The Psychopathology of Shrinks

By Alexander Cockburn in CounterPunch. While we do not agree about Paris Hilton (the use of a bogus psychiatric diagnosis to avoid personal responsibility is reprehensible) the ironies of the impact of Tony Soprano and the misuse of psychoanalytic procedures should not be passed up

Summer’s hot breath draws closer and the psychoanalysts of New York and Boston prepare their patients for the difficult two or three weeks of holiday separation. Traditionally, many Boston shrinks take their seaside weeks on Cape Cod, around Truro, sunning and gossiping while their patients muster on their beach towels a few hundred yards away. The touching scene is duplicated further south around the Hamptons on Long Island.

Undoubtedly beach chat among both analysts and analysands will ripple over the June excitements of the psychoanalytic trade, starting with the gallant efforts of Paris Hilton’s psychiatrist, Dr Charles Sophy, to engineer what her costly but incompetent lawyers failed to do, namely spring her from L.A. County Jail where – given the triviality of her offenses - she is grotesquely pent. But of course the prime topic will surely be the end of the Soprano series which, across the past eight years, courtesy of Lorraine Bracco's Jennifer Melfi – Tony Soprano’s analyst -- has been the biggest boost to the shrink business since Lee J. Cobb starred in The Three Faces of Eve.

Truly comical has been the solemnity with which psychoanalysts across the United States have been deploring the “breach of professional ethics” at a shrinks’ dinner party in one of the concluding Soprano episodes in which the identity of Dr Melfi’s patient as Mobster Tony was disclosed. The rare moments when shrinks aren’t seducing their female patients (70 per cent, in an informal New York survey some years ago) are usually consumed by such indiscretions, a tradition stretching all the way back to the notoriety of the patients trotting up the stairs of Bergasse 19, Freud’s chambers in Vienna.

It’s true that some psychoanalysts were indignant at the way Melfi, chided by her colleagues for enabling a sociopath, promptly dumped the Mafia boss as a patient, the climax of a process identified back in 1999 in the British Medical Journal by Dr Tony David as the collision of “the superego of Melfi’s civilised values and the intellect… with the murky id that is Soprano’s stock in trade.” “The strict ethical principles established by the American Psychological Association”, wrote one APA member furiously, “do not allow for the arbitrary dismissal of a client even if they are sociopathic in nature (unless there is danger to the therapist).”

It so happens that these same “strict ethical principles” of the APA have been the topic of unsparing rebuke which probably won’t be cited much on those holiday beaches. A recent report by the Pentagon’s Inspector General confirms what has been detailed in a number of news stories since 2005 concerning the starring role played by American psychologists and psychoanalysts in devising and supervising torture techniques as administered by the U.S. military in Guantanamo, Iraq and Afghanistan, as well as other secret interrogation centers run by the CIA.

These techniques -- as has been recently described here by Stephen Soldz have been “reverse-engineered” from the Pentagon’s SERE (“Survival, Evasion, Resistance and Escape”) program in which US military and intelligence personnel are taught how to withstand harsh interrogation. Psychologists have always been central to this enterprise and are now similarly central to the use of sleep deprivation, sexual and cultural humiliation and waterboarding in grilling America’s enemies. “Reverse-engineered” simply means the Pentagon is using the techniques to torture suspected terrorists.

In 2002 the Chairman of the Joint Chiefs of Staff concluded that “interrogation methods used were no longer effective in obtaining useful information from some detainees” and, as the Inspector General’s report details, “recommended that the Federal Bureau of Investigation Behavioral Science Unit, the Army's Behavioral Science Consultation Team, the Southern Command Psychological Operations Support Element, and the JTF-170 clinical psychologist develop a plan to exploit detainee vulnerabilities.” The use of dogs, sexual humiliation, and kindred tortures were only a couple of months away.

Amid furious protests from such APA members as Soldz and others the APA leadership has piously maintained that "psychologists have a critical role in keeping interrogations safe, legal, ethical and effective." The Pentagon Inspector General’s Report make clear this claim is ludicrous. So here we have shrinks refining Tony Soprano’s brutish violence, draping his id with the national flag. The August meeting of the APA’s “Council of Representatives” will be stormy as the members vote on a motion introduced by Neil Altman urging "A moratorium on psychologist involvement in interrogations at US detention centers for foreign detainees.”

Suing over drug which left her too scared to go out

From the Sunday Mail

A Scots mum is to sue drugs giant GlaxoSmithKline after claiming their antidepressant Seroxat made her scared to leave her home.

Diane Smith claims she became agoraphobic when she tried to wean herself off the controversial drug.

She even missed her son's wedding and could not go to see her dying father as she has become a prisoner in her own home.

Diane, 43, of Thurso, Caithness, has issued a writ in the High Court in London claiming £50,000.

Seroxat has been linked to a string of suicides and users say they have suffered serious side effects, including depression.

Diane's case is the first to be lodged over the effects of coming off the drug.

Her action was launched this year to beat an English High Court 10-year timebar as she started taking the drug in 1997.

In January, an investigation for the BBC's Panorama claimed GlaxoSmithKline covered up vital evidence about Seroxat's safety.

Mum-of-four Diane was on the antidepressant for five years from August 1997 to June 2001.

She said: "I was walking on the beach with my handicapped son Lee, who is now 18, when I suddenly felt dizzy and the whole beach started to sway. It was the strangest sensation.

"I went to see the doctor who said I was suffering from stress and prescribed Seroxat.

"I was on it for five years until 2001 when suddenly the psychiatrist took me off it. Then the trouble started.

"I felt suicidal. I get panic attacks and I cannot go out. I can't even go to the supermarket just down the road. I'm a prisoner in my own home. When my son James got married I couldn't go. When my daughter Denise graduated I couldn't go and when my dad died I could not be at his bedside - all because of this drug.

"I'm not really interested in the money. I'm more interested in getting the truth known because this drug is a danger."

Her husband James, 50, said: "It's been a terrible time for Diane and it has not been easy for the rest of us. It's broken our hearts."

Since it was first prescribed in 1990, Seroxat has been linked to at least 50 suicides of adults and children.

It was banned for under-18s in 2003 after a government watchdog found it trebled the risk of suicidal thoughts in depressed children.

A spokesman for GlaxoSmithKline said: "Seroxat has helped millions of people lead fuller lives and has helped revolutionise the treatment of depression and other psychiatric conditions. The majority of patients do not suffer symptoms on stopping Seroxat.

"If they do occur most patients find they are mild and go away on their own, although in some patients they may be more severe and/or prolonged.

"The most common symptoms include dizziness, sensory disturbances, sleep disturbance, anxiety and headache."

The drug company have been bombarded by lawsuits in the US.

Donald Schell, 60, from Wyoming, killed his wife, daughter and granddaughter, then shot himself after taking the drug for just two days.

His son-in-law Tim Tobin sued and GSK were ordered to pay £4.5million.

Are Pharmas Addicted to Lifestyle Drugs?

As seen in Business Week. The wonders of marketing new diseases. Finding new markets for old drugs like antidepressants is also in the mix.

Drugmakers are eager to spiff up your sex life and hairline, even as their lucrative products face mounting safety questions

At a storefront exhibit in New York to promote the new weight-loss pill Alli, four slender young women gather around a computer terminal to learn about the drug that some have called a miracle remedy for America's obesity epidemic. But not one of the women appears to be overweight, let alone obese.

That raises a question: Will Alli (pronounced "ally") become the next lifestyle drug—a magic pill for a quick fix? Might it serve those who want to shed pounds before a big event, such as a wedding, or, worse, women who yearn to be as stick-thin as runway models?

It is, after all, the first FDA-approved weight-loss product to be sold over the counter. Steven Burton, vice-president of the weight control division for GlaxoSmithKline Consumer Healthcare (GSK), which markets Alli, cringes at the term "lifestyle drug." He's also nervous about the hype. After a tour of the exhibit, he says: "People have to understand this is not about losing 30 pounds in three weeks."

