that such one-sidedness might result in bias.

Incredibly, the lists of symptoms for some disorders were knocked out in minutes. The field studies used to justify their inclusion sometimes involved a single patient evaluated by the person advocating the new disease. Experts pressed for the inclusion of illnesses as questionable as "chronic undifferentiated unhappiness disorder" and "chronic complaint disorder," whose traits included moaning about taxes, the weather, and even sports results.

Social phobia, later dubbed "social anxiety disorder," was one of seven new anxiety disorders created in 1980. At first it struck me as a serious condition. By the 1990s experts were calling it "the disorder of the decade," insisting that as many as one in five Americans suffers from it. Yet the complete story turned out to be rather more complicated.

For starters, the specialist who in the 1960s originally recognized social anxiety - London-based Isaac Marks, a renowned expert on fear and panic - strongly resisted its inclusion in DSM-III as a separate disease category. The list of common behaviors associated with the disorder gave him pause: fear of eating alone in restaurants, avoidance of public toilets, and concern about trembling hands.

By the time a revised task force added dislike of public speaking in 1987, the disorder seemed sufficiently elastic to include virtually everyone on the planet.

To counter the impression that it was turning common fears into treatable conditions, DSM-IV added a clause stipulating that social anxiety behaviors had to be "impairing" before a diagnosis was possible. But who was holding the prescribers to such standards? Doubtless, their understanding of impairment was looser than that of the task force. After all, despite the impairment clause, the anxiety disorder mushroomed; by 2000, it was the third most common psychiatric disorder in America, behind only depression and alcoholism.

Over-medication would affect fewer Americans if we could rein in such clear examples of over-diagnosis. We would have to set the thresholds for psychiatric diagnosis a lot higher, resurrecting the distinction between chronic illness and mild suffering. But there is fierce resistance to this by those who say they are fighting grave mental disorders, for which medication is the only viable treatment.

Failure to reform psychiatry will be disastrous for public health. Consider that apathy, excessive shopping, and overuse of the Internet are all serious contenders for inclusion in the next edition of the DSM, due to appear in 2012. If the history of psychiatry is any guide, a new class of medication will soon be touted to treat them.

Sanity must prevail: if everyone is mentally ill, then no one is.

8 Reasons to RUN from Anti-Depressants

While we DO NOT advocate for any alternatives in treatment for Depression, since we are, after all, not medical professionals, this video and related text is mostly valuable stuff - Reason 8 is a plug for the author's own system of how to breaking out of depression, which is available through the original link, so we will not list it here, (he plugs it in the video) As seen as on YouTube:

About This Video

1. They Don´t Work!

• Anti-depressants have no impact...

Almost 50 clinical trials were reviewed by psychologists from the UK's University of Hull, who found new-generation antidepressants worked no better than a placebo for most depressed patients.

See a few BBC Videos on this research and some other cool stuff:
http://search.bbc.co.uk/cgi-bin/searc...

The Original Research Document
http://medicine.plosjournals.org/arch...

• The UK Newspaper The Guardian reported on Feb.27, 2008 that the government yesterday released details of its £170m plan to train 3,600 more psychological therapists in the wake of a study showing that antidepressant drugs such as Prozac are no more effective than a placebo.
http://www.guardian.co.uk/society/200...

2. Big Pharma Lies!

• They routinely suppress the results of research which have negative results for their products.

The Wall Street Journal reports that the effectiveness of a dozen popular anti-depressants has been exaggerated by selective publication of favorable results, according to a review of unpublished data submitted to the Food and Drug Administration.

Among the many drugs that were found to have increased their effects as a result of selective publication and/or data manipulation:

Lexapro, Prozac, Paxil, Zoloft, Effexor

Wall Street Journal link:
http://online.wsj.com/article/SB12005...

3. You are a Victim of Marketing!

• The New York Times reports that the diagnosis of Bipolar Disorder has increased 4000% in 10 years!
http://www.nytimes.com/2007/09/04/hea...

• USA Today report shows that as ad spending goes up, the more you ASK for specific medications:
http://www.usatoday.com/printedition/...

• Big Pharma routinely pays many Psychiatrists:
Pharma paid $57 M to Medical Staff in Minesota alone (1997-2005)
http://www.nytimes.com/2007/03/21/us/...

4. Harmful Side Effects: Suicide, Murder, School Shootings

• Among people under 25, the risk of suicide doubles for those on anti-depressants:
The New York Times article:
http://query.nytimes.com/gst/fullpage...

• Unless you have been living under a rock....They are connected with most school shootings and many other murders.

Great ABC Report on School Shootings, Suicide, Murder
http://www.youtube.com/watch?v=1XHNJy...

Here´s a link to SSRI Stories - a never-ending list of new items connecting anti-depressants to murder, suicide, etc...
http://ssristories.com

5. Shrinks Still Have NO Test!

For More Info:
http://ssri-research.com/serotonin_th...

6. Quitting is a Bitch!

• This video shows just how bad the situation is:
http://www.sobersocial.com/view_video...

• See also, Bipolar Blast and Furious Seasons among countless other blogs on this subject:
http://bipolarblast.wordpress.com
http://www.furiousseasons.com

7. Long Term Therapy Works!

• The New York Times reports that psychotherapy for as long as nine months is significantly more effective than short-term treatment for alleviating depression associated with bipolar disease, new research suggests.
http://www.nytimes.com/2007/04/10/hea...

---

Reason 8 is a plug for the author's own system of how to breaking out of depression, which is available through the original link

Practical Advice for Police, Fire Fighters, EMTs, and others taking Civil Service Psychiatric Exams.

This is a repost of an earlier article, with a new title to make it easier to find for police, fire fighters, and others taking civil service psychiatric exams. Oriented towards fire fighters, there is still good advice for other public servants. See also this commentary by Physicist Richard Feynman on his own government psychiatric exam back in the day when he was just starting out.

---

More municipalities are increasingly relying on psychological tests - not only in the hiring phase but also in the entry-level examination format. For example, numerous fire fighter candidates with stellar credentials (including degrees in fire science technology, EMT and Paramedic certifications) doing well on all other portions of the exam yet failing the psychological part.

As noted here:

The psychological test is changing the fire service. Sure there are some folks who have a lot of baggage and shouldn’t be hired. But most of the red-hot’s, the back bone of the fire service, can’t make it through the process. Surprisingly, the evaluations are based on the performance of those in already in the fire service.

More and more agencies are using the psychological test in their hiring process. Psychologists are competing for this lucrative business and agencies feel they need the service to hire the right candidates. In one large department forty-percent of candidates were eliminated from the hiring process through the psychological tests. Fire administrations feel theirs hands are tied and get frustrated when they see a high percentage of their superior candidates that were eliminated by their physiological test and then being hired by other agencies.

"Psychologists are given more power then they should," says Robert Thomas Flint, Ph.D., who sometimes does re-evaluations of potential peace officers and firefighters who have failed psychological tests. Although he tends to agree 40-50% of the original decisions were valid, he finds that another 30-50% of the rejected candidates are acceptable and can handle the job.

It sounds that they would do just about as well using a coin flip to screen the candidates, if you think about it. In the rush to protect themselves from liabilities, the use of psychological testing is interfering with public safety. So much so that a cottage industry is growing up telling people how to pass the psych test. Check this out

You Have to Pass The Psych Test First Time Out!

Most candidates are more than surprised when I tell them up to 40% fail the psychological test given by many departments.

I received one phone call and two e-mails from relatives of a firefighter/medic candidate who failed a psych test before the candidate called asking "What can I do now?" He had been testing for 5 years and this was the first job offer. I asked him if he knew who we were? Yes. Did you know we had a preparation program for the psych? Yes. Why didn't you get it? I wish I had a dollar for every time I've heard this, "Things were going so great I didn't think I needed it."

Imagine after all the education, experience and time preparing to get this job like the above candidate . . . and you're eliminated. Then no one will talk to you to find out what happened. I've talked to too many candidates who were devastated and didn't know what to do next. This is a critical part of the testing process you need to prepare for and pass the first time out.

You've jumped through all the flaming hoops and made it through the background check. Then, you're conditionally offered the job pending the medical, which includes a psychological test. You take the test, no big deal right? Then the phone stops ringing.

You are out of the hiring process. You are told that you didn't meet the profile. What profile?

What do you mean I didn't meet the profile? I've got training, experience, education, every degree, certificate, merit badge, and a paramedic certification. I've been a volunteer, paid member of another department for 10 years, and lived and breathed this job. And, I don't meet the profile?

What's included in the psych test? There is a written test that sets up a profile of you. Then, there is an evaluation by a psychologist.

Written Test: The most common written portion of the psychological evaluation is the Minnesota Multiphasic Personality Inventory interview test of up to 1000 questions. The aim here is not to pass the test but to go into the job fully prepared. Put your pride and natural defensiveness aside. They ask a few questions in several different ways. You want to answer questions "strongly for" or "strongly against" instead of being in the middle undecided. Answer questions to present yourself as a more social, interactive, team playing type of person, i.e., you would rather be in a conversation with others than reading a book alone.

[...]

The Evaluation: This is where the wheels start coming off the wagon for too many candidates.

Before the interview, the psychologist will often have you take a separate personality test, fill out a personal family history, a biography and additional information forms.

The biggest error candidates make during the psychological evaluation is thinking there is a patient/doctor confidentiality even when the doctor has them sign a release that there is not. This is not your family doctor. Guess who's paying the bill?

What gets candidates in trouble here is they want this job so bad that they will say and do almost anything to get it.