Try as they might to distance themselves from the lifestyle drug sector, pharmaceutical companies can't seem to kick their addiction to these lucrative products. Even as consumers and government regulators grow more alarmed over drug safety, an examination of four popular lifestyle categories—weight loss, hair loss, sleep, and sexual dysfunction—shows that the pharmaceutical industry is by no means shying away from this controversial territory.

This is a surprising trend for several reasons. Lifestyle drugs are defined loosely as products used to treat conditions that are not life-threatening. Yet because people take these drugs over long periods of time, sometimes on a daily basis, it can be difficult for companies to persuade the Food & Drug Administration that the medicines will cause no harm in the future. On June 13 a panel of FDA advisers voted unanimously that regulators should not approve a weight-loss treatment called Acomplia, from Sanofi-Aventis (SNY), and most experts believe the FDA will follow the advice of its panel when it reaches a decision later this summer.

For manufacturers of lifestyle drugs, the Acomplia example offers a cautionary tale. Analysts originally pegged the product, now called Zimulti, as a surefire blockbuster, with potential sales of $4 billion a year. It is already on sale in 37 countries.

But the FDA is concerned that some patients in clinical trials have experienced depression, and a number of them have been troubled by suicidal thoughts. The drug seems to achieve its desired effects by blocking biological receptors in the brain that cause food cravings. But by intervening in this pathway, it may also unleash anxiety, phobias, and other psychiatric disorders, according to statements the FDA released when it first reviewed this drug in 2006.
A Bulging Epidemic

Obesity occupies a special place in the lifestyle arena. Most experts argue the condition is, in fact, life-threatening over the long run, because it can lead to heart disease and diabetes.

A drug such as Acomplia, if it is eventually approved, will face a restricted market—if only because it will require a doctor's prescription. But Alli, which costs about $60 a month, is a different matter. Its over-the-counter status virtually guarantees that it will attract fans well beyond those who are dangerously obese.

And for many, the potential benefits are as much about cosmetics as they are about health. "Losing weight helps my self-esteem and well-being," says Stephanie, a 38-year-old beverage company executive who asked that her last name not be revealed. She has lost 20 pounds in the past year by exercising and changing her diet, and she plans to add Alli to her weight-loss plan. "Looking good makes you feel better."

Glaxo's Burton says it's hard to estimate the potential market size for Alli. But he adds that the market for weight-loss pills that are not FDA-approved is about $1 billion a year. Add in diet foods and programs such as Jenny Craig, and you end up with a $40 billion-plus market.

Burton believes Alli's limitations will dissuade people from using it as a shortcut to a quick trim-down. The drug prevents the body from digesting about a quarter of the fat in a person's diet. Those who eat too much fat while taking the medication can experience unpleasant side effects, such as diarrhea. That will effectively force patients to stick to a low-fat diet while they are on the drug.

Government regulators have no qualms about raising safety concerns on drugs long after they hit the market, especially in the lifestyle segment. Late last year, after several Ambien users regaled TV talk-show hosts with bizarre stories about how the insomnia drug prompted them to drive their cars or even prepare entire meals in their sleep, the FDA demanded that Ambien maker Sanofi and all other manufacturers of sleep drugs add strongly worded warnings to their labels.

On Mar. 17 the agency went a step further, requesting that they also send letters to doctors notifying them of the warnings, and that they print guides for patients that describe the side effects and provide advice on how to use the drugs properly.

Clearly, America's craving for a full night's sleep is overpowering any concerns about strange sleep behavior. In the first quarter of this year, U.S. sales of Ambien jumped 54%, to $737.7 million. Overall, prescriptions for Ambien, Sepracor's (SEPR) Lunesta, and similar drugs jumped 15% last year, to 47.8 million, according to health-care information provider IMS Health, and total sales grew 29%, to $3.6 billion.

David Dinges, a sleep scientist at the University of Pennsylvania, suspects doctors are incorporating the warnings into their consultations with patients rather than withholding the drugs altogether. "They're being more vigilant about side effects, but I don't expect this will lead to a market reduction," says Dinges, who is a scientific adviser to several pharmaceutical companies. In fact, shortly after Ambien's patent expired on Apr. 20, 13 generic drugmakers rushed into the market with copycat versions.
Waking Effects

The flip side of insomnia is drowsiness during the day, another attractive target for makers of lifestyle drugs. Provigil, a drug from Cephalon (CEPH) that conquers such sensations, is finding an ever-broader audience, enjoying 35% sales growth in the first quarter of this year, to $201 million. While the drug is approved to treat narcolepsy and other recognized disorders, some analysts estimate that as much as 90% of its sales come from people who are using it "off label" to stay awake for long stretches of time.

It was probably such off-label usage that persuaded the FDA to delay a long-acting version of it, called Nuvigil. In addition, some patients developed skin rashes during a trial for a version of Provigil that was being tested to treat attention deficit disorder. The FDA has requested that Cephalon incorporate strong warnings about the side effects into Nuvigil's label, and the agency is now expected to approve the drug by June 16.
Baldness Won't Kill You

Even when there is plenty of capital riding on a new product, safety concerns can derail it. A couple of years back, biotech firm Curis thought it had a promising new treatment for baldness. So did Procter & Gamble, which partnered with Cambridge (Mass.)-based Curis to develop it.

But on May 9, P&G pulled out of the deal, citing unspecified safety issues in early trials. "Safety profiles are especially important for these drug candidates since, unlike…cancer and stroke, male pattern baldness is not a life-threatening disease," said Curis Chief Executive Daniel Passeri in a statement. Without P&G's support, it could be difficult for the unprofitable Curis to continue studying hair loss.

Such disappointments haven't dissuaded larger companies from making a run at baldness. Even though millions of men in the U.S. are destined to lose most of their hair, the treatment market today is a mere $1 billion a year. That may be because even drugs with high brand awarenesss, such as Rogaine and Propecia, often don't work so well.

Pfizer (PFE) is testing two drugs to treat hair loss. Its most advanced candidate was originally tested as an asthma treatment, because it relaxes smooth muscle cells in blood vessels such as those found in lung airways, allowing patients to breathe.

"We found the compound was not well-suited [to treating] this disease, but we are now exploring its potential in hair loss," says Pfizer spokesman Stephen Lederer in an e-mail. He adds that scientists still don't fully understand why relaxing certain blood vessels leads to hair growth, though this appears to be the same mechanism exploited by Rogaine.
In the Bedroom

Pfizer knows firsthand how rewarding lifestyle drugs can be when they work well. It pioneered the lifestyle category with its impotence blockbuster Viagra.

Sales of the little blue pills, first approved in 1998, rose 11% in the first quarter of this year to $434 million. First quarter sales of Viagra's two competitors, Eli Lilly's (LLY) Cialis, and GlaxoSmithKline's Levitra, also grew by double digits.

Now, Johnson & Johnson (JNJ) is preparing to enter the market for sexual dysfunction. At a June 7 event for Wall Street analysts, the company disclosed that it is continuing to study a drug for premature ejaculation, even though the FDA declined to approve it in 2004. To gain overseas approval, the company ran a number of additional trials, and the results have been so encouraging that J&J executives are thinking about approaching the FDA a second time.

The drug, Dapoxetine, is derived from common antidepressants known as SSRIs, which are sometimes used off label to treat premature ejaculation. Dr. Paul Stoffels, chairman of global research and development for the pharmaceutical division of J&J, says the first time the drug was up for review, regulators questioned whether premature ejaculation was truly a disease that needed to be treated. At a press conference after the June meeting, Stoffels declared: "We have generated data to show that Dapoxetine provides a relevant benefit to patients."

Motivational Deficiency Disorder

Watch the spoof on the new epidemic of Motivational Deficiency Disorder on YouTube - very subtle

The original video is available at the link, but here is another twist on the idea



see also the site DiseaseMongering.Org

Lawsuit against psychologist settled on eve of trial

via WCAX-TV in Vermont

A lawsuit against a Norwich psychologist accused of initiating a nine-month affair with a former patient was settled days before it was to go to trial.