Although I don't encourage candidates to be less than truthful, those candidates who are honest to a fault diminish their chances of passing the psychological interview! That's right. You folks want this job so bad you will tell the psychologist anything they want to know. Even stuff they didn't ask you. Once you start down this road of total honesty, creating trails where you don't have to, tossing out more information than was asked for thinking this guy is your friend is where you get into big trouble. Especially when the psychologist says, "Everyone has skeletons in their closet, this interview is not designed to eliminate you from the process", or "you don't want to be too squeaky clean." So you open up. Then the phone stops ringing and no one will talk to you. You are out of the process Mcfly. And, you don't know why.

So what should you do?

Only answer the question you're being asked. Before you volunteer information, think before you speak. If they want to know more they will ask. Don't appear to be closed but warm and cordial. Present your ideas clearly. Don't ramble or chat. Be articulate. This is how you're going to be in the field. Believe it or not this is part of the job interview. You are making an impression of who you are going to be as a firefighter.

Make sure you dress up and don't slouch. Be prepared to audition for the part of being a firefighter. Know your strong points. Be prepared to demonstrate you are a team player.

A large city fire department called in twelve candidates for the psychological interview. Only three passed. They sent in six more, only two passed. Another six more were tested. Again, only two passed. All those who passed were our candidates. They prepared in advance with our special report that took us over a year to compile to let them know where the land mines were before they went in. Ask them if it was worth knowing what was a coming?

This from a new firefighter:

I want to comment on your psych test information and report. I had to take one for two departments. Well all I know is that I went into the test and followed your advice. I tried to answer the questions as honestly as I could, while presenting myself as a very positive social person. Some of the "experts" out there say that you should be brutally honest on the test. Well 3 good guys I know did just that, and they did not pass either test. We lost 10 out of 25 guys on one test! In all honesty I might not have passed either if I hadn't followed your advice. I feel that is a very dangerous test, and some of the advice these people are giving out is costing great candidates a job. I wanted to let you know that your advice worked, and I owe you much thanks! Steve.

This from an in service firefighter:

During the last hiring process 2 years ago the psychologist passed 10 people. Of those 10, 2 have quit, 2 have been fired, and 1 committed suicide. I wonder if he is worth what the city pays him to evaluate prospects? Have a nice weekend.

So obviously, the shrinks aren't worth the money they are charging. And they are not delivering the results needed to protect the public and the professionals whose lives depend on each other.

The Decline of Psychiatry, Part 3

We have another report regarding the decreasing numbers of psychiatrists, this time from Alabama. See our earlier reports here

A shortage of psychiatrists, both in-state trainees and out-of-state recruits, in the state of Alabama has proved to be an increasing problem over the past decade.

In a study conducted by Dr. Richard Powers in April 2007, Alabama has only 7.1 psychiatrists per 100,000, while other neighboring states have 8.1 and the nation has 13.7, according to Understanding the Shortage of Psychiatrists and Selected other
Mental Health Professionals in Alabama.

Powers cites this shortage due to lack of funding for psychiatry programs, a shortage of in-patient beds, difficulties for physicians to obtain practicing licenses and an overall decline in the retention rate of Alabama psychiatrists.

The University of South Alabama offers one of the two only psychiatry programs in the state of Alabama. Both programs at USA and the University of Alabama at Birmingham have experienced difficulties, according to Powers' study.

Each experienced difficulties in training the maximum number of psychiatrists, many of whom practice in other states after training.

"The University of South Alabama suffered from management issues and the program at UAB suffered from a shortage of funding to support the maximum number of candidates," the study states.

[...]

The University of South Alabama College of Medicine department of psychiatry program works to combat these shortages through its funding, programs and output of trained graduates on a yearly basis.

[...]

A draft copy of the study can be seen in full here

Read this doc on Scribd: Understanding the Shortage of Psychiatrists in Alabama

Prozac, used by 40m people, does not work say scientists

As reported in the Guardian, an analysis of unseen trials and other data concludes it is no better than placebo. The study in question can be accessed on the Public Library of Science website

If we didn't know better it would seen that they knew this all along, one way or another. And this fits the classic definition of fraud, on some level.

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today.

The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill.

When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs.

The only exception is in the most severely depressed patients, according to the authors - Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better.

"Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed," says Kirsch. "This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported."

The paper, published today in the journal PLoS (Public Library of Science) Medicine, is likely to have a significant impact on the prescribing of the drugs. The National Institute for Health and Clinical Excellence (Nice) already recommends that counselling should be tried before doctors prescribe antidepressants. Kirsch, who was one of the consultants for the guidelines, says the new analysis "would suggest that the prescription of antidepressant medications might be restricted even more".

The review breaks new ground because Kirsch and his colleagues have obtained for the first time what they believe is a full set of trial data for four antidepressants.

They requested the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.

The pattern they saw from the trial results of fluoxetine (Prozac), paroxetine (Seroxat), venlafaxine (Effexor) and nefazodone (Serzone) was consistent. "Using complete data sets (including unpublished data) and a substantially larger data set of this type than has been previously reported, we find the overall effect of new-generation antidepressant medication is below recommended criteria for clinical significance," they write.

Two more frequently prescribed antidepressants were omitted from the study because scientists were unable to obtain all the data.

Concerns have been raised in recent years about the side-effects of this class of antidepressant. Evidence that they could prompt some young people to consider suicide led to a warning to doctors not to prescribe them for the under-18s - with the exception of Prozac, which was considered more effective than the rest.

In adults, however, the depression-beating benefits were thought to outweigh the risks. Since its launch in the US in 1988, some 40 million people have taken Prozac, earning tens of billions of dollars for the manufacturer, Eli Lilly. Although the patent lapsed in 2001, fluoxetine continues to make the company money - it is now the active ingredient in Sarafem, a pill sold by Lilly for premenstrual syndrome.

Eli Lilly was defiant last night. "Extensive scientific and medical experience has demonstrated that fluoxetine is an effective antidepressant," it said in a statement. "Since its discovery in 1972, fluoxetine has become one of the world's most-studied medicines. Lilly is proud of the difference fluoxetine has made to millions of people living with depression."

A spokesman for GlaxoSmithKline, which makes Seroxat, said the authors had failed to acknowledge the "very positive" benefits of the treatment and their conclusions were "at odds with what has been seen in actual clinical practice".

He added: "This analysis has only examined a small subset of the total data available while regulatory bodies around the world have conducted extensive reviews and evaluations of all the data available, and this one study should not be used to cause unnecessary alarm and concern for patients."

Here's a follow up link to another story on the study: Seems that Big Pharma is in a slight Panic

The Decline of Psychiatry, Part 2

Earlier we reported on the declining numbers of psychiatrists in Indiana. Now we have this report of a similar decline in Ohio:

[...]Trumbull is undergoing a psychiatrist shortage, according to those at Trumbull LifeLifes, the agency considering joining forces with Summa Health System in Akron.

‘‘It’s a perennial challenge here in Trumbull County, all over the state,’’ said James Sager, LifeLifes chief operating officer. ‘‘Finding and keeping psychiatrists is particularly a difficult challenge for us.’’[...]

According to the National Center for Health Workforce Analysis, Ohio had 1,019 psychiatrists six years ago, making 31st in the nation in the number of psychiatrists per capita. In comparison, Pennsylvania ranked 11th with 1,753.

[...]

Director of consultation liaison psychiatry at Summa, Tod Ivan, said he believes there is an overall shortage largely because of federal policy.

He said the government — through Medicare — has restricted funding for specialty care, like psychiatry, in favor or primary care. Also, Ivan said, policy regarding managed care makes it hard for psychiatrists to make a living, like for example, a 50 percent co-payment on mental health services through Medicare.

‘‘Nationally, for about 20 years, the numbers have remained flat,’’ he said.

Of course, they try to put a positive face on the report, citing partnership efforts with other population centers. We suspect that there is a larger long term trend that they are not at alll happy about, and that this report is just another pin in the Voodoo Doll of Psychiatry.

Rorschach Tests, a blot on the scientific landscape

An article on an exhibition devoted to the work of Hermann Rorschach, father of the test that bears his name. The exhibition celebrates the 50th anniversary of the Rorschach archive at the University Library in Bern. The archive, the only one in the world devoted to Rorschach, was founded by the Bernese psychiatrist Walter Morgenthaler in 1957 and was substantially enriched seven years ago by bequests from the psychiatrist's estate.

"Hermann Rorschach: a Swiss psychiatrist between science and intuition" is running at the University Library, Bern, from December 6 to February 23.

Of interest is that despite beliefs to the contrary, the test is scientifically useless:

Pseudoscience

While the Rorschach test continues to be defended and used by psychologists, its one not insignificant flaw is that it is scientifically virtually worthless.

In the United States in the 1940s and 1950s even mentioning inkblots got psychologists drooling like Pavlov's dogs, thanks to seemingly miraculous personality readings by Rorschach experts.

Under controlled studies however these "experts" failed miserably and it wasn't long before more critical scientists realised that Rorschachians were simply, and most probably subconsciously, using cold reading, a technique used by fortune-tellers and others posing as psychics and mediums.

"The readings say more about [the examiners] than the subjects," to quote Anne Anastasi, the noted differential psychologist.

The exhibition glosses over these negative aspects, but it does provide a fascinating profile of one of the most influential, if misguided, psychologists of the 20th century.

Thus it is of interest to those who wish to see how badly people can go wrong.

The Connection of AntiDepressants and Suicide

From a comment by Dr. Seth Roberts, seen on the blog site of Ashworth University. Napoleon is famous for the maxim that one should not look for evil intent when incompetence will suffice. But situations like this make one wonder.

Can Antidepressants Cause Suicide? Many parents have said yes.