The details of the settlement between Norwich therapist Monica Descamps and Jill Davis of New Hampshire were not released.

Jury selection in federal court in Burlington had been scheduled to begin Tuesday.

Davis sued her former therapist in May 2006.

In her lawsuit, Davis said she sought counseling with Descamps in February 2003, which lasted until February 2004. At that point the psychologist ended counseling and initiated a romantic relationship with Davis, which lasted nine months.

In court papers, Descamps acknowledged the improper conduct.

The Dismal Failure of Psych Tests for Public Servants

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.

Psychiatrist Indicted For Fraud In Paxil Trials - Faces a Maximum Prison Sentence of 445 years, and 10 Million Dollar Fine

From WDSU in Louisiana

Dr. Maria Carmen Palazzo has been indicted by a federal grand jury on 55 counts of health care fraud and false documentation in connection with a clinical trial of Paxil in children and adolescents.

U.S. Attorney Jim Letten said the indictment alleges that during approximately a five-year period, the 55-year-old Palazzo defrauded Medicare in connection with services she claimed to have rendered to patients in a Psychiatric Partial Hospitalization Program at Touro Infirmary.

The indictment also charges that Palazzo defrauded Medicare by submitting fraudulent invoices to Touro for consulting and medical director services. The indictment said because of that Medicare paid Palazzo over $653,000 she was not entitled to receive.

Palazzo, who specializes in psychiatry, is also charged with offenses relating to clinical trials involving Paxil.

According to the indictment, Palazzo, as a clinical investigator for SmithKline Beecham doing business as GlaxoSmithKline, fraudulently failed to maintain and prepare records required by the FDA for evaluation the drug's safety and effectiveness in children and adolescents.

If convicted, Letten said Palazzo faces a maximum term of 445 years, and a fine of $10.15 million.

See also the US Attorney office for future press releases

Diagnosis: Conflict of Interest

An article on the transformation of continuing medical education into an enterprise for drug marketing. From an Op-Ed in the NY Times, by Daniel Carlat, who is a professor at Tufts Medical School, and the editor in chief of The Carlat Psychiatry Report. (free registration required)

[...]

Most states require that doctors obtain a minimum number of credit hours of continuing medical education each year to maintain their medical licenses. Not so long ago, most of these courses were produced and paid for by universities and medical associations. But this has changed drastically over the past decade.

According to the most recent data available from the national organization in charge of accrediting the courses, drug-industry financing of continuing medical education has nearly quadrupled since 1998, from $302 million to $1.12 billion. Half of all continuing medical education courses in the United States are now paid for by drug companies, up from a third a decade ago. Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care.

For example, GlaxoSmithKline footed the bill for dozens of educational courses intended to emphasize the benefits of Avandia over other drugs. An influential Internet-based educational program paid for by the company focused on specific studies that highlighted Avandia’s advantages without discussing one of the drug’s most worrisome side effects, increased levels of the lipids implicated in heart disease.

Avandia’s chief competitor, a drug from Takeda Pharmaceuticals called Actos, improves lipid levels but was hardly mentioned. When GlaxoSmithKline’s program did cite Actos, it did so tepidly. The information in the course was presented by noted diabetes academics paid by GlaxoSmithKline and other drug companies.

GlaxoSmithKline is not the only offender. The major organizations in diabetes education, like the National Diabetes Education Initiative, offer dozens of continuing medical education courses on diabetes that are free to doctors and paid for by drug companies. Predictably, each course focuses on the advantages of the sponsor’s product and minimizes discussion of dangerous side effects.

Education that doubles as advertising for drug companies occurs in all branches of medicine. Merck promoted Vioxx for arthritis by using programs for continuing medical education, which helped contribute to the more than 100 million prescriptions of the drug before it was pulled from the market.

According to Dr. David Graham, a safety researcher for the Food and Drug Administration, Vioxx was responsible for up to 140,000 cases of serious heart disease from 1999 until 2004, when it was withdrawn. But the potential cardiac dangers of Vioxx were played down in the courses paid for by Merck. In one instance, the company canceled lectures it had sponsored by a Stanford researcher who had mentioned, in talks to doctors, the cardiac risks from taking Vioxx.

Drug companies should never have been allowed to become the primary educator for America’s doctors. The Accreditation Council for Continuing Medical Education, a nonprofit organization composed of the major medical associations, establishes the rules that govern continuing medical education. According to the guidelines, companies are forbidden from directly paying doctors who teach continuing medical education courses.

But the standards have a loophole that allows drug companies to circumvent the regulations. They hire for-profit “medical education communication companies” to organize the courses. These companies receive millions of dollars from drug companies to create course work and to pay doctors to deliver the content. Sometimes, they pay doctors to give lectures to other doctors. Other times, prominent doctors are paid to be listed as the authors of journal articles that are written by ghost writers, a practice that was extensively documented in court records from a lawsuit against Pfizer.

Either way, the content is rarely developed by the identified experts. Instead, it is developed by the undisclosed communication company, which is paid by the sponsoring pharmaceutical company.

Essentially, this is a new twist on that well-known instrument of corruption, money laundering. Drug companies don’t directly pay doctors to teach courses. Instead, they pay someone else to cut the checks. Similarly, the drug companies don’t explicitly tell doctors to say good things about their products. Instead, they hire a company to write good things about their products and to pay doctors to deliver the messages.

[...]

These practices have recently attracted congressional attention. And of course, we are particularly interested in the 'marketing" of psychiatric drugs. See also this reaction to the article

Panel urges FDA to reject diet pill linked to suicidal thoughts

Lest we forget that it is not just psych drugs that do this. From this USA Today report

Federal health advisers unanimously rejected an experimental diet pill Wednesday after hearing testimony that it increases the risk of suicidal thoughts, even in patients without a history of depression.

The manufacturer, Sanofi-Aventis, failed to prove that the prescription medication rimonabant is safe for consumption, the panel said.

The 14-0 decision by the expert panel makes it unlikely the Food and Drug Administration will approve the drug. The agency usually follows its advisory panels' advice, but it isn't required to do so.

"There is a reasonable suspicion we'd better learn some more and watch this affair more closely before we launch into massive use of this drug," said panelist Jules Hirsch, a senior physician at New York's Rockefeller University.

Research shows that rimonabant blocks parts of the endocannabinoid system, which stimulates appetite and promotes the storage of calories as fat. It changes patients' sense of fullness and drive to eat.

Drug trials showed that obese patients who took a 20-milligram pill of rimonabant daily while cutting calories lost an average of about 14 pounds in three to six months compared with 3½ pounds for those taking a placebo.

However, patients taking the pill reported twice as many psychiatric side effects, including depression, anxiety and sleep problems, than those who received a placebo, Amy Egan, an FDA medical officer, told the advisers. "The numbers of events are small, but in aggregate they are worrisome," she said.

Egan said 88% of those reporting psychiatric problems while on the drug had no history of depression.

The company believes the psychiatric problems were tied to pre-existing conditions. Sanofi-Aventis' Richard Gural said the drug is not appropriate for anyone with a history of depression or suicidal thoughts, or who is taking antidepressant medication.

The company said in a prepared statement that it will work closely with the agency to "address the committee's recommendations."

The FDA is to make a final decision on the drug by July 26.

Sidney Wolfe, director of Public Citizen Health Research Group, testified that "the evidence for increased suicidal tendencies and depression is of particular concern for a drug targeted toward the obese, a population that has been shown to have a significantly higher incidence of depression compared to non-obese individuals."

Only a few other diet drugs are on the market in the USA, including one that keeps some dietary fat from being absorbed by the body and another that works on brain chemistry to enhance fullness.

Psychologist Thomas Wadden, an obesity researcher at the University of Pennsylvania School of Medicine in Philadelphia, says the decision is "a big disappointment for the field of obesity medicine. Doctors and their obese patients need new weight-loss medications that are safe and effective."

But note that psych drugs are still on the market.

Woman develops schizophrenia after starting to use antidepressants.