David Healy, a Scottish psychiatrist, prompted by those stories, did a small experiment in which undepressed persons took anti-depressants. About 10% of them started having suicidal thoughts.

Drug companies and the University of Toronto (where Healy had been offered a job) reacted very badly to this information, as Healy describes in Let Them Eat Prozac.

An article in the latest issue of the American Journal of Psychiatry by David Leon, a biostatistician on the FDA oversight panel, describes why he voted to extend a warning about this from children (< 18 years old) to young adults (18-24 years old).

This was the main data:



What’s shown is the odds ratio for a report of suicide ideation or behavior, comparing those who got anti-depressants with those who got placebos. An odds ratio of more than 1 means greater risk in those who got anti-depressants. The red bar is from a different study.

When different ages are lumped together there is no increase in risk but that hides opposing tendencies at high and low ages.

The article contains this curious sentence: “The results did not provide definitive evidence of risk, yet they failed to demonstrate an absolute absence of risk.” No possible results could “demonstrate an absolute absence of risk” so it is unclear what Dr. Leon meant.

Later he writes: “My vote to extend the black box warning to young adults was based on concern that risk of suicidality could not be ruled out and, given the widespread antidepressant use, even a small risk must not be ignored.”

Yes, he has it backwards: The data do not “fail to rule out” suicide risk (no possible data could “rule out” such risk, i.e., show the risk is zero); they manage to overcome a barrier to show it’s there.

And yes, he’s congratulating himself (”even a small risk must not be ignored”) for doing his job.

Uh-oh.

That someone — a biostatistician, no less — in such a powerful regulatory position fails to understand basic concepts is bad enough; to make things worse, Dr.
Leon has received money from three of the companies (Eli Lilly, Organon, and Pfizer) he oversees.

And now from our sponsors: Diseases for Sale

We found a post that probably needs to be quoted in full:

If you're a physician, you know Medscape. A division of that internet health care behemoth, WebMD, Medscape pounds our inboxes daily with offers of free CME. Much of the CME is industry-sponsored, which is not exactly a news item for most of us. But what you may not be aware of is that Medscape sells its disease-specific "resource centers" to the highest bidder. For example, the ADHD Resource Center is purchased by Shire, the Bipolar Disorder Resource Center is owned by GlaxoSmithKline, and the Pharmacological Management of Pain Resource Center is now the property of Cephalon.

How much do companies pay in order to take control of what doctors learn? Good luck extracting this information from Medscape, but rumor has it that about $500,000 gets you a sort of "base package" which includes four articles. The sponsoring company gets to specify the topics and the authors, of course. There is a menu of extras, so if you really want to saturate the medical mind with your marketing message, you can presumably part with well over a million. And this doesn't include income from the advertising banners that appear to populate each and every web page on the site.

Yes, doctors know Medscape. And Medscape knows money.

Psychologist charged with filing false rape report to cover up a marital affair.

From the Pioneer Press

A psychologist who claimed she was raped by a patient in her Selby Avenue office lied about the incident to cover up her extramarital affair with the man, according to a court document.

Jill Marie Ajao, 41, was charged Friday in Ramsey County District Court with falsely reporting a crime, a misdemeanor.

A call left at her home in St. Paul was not immediately returned.

On Oct. 26, 2006, police responded to a call from Ajao at her office, where she appeared "crying and visibly upset," the complaint said.

The complaint goes on:

Ajao told police that two days earlier, a new patient named "Jeff" had come in for a scheduled appointment at 2 p.m. During the session, "Jeff" raped her, she said, providing specifics of the rape.

The next day, police contacted a Minnesota Bureau of Criminal Apprehension sketch artist, who worked with Ajao to design a likeness of the suspect.

The day after that, Ajao changed her statement, saying she'd met the man at a bar down the hall from her office. She also said she had been at a sexual aids store called the Love Doctor on University Avenue and speculated that the man had seen her there and somehow found out who she was.

On Oct. 30, police interviewed a witness from the bar, who said she recalled Ajao being there with a man, and that they seemed familiar to each other. Police released to the media a surveillance photo of the man leaving the bar and received "hundreds" of calls in response from the public.

In January, Ajao met with St. Paul police Sgt. Paul Schnell at her request - changing her story again.

This time, she said she met a man online, and they got together Oct. 24 when she called him. She told police "there was an expectation that there would be no sex" but that her real intention was to "surprise and pleasure her husband" by putting an encounter together.

It was not immediately clear what she intended regarding her husband.

Still later, in February, Ajao sent an e-mail to the man, which was obtained by police. In it, the man asked if she "finally admitted that the encounter was consensual and that she claimed rape to cover up an affair." She replied that she had.

Police said the case is highly unusual and emphasized that real victims would be believed, as Ajao initially was

Antidepressants Now No. 1 Drug Prescribed For Women 18-44 - High Number Of Prescriptions Worrying Some Experts

Snippets from a report on MSNBC

Studies are showing that for every 100 American women, 37 have been prescribed an antidepressant, which is now the No. 1 drug prescribed to women ages 18 to 44.

Some experts said they're worried.

"Some of the women are not really depressed," said Diana Zuckerman, president of the National Research Center for Women and Families.

She said these numbers are too high. A big issue for her is that too often a medical doctor like a gynecologist or general practitioner is prescribing the antidepressant rather than a psychiatrist trained to treat mental health issues. As a result, many patients on mood meds are not getting the follow-up care they need. One study suggests that just 20 percent of adults on these drugs are getting follow-ups.

"But realistically, you want somebody who's keeping an eye on that patient and a lot of doctors are just not going to do that," Zuckerman said.

[...]

In fact, about two-thirds of people on these drugs experience side effects, which can be severe and devastating.

Internet bloggers are even sharing their experiences with antidepressants online. They descibe these effects as a "nightmare" and like "torture." Common reactions include "weight gain, decreased sex drive and severe stomach cramping."

"Something is going on with these drugs," Zuckerman said. "Not everybody metabolizes them the same way. It doesn't have the same effect on every person and some people are harmed by them."

Of course, we remain skeptical about the psychiatrists.

Ritalin: The scandal of kiddy coke

Snippets from a longer story in the Daily Mail

Eight months ago, Daniel, now 14, was put on Risperdal - an antipsychotic drug usually given to schizophrenics.

"It was as if my son had been replaced by a doped-up zombie,' says Hayley, 35, who took him off it a month later.

"I could hardly wake him in the morning. It was as if all his personality was disappearing, like a patient in a mental institution."

Last week, it emerged that around 8,000 British youngsters are being treated with this powerful tranquilliser and another, similar drug called Zyprexa - despite the fact that their dangerous side-effects range from diabetes to brain tumours.

Hundreds of thousands of others are still being prescribed Ritalin, an amphetamine-like stimulant which has the same effect as "speed" and cocaine, and which, according to new evidence from the U.S., doesn't even work in the long-term.

[...]

Recent findings also suggest that Ritalin can stunt growth as well as causing heart problems, insomnia and weight problems.

In the U.S., there have been 51 deaths among children and adults taking Ritalin since 1999.

According to the Medicines and Healthcare Products Regulatory Agency, 11 British children on Ritalin have died.

The cause of two deaths was heart-related: one had a heart attack, the other an enlarged heart.

One was recorded as a "sudden death". One died of a brain haemorrhage; another of a swelling in the brain.

Two committed suicide, and the last died of neo-natal respiratory distress syndrome.

Not surprisingly, experts fear that inappropriate drugs are not only being used to control children's behaviour, but are being massively over-prescribed to some children who are simply naughty.

ADHD, they say, is nothing more than a symptom of Britain's time-poor society, where children of parents working long hours are cracking under the strain of family life.

There are criticisms, too, that some doctors dole out pills when therapy would be a safer option.

In the U.S., where one in ten children takes Ritalin and where doctors write two million prescriptions a month, the situation is even worse.

A growing body of experts is even questioning whether ADHD exists at all.

"As a society, we are quick to reach for a pill," says David Healy, one of the world's leading psycho-pharmacology experts, and Professor of Psychiatry at Cardiff University.

"There's much less willingness on the part of the medical profession to say to parents: 'You have an awkward child. You must discipline them.'

"So we prescribe pills instead.

"The drugs used to treat ADHD are the same as speed and cocaine.

"We react with horror to the idea that our kids would use such drugs, but don't react about drugs such as Ritalin being given to them.

"There's a risk that your child won't grow as well.

"There are high risks that children will go on to use street drugs, too, because they will have grown used to their effects."

Professor Healy says anti-psychotic drugs such as Risperdal were used in the Soviet Union to extract information from political prisoners.

"People who took them would tell anything to anyone," he says.

"When you think about giving these drugs to kids, it's a whole new ball game."

Dr Tim Kendall of the Royal College of Psychiatrists, who is heading a team drawing up new NHS guidelines for ADHD, insists there is a place for drugs in treatment, but admits: "We have a situation where GPs prescribe anti-psychotics inappropriately.

"There is no real excuse for prescribing drugs which are associated with such severe side-effects."

But even where Ritalin is used, Dr Kendall says guidelines do not make it clear when doctors should diagnose ADHD and when they should prescribe drugs.

"If you diagnose people loosely, you could end up with 16 per cent of the child population with ADHD.

"Under tight criteria, only 1.6 per cent would be diagnosed," he says.

"A generous understanding would be to say that doctors have reached a point where they don't know what else to offer, and they haven't got the right support to help parents."

[...]

Three out of five women would prefer advice from Bob Vila, the home-improvement expert, than from talk-show psychologist Dr. Phil

From this report, edited for clarity

Three out of five women would prefer advice from Bob Vila, the home-improvement expert, than from talk-show psychologist Dr. Phil, according to a 2004 survey by Sears, Roebuck and Co.