In which a woman has a psychotic episode and develops schizophrenia after starting to use antidepressants. As seen in this report

Maritza Tello's personal hell began while she was a first-year student at the University of Saskatchewan and it lasted six years.

Feeling depressed, the university student went to a psychiatrist and received some anti-depressants.

"In the third week I had a psychotic episode -- I lost complete awareness of reality and everything totally changed. I was terrified. I thought that I was going to die because my thoughts were coming very fast," Tello said during a lunch break at the Schizophrenia Society of Saskatchewan's annual conference and 25th anniversary celebration, which was held Tuesday at the Delta Hotel.

Diagnosed with schizophrenia, rational thinking was impossible for the then-24-year-old who suffered from delusions and horrific hallucinations.

"The doctors couldn't find a medication that worked for me so I struggled with reality and psychosis for six years ... When I was first diagnosed with schizophrenia, the psychosis took me to another dimension of life and time," Tello said.

While she was participating in a drug study in Calgary the right medication was found for her and the past 13 years have been kinder.

"In the last six months I've changed medication so I'm even better," Tello said.

Now 42, she is a peer support worker at the Phoenix Residential Society. Tello is forthcoming about her disease so people understand that mental illness requires help, not unlike a broken leg. [...]

Progress, including improved medication, has been made in treating schizophrenia, said Anita Hopfauf, the society's executive director.

"We work more with families than people with the illness," Hopfauf said. "We started out as just a few concerned family members getting together to form a support group and it has really grown into a large organization."

About 200 Saskatchewan people belong to the society, which advocates on behalf of schizophrenics.

"We need to accept people with mental illnesses and to show compassion and understanding for those people who are suffering with a really difficult disease," Hopfauf said. "Sometimes it's harder to live with the stigma than the illness."

But wasn't it the drugs that caused the problems in the first place

Psychologist accused of Wife Beating

From this report out of Indiana

David M. Buckingham, who heads up a staff of behavioral therapists at Buckingham & Associates that includes his psychologist wife Beth Buckingham, had been arrested on May 26 and charged with battery resulting in serious bodily injury and domestic battery.

While in the Hamilton County Jail pending his release on $10,000 bond, he made a series of phone calls that she also reported as evidence of illegal intimidation, Fishers police spokesman Sgt. Gerry Hepp said.

Hepp characterized the calls as "threatening" but said today the investigation did not find sufficient evidence to bring additional charges.

David Buckingham, 52, could not be reached for comment today at his offices in the 13000 block of Parkside Drive. Beth Buckingham did not return phone calls to the business seeking comment.

In a sworn statement filed in court, Fishers police officer Tom Weger said the assault occurred on May 26 at the couple's home in the 9800 block of Sugarleaf Place in Fishers.

"The accused slapped her in the face with an open hand, slammed the car door on her right foot and stomped several times on her left foot," said Weger, who had arrived to investigate after Beth Buckingham fled to a neighbor's home to call police.

Hepp said the ruckus occurred during the early afternoon, after Buckingham's wife had returned from the grocery and began arguing with her husband about a situation involving a daughter.

When he took her keys to keep her from driving off again, Hepp said, she decided to pack and leave with her daughter for the weekend.

After her husband returned home, she told police, she got into his car to get her keys to her car.

"As she exited the car, Mr. Buckingham struck her with an open hand across the face . . . then slammed the car door on her right foot . . . stomped on her left foot," Hepp said.

He said Buckingham left the house before surrendering to police outside his office near 131st Street and Ind. 37.

Buckingham, who once served as a director of research at Community Hospitals of Indianapolis, is a 21-year practitioner still affiliated with Community Health Network.

Hepp said the May 26th incident involving the mental health care professional was not the first domestic disturbance in his household to merit police inquiry.

He said an argument Buckingham had with older daughter on Nov. 24 led to another family evacuation.

The next day, Hepp said, Buckingham's wife called police to complain that he would not allow her back in the house to pick up clothes or medication for herself and her children.

Update

As reported here Feb. 23, 2008

Plea deal expected in psychologist's domestic violence case

Psychologist is expected to plead guilty in domestic violence case

A prominent Fishers psychologist has agreed to plead guilty in a domestic violence case involving his wife, a fellow therapist, a prosecutor confirmed Friday.

Special Prosecutor Todd Meyer said David M. Buckingham, whose wife, Beth Buckingham, also is a psychologist and behavioral therapist at Buckingham & Associates, is scheduled to plead guilty March 13 in Hamilton Superior Court.

Details of the plea agreement Meyer negotiated with defense attorney Bruce Boje are expected to be filed then.

There are two case numbers related to David M. Buckingham in Indiana in this time period

Case #3129586 29D03-0707-CM-234 Re: Domestic Violence

Case #3129877 29D03-0705-FC-179 Re: Invasion of Privacy

GP Order of Guilty Plea and Sentencing Hrg. of May 1, 2008 entered. Def. sentenced on Count I under 29D03-0707-CM-234 to: One (1) yr. at the Hamilton Co. Jail, suspended with credit given for three (3) actual days already served.

Suspended portion of this sentence shall be served on supervised probation-Consecutive to Count II under cause number 29D03-0707-CM-234 to: One (1) yr. at the Hamilton Co. Jail, suspended with credit given for four (4) actual days already served.

Suspended portion of this sentence shall be served on supervised probation. Restitution in the amount of $1500. shall be paid to Beth Buckingham in the following manner: payment to be made through the Court's Probation Dept. on or before the expira- tion of three (3) months from the date of sentencing. Def. shall pay all fines, costs and expenses if any as per Court's directive.

Court terminates No Contact Order entered under 29D03-0705-FC-179 effective this date. State moves to dismiss cause no. 29D03-0705-FC-179-Count I and under cause no. 29D03-0707-CM-234-Counts II, III, IV and V. Motion to dismiss granted. Bond ordered released. /s/ by Samuel Robinson, pro tem.

Another case illustrating the very bad side effects of anti-depressants.

As seen in this report

Victor Pimental received a five-year prison sentence Thursday and must pay $27,529 in restitution for stabbing his ex-girlfriend at a Grand Avenue bus stop near Safeway in Glenwood Springs.

"My heart goes out to her," he said with a shaky voice. "I don't know what happened that night. I don't know why ..."

Pimental, 54, pleaded guilty to second-degree assault as part of a plea agreement. He also originally faced charges of first-degree attempted murder, first-degree assault and felony menacing charges.

He said he takes full responsibility for his actions, that he's an alcoholic and depressed. He said he's been sober for six months and hopes to make better decisions through rehabilitation.

"He was taking Celexa," Pimental's attorney, public defender Garth McCarty said. "Which does cause some problems, especially when mixed with alcohol."

McCarty said some of the drug's side effects include manic depression, hallucinations and paranoia. He described the attack as a "complete mental or nervous breakdown" for Pimental. He added that head injuries to Pimental's frontal lobe could have affected Pimental's judgment.

Celexa is a brand name for Citalopram, commonly prescribed for depression.

Pimental's brother spoke on his behalf.

"I traveled 800 miles to be here," he said. "He is a great brother. He made some bad choices, and his injuries may explain why he couldn't stay on the right track."

He also mentioned unfortunate circumstances with family that caused great stress and led Pimental to drink. He said he hoped Pimental would be out of jail before their mother died.

"I can't see her going to her grave and not knowing her son's out of prison," he said.

Ninth Judicial District Judge Denise Lynch said Pimental stabbed his ex-girlfriend once in the back and once in the arm. The attack severed a radial nerve and caused permanent injury and a partial loss of movement in the woman's left arm, she added.

Lynch said she doesn't doubt that head injuries may have been a factor and that Pimental had a rough life.

"But I can't ignore the fact that this is a very serious crime," Lynch said.

Pimental will remain in the Garfield County Jail before being sent to a Department of Corrections facility. He's awaiting resolution of two DUI cases and a domestic violence case in the county.

Pimental was arrested on Dec. 11. Police said he contacted the victim on her cell phone as she waited at the bus stop on Grand Avenue near Safeway early in the morning. While she was on the phone, Pimental crossed the street and approached her from behind, pulled a knife and stabbed her. She managed to get away and ran into the store where she called police.

"I wake up every morning and go to bed every night and say a prayer for her," Pimental said before sentencing.

Leading American Psychiatrist Calls DSM IV Diagnostic Method Dehumanizing.

As reported here Contemporary American psychiatry has been dealt a shattering blow by no other than one of the most influential psychiatrists in academia.

Dr. Nancy Andreasen, Director of mental health clinical research at the University of Iowa, the editor of the American Journal of Psychiatry, and author of 500 publications, including the influential book, "The Broken Brain" (1984, recently released) in which she describes the "biological revolution" in psychiatry, has delivered a devastating blow to American psychiatry.

In her critical article in the Schizophrenia Bulletin, Dr. Andreasen makes some astounding acknowledgements--including the fact that American psychiatry is a veritable wasteland in need of "a reverse Marshall plan so that the Europeans can save American science by helping us figure out who really has schizophrenia or what schizophrenia really is..."

Dr. Andreasen points an accusing finger at psychiatry's reliance on an invalidated diagnostic guideline:

"The DSM has had a dehumanizing impact on the practice of psychiatry. History taking — the central evaluation tool in psychiatry — has frequently been reduced to the use of DSM checklists. DSM discourages clinicians from getting to know the patient as an individual person because of its dryly empirical approach. Third, validity has been sacrificed to achieve reliability. DSM diagnoses have given researchers a common nomenclature — but probably the wrong one. Although creating standardized diagnoses that would facilitate research was a major goal, DSM diagnoses are not useful for research because of their lack of validity."

Yet, she notes, the DSM-III and its successors, DSM III-R and DSM-IV were universally and uncritically accepted as if they were the ultimate authority on psychopathology and diagnosis. DSM forms the basis for psychiatric teaching to both residents and undergraduates throughout most of the United States.

Equally astounding--especially to those who didn't pay heed to critics who pointed out 20th century psychiatry's failings and decades of abusive "treatments"--is that Dr. Andreasen has to go back to the 19th century to find a period during which psychiatry resembled something close to a healing profession:

"the early psychiatrists attempted to develop therapies that might help to relieve mental pain in as humane and effective a manner as possible.

The picture of Pinel freeing the mentally ill from their chains is perhaps the most famous icon of their therapeutic approach. ‘‘Moral therapy’’ was developed in many countries in Europe, in Britain, and in the United States. In an era when no pharmacological treatments were available, it emphasized a variety of psychotherapeutic techniques that included personalizing the care to the individual’s needs, using nonintrusive and compassionate approaches, appealing to reason when possible, and giving the patient some responsibility for improving symptoms and behavior."

This firm conceptual and moral grounding, she acknowledges, is what psychiatry should strive to maintain--not the invalid, dehumanizing current practices.

She also acknowledges that the evidence has shown since the 1970s that "American psychiatrists were over diagnosing mental illnesses in comparison with the rest of the world and not doing systematic clinical assessments and that their diagnoses and clinical assessments were not reliable."

"Someday, in the 21st century, after the human genome and the human brain have been mapped, someone may need to organize a reverse Marshall plan so that the Europeans can save American science by helping us figure out who really has schizophrenia or what schizophrenia really is..."

In the meantime, psychiatry continues to expand its domain, devaluing those it labels as mental patients, subjecting them to harmful chemical interventions that undermine both their mental and physical health.

Dr. Andreasen is strangely silent about the all-pervasive influence the pharmaceutical industry has wielded on psychiatry during the second half of the 20th century. Conflicts of interest have been a dominant factor in the task force responsible for the formulation of DSM-III R and DSM-IV. Those conflicts of interest have been documented by Dr. Lisa Cosgrove and Dr. Sheldon Krimsky. [Link] and [Link]

More kids raiding medicine cabinets for psych drugs to get high

From this report. Of course, it would be better if people had not gotten so pill happy in the first place. The wonders of modern market.

A Stanwood High School junior recalled the first time he abused prescription drugs.

"I took an antidepressant with a shot of vodka," he said. "It felt the same as if I was drinking five beers - just dizziness and almost falling down, but without the feeling of throwing up you can get with five beers."

He decided to take the drug, which wasn't prescribed to him, because he was feeling down - and wanted to get high.

The boy, whom The Herald is not naming, is unapologetic for his drug habit. "It's knowing you should stop but not wanting to," he said.

From Stanwood to Mukilteo, Monroe to Everett, teenagers across Snohomish County are using more prescription drugs to get high.

Prescription drug abuse among teens is not new. It's a national problem.

Area school districts and communities are only now beginning to get a handle on how widespread the problem is.

With no odor and often no overt signs of being under the influence, it's a habit that's easier for teens to hide - until they go too far.

Students have overdosed on prescription drugs at Snohomish Freshman Campus and Meadowdale Middle School in Lynnwood within the last five years.

The state earlier this year, for the first time, released statistics on the numbers of teens who reported abusing prescription painkillers.

In Snohomish County, 1 in 7 high school seniors who answered the survey reported taking a painkiller to get high during the month before the survey was taken.

Nationally and statewide, alcohol and marijuana remain at the top of the abuse list for teens, though it's leveled off.

Experts point to the continuing rise in prescription drug abuse - a problem they fear is being overlooked by a pill-popping culture.

Parents should take notice, said Dr. Bill Dickinson, medical director of behavioral health services at Providence Everett Medical Center.

"These are kids who letter in sports, have talents. They're your next-door neighbors," he said. "Parents need to understand that it's their kids - it's always possible they can have a problem."

Abuse is on the rise

Teenagers are the fastest-growing group of new abusers of prescription drugs.

Teens accounted for nearly 1 in 10 of new users in 2003, the latest study available from the National Center on Addiction and Substance Abuse at Columbia University in New York.

Washington ranked No. 1 for young peoples' abuse of prescription pain relievers in a 2004 study by the federal Substance Abuse and Mental Health Services Administration.

Locally, Snohomish County seniors were more likely to report drinking alcohol or smoking pot than taking a prescription painkiller to get high, according to their responses on the 2006 Healthy Youth Survey.

Still, the rate of prescription drug abuse is greater than those who took other illegal drugs, such as LSD or meth, combined.

The state study, released this spring, is considered a key indicator of teen habits and attitudes.

To get a better sense of kids' knowledge and attitudes toward prescription drugs in their community, Monroe pulled together a group of school, police, youth, health and religious leaders.

East Youth Advocacy Network crafted a survey that was given earlier this spring to 1,400 students in Monroe's middle and high schools.

Responses show most students know it's wrong to abuse pills, but also that abuse is a sizeable problem.

The survey found most students - about 75 percent - believe taking prescription drugs not meant for them is wrong and dangerous.

Yet two-thirds know at least one person who abuses prescription drugs. And nearly a third were offered a prescription drug to get high at least once in the month before the survey.

Most students said they were first aware of prescription drug abuse as an issue as middle-schoolers.

A dangerous habit

Prescription drug abuse creates pernicious addictions. Many of the drugs linger in the body long after the effects wear off, increasing the danger.

A drug such as methadone lingers for two or three days, for example, said Ann Marie Gordon, laboratory manager at the Washington State Patrol toxicology lab in Seattle.

It's not like aspirin, where you take one every four hours, she said. "You do that with methadone and you die."

OxyContin is one of the more well-known drugs among teens.

The painkiller was the only substance to rise in instances of abuse among middle- and high-schoolers nationally on the 2006 Monitoring the Future survey.

In school hallways, one 80-milligram pill can go for $80 - as much as an iPod Shuffle.

The drug, like others, alters the brain's chemical messengers that control survival mechanisms, such as eating, sleeping, mood, energy and sex drive.

"So here you are at a time in your life, a teenager, where you want to know about the adult world," said Dr. Dickinson of Providence hospital. "You're strong. You're fast. And you find something that, 'Hey, this makes me stronger, faster.' It's a lure."