That doesn't surprise Teresa Follmer, a designer with Home Depot in Mesa who hosts many weekend workshops on home improvement.

The lessons from Vila or other home-improvement experts could raise a woman's sense of well-being and self-esteem.

"You get a lot of satisfaction knowing that you can accomplish something yourself," Follmer said. "It's a great feeling knowing you don't have to ask for help or pay someone to do it for you."

Many women even have the correct do-it-yourself tools at their fingertips, though they don't know it.

"What I've learned from teaching the (basic home-repair) class is that many people already had the tools, the power tools especially, they just didn't know what they were for or how to use them," said Greg Christy, the Chandler-Gilbert Community College instructor on home repair and a True Value manager in Sun Lakes.

More women are tackling small fix-it jobs and home-improvement projects, and more want to learn.

"Look at the stats. This is a trend," said Eden Jarrin, co-creator of BeJane.com, a home-improvement Web site for women, and column contributor to newspapers and online media. "Women are owning more homes, and they want to take care of those homes so that they reflect who they are."

Fannie Mae, the largest guarantor of home mortgages, reported that by 2010, there will be 32 million female homeowners, compared with today's 17 million. In addition, 9 percent of homeowners in 2005 were single men, and 21 percent were single women. The do-it-yourself domain has taken notice and spawned an industry of women-friendly tools, books, television shows and Internet sites.

As a result, more women are dropping in on Home Depot repair and project workshops.

[...]

Bill Maher on Government Disease Mongering

"Diet and exercise don’t fail, a fact brought home last week by a new Duke University study that showed diet and exercise is just an effective a cure for depression as Paxil and Zoloft. So ask your doctor if getting off your ### is right for you."



Hat tip to BrandWeek NRx, eDrugSearch, ClinPsych, PharmaGossip and Pharmalot.

The Failure of Quebec Governmental Mental Health Services for Children

Let's see, we have children in government controlled youth centers, where 80% are under the control of of a psychiatrist. About 67% are on prescription drugs, and 40% are on psychiatric drugs. Are we really surprised at these figures?

Granted, many are from broken homes, etc. and maybe the only practical method they have is to sort of warehouse them and drug them up. (Never mind the cycle of side effects that can drive people crazy)

But these kind of figures sound like the figures of a failed system to me. It's a surprise that the figures aren't worse. And of course, they don't make the connection between the psychiatrists and the high rate of psychiatric prescriptions. If you are hammer, everything looks like a nail.

Taken from this report in the Montreal Gazette.

Quebec children in youth protection services are extremely damaged, warned an author of a report showing nearly 40 per cent are prescribed drugs for psychiatric problems.

Children as young as six years old are medicated to control hyperactivity, aggression, depression and suicidal tendencies, said Pierre Charest, head professional services at Centre jeunesse de Montreal.

[...]

Made public earlier this week, Charest's report, however, strongly recommends finding alternatives to drug therapy, especially for young children.

Commissioned by the provincial health department, the working committee's study on the mental health of children under government care shows a disturbing trend of mental disorders.

The study tracking 3,600 youths in Quebec's youth protection network last year reveals that one in four suffers from multiple mental disorders. The majority are being treated for minor issues while 17 per cent are seriously ill.

Children ages six to 11 years old seem to have the most mental health issues, the report found. About 67 per cent are on prescription drugs.

"The rate of mental illness in group homes is very, very high. It's definitely higher than in the general population," Charest said.

Health professionals welcomed the report, a first of its kind for Quebec.

"For the first time we have a portrait of the Quebec reality," Douglas Hospital child psychiatrist Philippe Lageix said.

"But it's not something new that's popped up suddenly in Quebec."

Children in youth protection represent the most at-risk population for mental illness because of several factors, Lageix explained.

It's a predictable pattern:

"We meet one patient after another and realize that their parents have problems. They are exposed during pregnancy to (drugs, alcohol, cigarettes, malnutrition) and then neglected, then placed.

"They peak on all risks," he said. Those with severe mental health and behaviour problems cannot stay with their own families or be placed in foster care, he added.

But Quebec is not alone. Comparative studies show Ontario, Holland and the United States are dealing with similar issues, Lageix said.

"Very vulnerable youth are getting services from (youth protection) agencies and a lot of them are medicated," Lageix said. "But do we treat too much or not enough? That's a social debate."

Experts suggest health services to youths in centres has improved during the last decade.

In Quebec, nearly 80 per cent are under the supervision of a psychiatrist or other professional despite the shortage of physicians. But 20 per cent are fending for themselves, the report found.

[...]

Among the study's recommendations:

Better screening to evaluate and follow youth with multiple problems, special programs adapted to children with mental health issues, improved training for caregivers and professionals dealing with children at risk, multi-disciplinary teams in place in group homes and more studies to seek alternatives to medication therapy.