Teens don't appreciate the dangers.

According to a 2006 survey by the Partnership for a Drug-Free America, 40 percent of teens said prescription medicines were "much safer" than illegal drugs, while more than a quarter thought painkillers aren't addictive.

Doreen O'Connor-Nash, intervention specialist at Kamiak High School in Mukilteo, recalls an incident four years ago.

Four freshmen sat at a cafeteria table over lunch. One pulled out a baggie, into which they each dropped a pill or two.

Tylenol with codeine. Heart medication. Viagra.

A little bit of whatever they had found in the medicine cabinets of their parents or swapped from friends.

"They were not very secretive about it," she said.

Kids haven't been that casual since, but the abuse persists, she said, judging from the students who come through her office for counseling.

Others report similar attitudes.

It's not uncommon, for example, for a friend to give a classmate in pain a pill for relief, like Vicodin, said Lisa Westberg, a drug and alcohol counselor at Cascade High School in Everett.

"Just because she didn't buy it from you doesn't mean it isn't wrong," Westberg tells them.

Problem starts at home

The home medicine cabinet is where most teens find their fix.

Such ease of access is likely one reason more teens are abusing pills.

One girl, a Stanwood senior, abuses an anti-depressant called trazodone, which her doctor prescribes for her anxiety.

She also has a job and keeps decent grades - most wouldn't suspect she has a problem.

She said she doesn't take the pills at school because she said she wouldn't be able to function.

"I get dizzy and kind of muscle relaxed. And I can't walk whatsoever," she said.

Instead of taking the normal dose, she waits and saves up several pills to take at a time. The method keeps her addiction under her parents' radar by using up the medication in the expected time frame.

Others raid their parents' prescriptions.

In a 2005 survey by the Partnership for a Drug-Free America, 62 percent of teens said they took drugs not prescribed to them because they were easy to obtain from their parents' medicine cabinet.

Many parents seem unaware.

On the same survey, three out of five parents reported discussing illegal drugs such as marijuana "a lot" with their children, only a third of parents discussed the risks of using prescription medicines to get high.

"A lot of parents may feel, 'Well, at least it's not meth. It's just a couple of pills,' " said Martha Dankers, a member of the East Youth Advocacy Network in Monroe. "They don't understand the tremendous risk to kids."

And despite classroom lessons, many teens don't seem to know it either.

"Teens' philosophy on drug abuse of pills is, 'If two works, 12 will work better,'" said Wendy Bates, an intervention specialist for Stanwood and Granite Falls high schools. "They don't view it as a limitation but, 'How far can I go before I go too far?'"

Few get help

One Kamiak High School junior now celebrating six months of being drug-free started abusing prescription drugs at middle school.

A friend gave him a pill for attention-deficit disorder, Adderall, telling him it would help him study for their big test.

It did.

It also made him feel good.

He wanted more. Soon, he was hooked, paying as much as $20 for a single pill.

The habit led to trying other things to get a buzz - alcohol, OxyContin, the club-drug Ecstasy, marijuana, methadone.

When he came home drunk one night, his parents found one of the pills in his pocket.

It took 35 days at an inpatient rehab center in Burien to get him to this point.

"It's been better - a lot better," the boy said. "I'm quick-witted, smarter. You actually have a personality, and money. And good relationships with your family, which is good."

But health workers say few teens get the help.

Fewer teenagers step up to get help overcoming any chemical dependency. And facilities that specialize in adolescent addictions also are harder to find.

The young patients who do end up in treatment centers paint a scary picture.

"We're seeing kids come in who are heavily addicted to these medications and experiencing significant withdrawal symptoms," said Eugene Brown, director of youth programs at Sundown M Ranch.

The Yakima treatment center treats about 500 teens each year for various addictions.

In the past two years, staff have noticed a rise in those coming in for dependency on prescription pain relievers, Brown said.

Treatment centers in the Puget Sound area report similar trends.

"Sometimes we have people who are really severely dependent and they're only 15 or 16, bleeding and ulcers, in detox centers," said Melissa Morgan, clinical supervisor for Focus Everett Substance Abuse Services.

"They're involved in some pretty deadly stuff."

Saving Generation Rx

Some place blame for the trend on the confusing landscape of a consumer society bombarded by name-brand drugs.

"What's normal in America? It's pretty normal to take pills," said Steve Pitkin, drug and alcohol counselor at Lake Stevens High School.

"'Do you have a Xanax?'People ask for it like it's aspirin," he said of the prescription drug used to treat anxiety and depression. "There's a whole cultural minimization and confusion about taking pills."

In Monroe, community leaders are trying to change that.

Monroe Police Department's Crime Prevention Council has launched a public awareness program, which tries to grab the attention of teens and their parents.

The "Pills Kill" campaign features the image of a teenage girl gazing out with a blank stare, a white pill resting on her tongue.

The image appears throughout the city on brochures, school posters, bus ads and on the movie theater's big screens.

At the same time, pharmacists are being given cards developed by Valley General Hospital, reminding them not to over-prescribe medications and to discuss with parents the risks of leaving unused drugs in the medicine cabinet.

Education needs to keep up with the prevalence of prescription drugs.

For instance, one in five adults nationwide are prescribed painkillers, said Caleb Banta-Green, a researcher with the University of Washington's Alcohol and Drug Abuse Institute.

Parents should either lock up or throw away medication they don't use or need any more, he said.

Prescription drug abuse is "still thought of as a problem 'out there,' and people aren't personalizing it and realizing it could happen in their home," Banta-Green said. "It's not going away."

Thousands of Peterborough people could have been prescribed anti-depressant drugs needlessly.

Taken from the Evening Telegraph

New figures have revealed rocketing numbers of people in Peterborough are being prescribed anti-depressant drugs – with one person in 20 now on medication.Figures obtained by The Evening Telegraph show that last year doctors wrote out almost 89,000 prescriptions for drugs such as Prozac.

That is a 12 per cent rise on just two years ago when city GPs authorised just over 78,000 prescriptions for the drugs.

The new figure means around one in 20 of all adults in Peterborough are clinically depressed.

Today, Karren Ferris, from Tallington, who had been on anti-depressants for six years, said the medication had ruined her life.

The mum-of-two started taking the drugs after stopping work to have children and said it plunged her into a downward spiral.

She added: "I made some silly decisions. I thought I was all right on it and instead I was just burying my problems.''

[...]

The findings in Peterborough come despite growing concerns about Britain's excessive reliance on chemical treatments and their possible side-effects.

Guidelines from the National Institute for Health and Clinical Excellence (NICE) in 2004 recommended that they should not be used as a first-stop remedy for depression.

Vice-chairwoman of Peterborough City Council's health and adult social care scrutiny panel Cllr Janet Goodwin said they would discuss the issue at their next meeting.

She added: "The well being of people in Peterborough is the main thing. We have to rely on doctors to prescribe what they consider is best for the patient and each one is an individual case."

Ray White, whose 28-year-old son Jason died two years ago after an eight-year battle with schizophrenia, believed patients in Peterborough needed better access to more "holistic" treatments. Mr White, whose family has raised £30,000 for mental health charity Mind, said: "I'm sure if there were more initiatives for alternative treatment, doctors would feel more confident pushing patients towards them. "There is no doubt that more holistic treatment, through exercise and counselling, can play a big part in treating depression."

Her life was very nearly destroyed by anti-depressants

From this report in Peterborough Today

Fifteen years ago Karen Ferris had it all. She was a successful business woman with two thriving hair salons in Peterborough, a beauticians, an active social life and a happy marriage to boot.

Living life to the max she was working hard and partying hard but Karen threw it all away with her passion for 'the hedonistic lifestyle' and all that comes with it. More than a decade of celebrity functions, award nights, social events and drinking to excess led to her downfall and her body eventually said 'no'.

She became an alcoholic, suffered a nervous breakdown, and all the trauma and stigma associated with mental health issues, only to wind up a few years later dependent on anti-depressants. [...]