Quebec Health Minister Philippe Couillard has endorsed the study's recommendations saying funds are available in the 2007-2008 budget.

Study reveals 6,225 deaths due the effects of Paxil, Zyprexa, Risperdal, and Clozaril.

Recently a study was published in the Archives of Internal Medicine regarding "Serious Adverse Drug Events Reported to the Food and Drug Administration, 1998-2005".

The abstract reports that

From 1998 through 2005, reported serious adverse drug events increased 2.6-fold from 34 966 to 89 842, and fatal adverse drug events increased 2.7-fold from 5,519 to 15,107. Reported serious events increased 4 times faster than the total number of outpatient prescriptions during the period. [...]

For 13 new biotechnology products, reported serious events grew 15.8-fold, from 580 reported in 1998 to 9181 in 2005. The increase was influenced by relatively few drugs: 298 of the 1489 drugs identified (20%) accounted for 407,394 of the 467,809 events (87%)

This is alarming in itself. But then, if you get to read the actual report, there's more. As noted by the Furious Seasons weblog (who managed to get a copy of the study and put it online) there is more damaging information in the report:

What the media failed to report is that Zyprexa, Risperdal, and Clozaril, three atypical antipsychotics, and Paxil, an SSRI anti-depressant, were tied to the deaths of 6,225 Americans from 1998 to 2005. These numbers are shocking and far outpace estimates I've run into previously. That this data was not reported by the media is inexcusable, given the millions of Americans--and others around the world--who take these four drugs.

[...]

Since news broke around Zyprexa last year and accusations that its maker, Eli Lilly, had downplayed and covered up known injuries caused by the drug, the media has not provided an accounting of how many people died as a result of taking the drug. For my part, I downplayed the numbers I ran across in press accounts and in the Zyprexa documents. I didn't want to cast false aspersions.

But, now, I can say this:

• Eli Lilly, your drug killed 1,005 Americans.
• And, Janssen/J&J: your drug killed 1,093 Americans.
• GSK and makers of generic Paxil: you guys make a drug that killed 850 Americans.
• As for Novartis, makers of Clozaril, and whomever makes its generic form: you asshats killed 3,277 Americans.

The doctors who prescribed these drugs are just as responsible, ethically if not legally.

And I have a question for you guys: How's it feel?

Excepting Paxil, each of these drugs killed more people than Vioxx, which claimed 932 lives, according to the study. Vioxx was pulled from the market in 2004, following intense publicity around its association with heart attacks. Some estimates of deaths related to Vioxx go as high as 55,000 deaths, but I don't know how solid those numbers are.

So why is it that the New York Times was virtually alone in reporting on Lilly's attempts to downplay problems with Zyprexa and accusations that it marketed the drug off-label? The documents were in the hands of NPR, the Wall Street Journal, and the Washington Post--and yet these media giants remained largely silent. Wimps.

We can only agree with the sentiment

Youth Suicide Rates Up? Not So Fast

We have previously looked at the 2004 increase in youth suicides, falsely blamed on a decrease of antidepressant prescriptions. Now someone has looked at the numbers in detail:

The headlines read, "Highest increase in youth suicide" and "girls aged 10-14 increased 75%." And of course, the only explanation anyone seems to want to debate is antidepressants: was it too many prescriptions, or too few? And self-righteous indignation all around.

Well, I did something apparently no one else cares to do: I looked up the individual suicides. They are individuals, right? With different reasons for doing things? And guess what? I have another explanation: Ohio.

The year in question is 2004, the most recent year the data is available. I focused on girls aged 10-14, because that's what the majority of the news articles focused on. Most reports described an increase of 75%, from 56-94. I actually found 98 total suicides in this group.

If antidepressants had any effect-- in either direction-- then the increase should have been spread out throughout the country.

Most states had very few suicides in this demographic. Maine had zero. North Carolina had 1. Oregon, 1. Florida, 1. Etc. These small numbers are generally unchanged from 2003. California, which had the one of the highest absolute number of suicides, had 6 in 2003, and 7 in 2004.

If you look at Ohio, however, you see something interesting. In 2003, there were no suicides. In 2004, there were 11.

Indiana was next: 0 in 2003, 6 in 2004.

This, of course, speaks to the problem of medicine’s over-reliance on epidemiology. People are different, and even “matched controls” have such variability that association studies are often nearly useless. This is even more true in psychiatry. Suicide is not an involuntary pathogen, it is a complex, volitional behavior whose causes can only be meaningfully investigated at an individual level.

I have to go back and look closely at all the states' data, etc. But it seems to me that when two small states account for almost half of the entire increase in the suicides, we should stop talking about antidepressants and maybe go find out what the hell happened over there?

Those blessed with an evil wit will point out the preponderance of political advertising in Ohio during that elections year. The more cynical will point to the arrival of Teen Screen on the scene in Ohio at about this time, something that might or might not be relevant.