It was a dark time and not something Karen, 42, likes to dwell on, having successfully detoxed and got her life back on track, but she is keen to tell the community about her experiences in the hope of preventing others going down the same route.

She said: "My business was my life and I hate to hear myself moaning about it, because so many women would have loved to have been able to give up work and look after the children, but it made me so unhappy. "My partner said what's the point of having two stressed out people in the house? He encouraged me to sell the business and become a full-time mum.

"Basically when I did, my whole world caved in. I was a business person, people said I was very lucky but at the end of the day you are what you are.

"I started suffering from depression and went to my doctor who put me on Prozac."

Prozac, which is a trade name for the anti-depressant drug Fluoxetine, is generally prescribed to people with moderate depression.

Karen doesn't know why she was put on Prozac, rather than given counselling or another drug, and she accepts that for some people it can do wonders, but for her it marked the start of a six-year downward spiral in which she lost her husband, her dignity and nearly her children.

Karen said: "Basically it ruined my life. When I was on it I started craving alcohol again. You lose your feeling, your essence, your sex drive, everything goes and if you have a glass of wine it's like you have had three.

"I know what people will be thinking and I know I'm the one that had a drink, you can't blame the drug for that.

"But in the last two months since I've been off it I've achieved more than I have ever done in the past six years.

"I made some silly decisions and I'm not saying it's the Prozac's fault, but I thought I was alright on it and instead I was just burying my problems."

Karen tells her story today because she fears people see medication as a quick fix to their problems rather than facing up to things.

[...]

But each individual is different and Karen does not blame her doctor, only herself for not addressing the problem sooner.

She said: "It makes you argumentative and horrible to the people you love – even your children.

"I was living a pity party full of anger and resentment."

It was only after a severe relapse in her mental stability that she sought help and was immediately advised to stop taking the Prozac. [...] Without their help she would still be taking the drug.

She said: "It's only two-and-a-half months in and I'm still very emotional. I don't feel euphoric. I just have feelings which I haven't had for so long.

"Since I have been on this new treatment programme I have felt level and I'm very emotional, but I think that's because I'm dealing with my issues without any crutch now." [...]

Former patients sue Putnam mental facility

As seen in this report

Two former residents of a private mental-health facility, which was fined by the state last year for breaking the law, have filed a class-action lawsuit against companies that run the facility, alleging they were abused physically and emotionally.

The suit, filed in federal court in White Plains, names as defendants companies affiliated with two residential treatment facilities in Southeast as well as the principals of those companies and several employees. The defendants include SLS Residential Inc., SLS Health, SLS Wellness, Supervised Lifestyles Inc., Chairmen Alfred Bergman and Joseph Santoro, a psychologist and several others employed by SLS.

The lawsuit, filed by former patients Nicholas J. Romano and Deborah A. Morgan of New Jersey on behalf of themselves and many unnamed patients, seeks $75 million in compensatory damages, $150 million in punitive damages and an injunction that would bar SLS from further violating patients' rights.

The plaintiffs, who are in their early 20s, also claim that SLS violated the rights of its patients under the Americans With Disabilities Act.

SLS runs residential treatment facilities for adolescents and young adults at two distinctive houses, one on North Brewster Road and the other off Putnam Avenue and Route 6 opposite Drewville Road.

The state Office of Mental Health last year fined SLS Residential $80,000 for violations of the state Mental Hygiene Law and ordered that it stop admitting patients - and stop violating the rights of the patients it was treating.

The OMH said SLS Residential routinely restrained clients and kept them from making phone calls. It also found that staff would search patients, their rooms and packages sent to them.

Spokeswoman Jill Daniels said the OMH has since allowed SLS to admit new patients.

She said the company has requested a hearing, scheduled for next month, to respond to the claims of violations. SLS has not paid the $80,000 fine and won't be required to until after the hearing, Daniels said.

The lawsuit says money was one reason that SLS staff prohibited patients from making and receiving phone calls, because if patients complained to their families and were removed, SLS would lose money.

"SLS advertises and holds itself out to the general public as a treatment facility that provides compassionate and effective treatment for individuals suffering from severe mental illness," says the suit filed by attorney Michael H. Sussman of Goshen. "... The corporate and individual defendants have made these false representations to induce individuals suffering from mental illness to enter SLS, for which their insurance companies pay daily rates as high as $900."

The families of Romano and Morgan paid in excess of $200,000 to SLS for "treatment that was harmful and exploitative," the suit says.

The abuses that Romano and Morgan allege to have suffered while at SLS are similar to the claims of violations for which the state fined the company last year. The pair allege that they and many other patients were subjected to those abuses and were assaulted by SLS employees.

Romano was a patient in 2004 and 2005, and Morgan was there in 2005 and 2006. Morgan was placed in an isolation room that SLS called the Intensive Treatment Room, but instead of treating her, staff members would taunt, ridicule and humiliate her, the suit says.

Romano said he was forced to participate in a group situation in which he and other patients were degraded and punished.

Sussman said the OMH findings prove that the patients who claim they were mistreated were telling the truth. The fact that SLS employs people who abuse patients shows that the company can't be trusted, which is why the suit seeks the injunction, he said.

"What's gone on appears to have been very exploitative to the very vulnerable," Sussman said.

Reached Thursday, Santoro said he would have an attorney call for comment, although none did. Previously, a spokesman for SLS noted that the state's findings last year were unlike any report SLS had received in its 20-year history and said an overwhelming majority of patients were satisfied with their treatment.

SLS made news last year when it took a Pleasantville lawyer to court to keep him from protesting outside SLS facilities.

Attorney Glen Feinberg, whose son was a patient at SLS in 2001 and 2002, felt that his son was traumatized from the treatment and wanted to picket SLS facilities to warn others. Feinberg, who was supported by the New York Civil Liberties Union, eventually won the right to picket.

B.C Psychiatrist Disciplined over Unethical Conduct

From the Vancouver Sun

A B.C. psychiatrist has been erased from the medical register after hiring two former patients as employees.

The B.C. College of Physicians and Surgeons said Dr. Anca Ioana Bostinariu admitted that given the nature of the pyschotherapeutic relationship she was guilty of unprofessional conduct by hiring the pair. [...]

She's been transferred to the temporary register and issued a formal reprimand under section 60(3) of the Medical Practitioners Act.

She has also been ordered to participate in assessments and counselling and in professional development in the area of boundaries and ethics.

The college has also stipulated that Bostinariu be involved with a mentorship program with a physician approved by the registrar, and be monitored by the college to ensure her future professional conduct is "above reproach."

Paris Hilton out of Jail due to "Medical Condition" discovered by her psychiatrist

But if it was anyone else, they would have done the full time. There is not much public sympathy for her release:

So Paris spent her big three days in prison before getting released yesterday, to serve the rest of her sentence under house arrest a la an ankle monitor. The reason for La Hilton's release was said to be due to her fragile mental state, as her psychiatrist, Dr. Charles Sophy told law enforcement that Paris was at risk of some sort of nervous breakdown.

Um, doesn't everyone have a little bit of a nervous breakdown when they are sent to prison?

Anyway, after all that hoopla, and Paris probably dancing a jig that she gets to spend the next 40 days lounging around her mansion, the heiress has been ordered back to court today, for a hearing to determine why the Sheriff's Department allowed her to get out of jail when the judge had expressly ordered her to serve out her entire sentence.

Send her back! Send her back! Send her back!

(The late night Talk show comedians have been having a field day with this. Jay Leno even labeled her disease as a case of "Rich Bitch-itis".)

UPDATE: The latest news is that Paris Hilton has been sent back to jail, crying, and screaming how unfair it all was. She is to serve the full time sentenced, with no mitigation of her sentence due to good behavior, or other means such as house arrest, work crew, etc. Many people seem to approve of this action by the judge. At least one gossip news site is also saying that Hilton is receiving "appropriate medical attention" in the form of psych drugs.

And we also recommend an investigation into this psychiatrist Doctor Charles Sophy. As noted here, this psychiatrist has been involved in other curious legal mysteries

The headshrink who treated Paris Hilton for her mysterious ailment during her jail stint was involved in another high profile case -- and the circumstances were just as curious.

Dr. Charles Sophy, a Beverly Hills psychiatrist, had a role in the Michael Jackson molestation case in 2003. Sophy's only public acknowledgement of Jacko was made to the television show "Celebrity Justice," where he admitted, "I'm involved in the Jackson case ... but not the way that you think."

TMZ has learned Sophy took a high-level position at the Department of Family and Child Services just as the Jackson story broke. He requested a memo from the staff -- detailing an interview Jackson's accuser gave to social workers -- in which the boy denied being sexually abused by Jacko.

Almost immediately after Sophy got the memo, it leaked to the media. Sophy would never publicly say why he needed that memo or talk about how it leaked.

Now Sophy is again connected to a celebrity legal mystery.

Note that the skepticism and huge public outcry regarding Hilton may result in a return to jail. We are firm believers in equal justice under the law, and beleive it should be enforced. House arrest in a fabulous mansion is not really equal justice. As seen in this report.

Thursday’s taste of freedom may have been brief for Paris Hilton.

The bubbleheaded blond party girl, whose release from jail after only three days of what was originally a 45-day sentence prompted a firestorm of criticism over wealth, celebrity and justice, faces a court appearance today that may send her back to a cell.

After a huge outcry Thursday, and in response to a motion filed by the Los Angeles city attorney’s office, Judge Milton T. Sauer ordered Hilton, 26, to appear today in court for a 9 a.m. hearing regarding her early release.

Early Thursday, the Los Angeles County Sheriff’s office sent the heiress home to her Hollywood Hills mansion to wear an electronic ankle bracelet for the remaining 40 days of her sentence for violating probation in a reckless driving case. She was released for medical reasons, said Los Angeles Sheriff Lee Baca, refusing to elaborate.

After she was freed, everyone from the Rev. Al Sharpton to Erie County District Attorney Frank Clark blasted the decision.

“It sends a terrible message,” Clark said. “I think it looks awful. So many people say that there are two classes of justice — there’s one class for the rich and privileged and then there’s the justice system that serves all the rest of us.

“We who are in the system are constantly saying that that isn’t true, that everybody is basically treated the same, and then something like this happens, and it proves to everybody beyond a reasonable doubt that there are two classes of justice and if you are in that class that is wealthy and influential, you are going to be treated differently than the average John or Jane Doe.”

Hilton was sent home from the L.A. County jail’s Lynwood lockup shortly after 2 a.m. Thursday, a stunning reduction to a sentence that was cut from 45 to 23 days because of “good behavior” before she even set foot in jail.

Clark said he has never seen a case like this. “Have I ever heard of an individual, who, after sentencing, all of a sudden gets a series of reductions for no discernible legal reason? The answer is, in almost 35 years, no,” he said.

Sharpton released a statement saying that although he had empathy for Hilton, whom he had met when he hosted "Saturday Night Live" in 2003, “this early release gives all of the appearances of economic and racial favoritism that is constantly cited by poor people and people of color.”

Sharpton said that when he was jailed on civil disobedience charges, he went on a hunger strike, and jail officials “paid for a doctor to come see me daily rather than release me.”

But Baca, in an interview with the Los Angeles Times, defended his decision. “The problem here is that there is a medical issue, and it isn’t wise to keep a person in jail with her problem over an extended period of time and let the problem get worse,” he said. He refused to elaborate.

Clark said jail officials may have been relieved to have a medical reason to release the attention-grabbing heiress, who had three sessions with her Beverly Hills psychiatrist while she was behind bars.

With Hilton as an inmate, the jail is “under horrible scrutiny, which they don’t like at all,” said Clark. “The entire world of paparazzi is camping out on the jail doorstep every day.”

Local defense attorney Thomas J. Eoannou, who successfully defended country singer Tim McGraw when he and Kenny Chesney were accused of scuffling with sheriff’s deputies in 2000, says celebrity “cuts both ways” in criminal cases.

“I think that celebrities are oft-times dealt with more harshly,” said Eoannou. “I don’t know that if you were the average Joe, you would have gone to jail for 45 days and been ordered in solitary confinement, which she was.”

Hilton was kept in a special protective custody wing and housed without a cellmate.

“I think the judge was sending a message that just because you’re a celebrity doesn’t mean you’re not going to jail,” Eoannou said.

Baca, the Los Angeles sheriff, said, “My message to those who don’t like celebrities is that punishing celebrities more than the average American is not justice,” he said.

But locally, that explanation wasn’t cutting much ice.

“I guess if you get arrested for anything, L.A. is the place to do it,” said Kathleen DeLaney, an academic archivist at Canisius College. “To go to jail, I’m sure she was terrified. But how many other women go to jail who are absolutely terrified, and have no recourse?”

Clark says if Hilton were arrested locally, she would have served her time. “We’ve had celebrities in our jails,” said Clark, including Chesney and McGraw.

When Earl Simmons, more widely known as the rapper DMX, was charged with speeding and drug possession in Cheektowaga in March 2000, said Clark, “ we had him in and out of jail, he was yelling and screaming, he was throwing things and we kept him right in there. I think we’re a blue- collar place; we have a healthy skepticism and are less prone to be awfully impressed” by celebrity.

“ I don’t blame Paris Hilton at all,” said Clark, pointing out that anyone in her position would do anything they could to win their own release. “ The sad part is that they bought it.”

Nigeria sues Pfizer for $7bn over 'illegal' tests on children

As reported in the Guardian

The Nigerian government is suing the world's largest drug manufacturer, Pfizer, for allegedly carrying out illegal trials of an anti-meningitis drug that killed or disabled children.

Nigeria is demanding 7 billion dollars in damages from the US company for the families of children it says died or suffered serious side effects when the antibiotic Trovan was administered in the northern state of Kano during a meningitis outbreak in 1996. The Kano state government also has civil and criminal cases pending against Pfizer.

The Nigerian authorities say that 200 children were part of the Trovan experiment without the approval of local regulatory authorities. They allege that as many as 11 died as a result of the treatment and others developed conditions including brain damage and paralysis.

Trovan was approved in the US in 1997 for use by adults but not children. Two years later the US Food and Drug Administration warned that the drug could cause liver damage and it has since been discontinued.

In court papers filed in Abuja yesterday, the government accuses Pfizer of conducting illegal tests on children.

"The plaintiff contends that the defendant never obtained approval of the relevant regulatory agencies ... nor did the defendant seek or receive approval to conduct any clinical trial at any time before their illegal conduct," it said.

A Pfizer spokesman in New York, Bryant Haskins, said in a statement that the drug was administered in accordance with Nigerian law.

"These allegations against Pfizer, which are not new, are highly inflammatory and not based on all the facts. We continue to maintain, in the strongest terms, that the Nigerian government was fully informed in advance of the clinical trial; that the trial was conducted appropriately, ethically and with the best interests of patients in mind; and that it helped save lives," he said.

Pfizer has previously said that it obtained "verbal consent" from the parents of the affected children, and that the drugs were administered in a way that was "sound from medical, scientific, regulatory and ethical standpoints".

Two years ago, a US court dismissed a lawsuit by several Nigerian families who allege that they were not sufficiently warned that their children could be affected by the antibiotic.

A civil and criminal suit by the Kano state government against Pfizer was postponed yesterday until next month. It is seeking $2bn in damages.

The Nigerian government is looking for compensation for the cost of treatment of the victims of the drug test and their families. It is also seeking $450m for what it says is the suspicion of western medicines created by the case.

The country's health authorities say that the Pfizer controversy is partly responsible for many families in northern Nigeria refusing to allow their children to be vaccinated against polio. That in turn has been blamed for an outbreak that spread across parts of Africa. The Kano authorities also refused to distribute the polio vaccine.

Pfizer is well known as a manufacturer of a wide variety of drugs, including a number of psychiatric concoctions.