Teens are prescribed more medications than ever, while teenage suicides are soaring.

One of the paradoxes of child and adolescent psychiatry is that, at a time when teens are prescribed more medications than ever, teenage suicides are soaring. Antidepressants and antipsychotics are supposed to decrease suicide, not increase it.

A report of the Centers for Disease Control (CDC) of March 6, 2015, says that suicides per 100,000 population among persons aged 10-24 increased from 1.8 in 1994 to 3.1 in 2012, an annual increase of 3.0 percent. This is almost doubling over that 18-year period.

See the report here

Male rates are far higher than female, and suicides among male adolescents rose annually by 2.2 percent. But here is the shocker: suicides among female adolescents rose from 0.5 per 100,000 in 1994 to 1.7 in 2012, an annual change of 6.7 percent.

Hanging (“suffocation”) has soared among young women, and the CDC report noted a grim landmark: “Suffocation surpassed firearm as the most common mechanism of suicide among females in 2001.”

Whatever medications these young men and women receive are not working. A truly alarming increase in the consumption of psychopharmaceuticals has taken place at the same time as the increase in suicide. For example, the prescription of antipsychotic medications for patients under 20 rose from 300 per 100,000 population in 1993-95 to almost 1500 in 2002. (New York Times, “Beyond Ritalin,” June 6, 2006, 18)

Could there possibly be a connection?

Or do you "double down" and insist that the problem is that what we need is more drugs?

Guess what this shrink says. Yep, more DRUGS. without figuring out the source.

American Kids are the Most Medicated in the World I would say this is very suggestive.

My Trip Through the Polypharmacy Blender

A long story by Rory Tennes on the Risx website, describing his descent into psychiatric hell.

We only present a few snippets, and recommend reading the full article.

I was asked by David Healy to write my own story after he read my comment on another RxISK story. I agreed but have been surprised how hard it was to sit down and do it. I knew the story, the words were in my head. Yet I avoided getting started. Perhaps it was because of the painful emotions I knew it would bring to the surface. Or maybe because it reminds me of the pain and suffering my family had to endure, how much we lost and the fact that I may not be able to do anything about it. Or it could be my frustration from the cognitive difficulties I still have, making writing a difficult task that drains what little energy I have.

My trip started this way: I was ill, injured and in pain. I went to my doctors for help, and they proceeded to drug me into oblivion. My PCP or “family doctor” diagnosed me with fibromyalgia. I don’t think he really knew what I had, but once he put a name on my symptoms, he started throwing drugs at them. I was in constant pain, chronically fatigued and began to have severe bouts of anxiety. For four years I saw doctor after doctor but none of them could tell me what was wrong, or why I was getting worse not better despite all the drugs. It turns out I had autoimmune arthritis. I’d had it for 30 years, and since it was misdiagnosed and untreated for so long, my spine was a total wreck.

I have worked in construction for 38 years, as a skilled tilesetter with my own business. I love the work but it can be rough on the back. I am now on disability due to a combination of my disease and the multiple toxic “treatments” I was put on.

[...]

Before my trip through the Pharma looking glass began, I had quit drinking altogether. I had been sober for five years, solidly sober and liked it. In October 2010 I was on Trazodone and Wellbutrin. When Flexeril and Naprelan were added, within weeks I suddenly had strong urges to drink, which had been totally absent until that point. I now know that Flexeril (cyclo-benzaprine) acts just like a tricyclic antidepressant and should never be mixed with trazodone or Wellbutrin. The urge and the thoughts of drinking came on suddenly and very strong.

I made two trips to alcohol rehab, attended AA regularly but could not stay sober to save my life. I had numerous run-ins with the law as well. My behavior had become so bizarre, unpredictable, unstable and dangerous that I thought I had lost my mind and myself completely. I had no control over my thoughts, emotions or behavior, no matter what I did or how hard I tried. I watched my family suffer horribly in fear and confusion at what was happening.

Now I know why. Drugs can drive people to drink for relief from the agonizing akathisia that they cause. Couple that with the disinhibiting effect of the drugs, and it’s a recipe for alcoholism. That’s not just true for the antidepressants, but Lyrica too. The warning on Lyrica says that “People who have had a drinking problem in the past may be prone to abuse Lyrica.” It really should say: “If you take Lyrica you may have strong, uncontrollable urges to drink.” Lyrica can cause alcohol abuse, I have no doubt. So can Cymbalta, Zoloft and several other drugs I was on. I didn’t have a chance in hell to stay sober on those drugs.

[...]

‘Darwinian’ test uncovers an antidepressant’s hidden toxicity.

Rodent study finds that exposure to an antidepressant in womb or in youth can cause lifetime decline in sexual behavior, body weight, and competitive ability.

Once you strip away the scientific verbiage, it becomes obvious that the prolonged use of these drugs creates generations of "losers".

As reported on Science Daily

Because of undetected toxicity problems, about a third of prescription drugs approved in the U.S. are withdrawn from the market or require added warning labels limiting their use. An exceptionally sensitive toxicity test invented at the University of Utah could make it possible to uncover more of these dangerous side effects early in pharmaceutical development so that fewer patients are given unsafe drugs.

To prove the point, the U researchers ran their test on Paxil, an antidepressant that thousands of pregnant women used in the years before it was linked to an increased risk of birth defects. The U.S. Food and Drug Administration now requires a warning about use in the first trimester of pregnancy. In the U study, mice exposed during development experienced multiple problems: males weighed less, had fewer offspring, dominated fewer territories and died at a higher rate. Females took longer to produce their first litters, had fewer pups and pups that were underweight. The drug doses were relatively close to those prescribed for people. In the conventional animal safety testing reported by the drug's manufacturer, no reproductive side effects emerged until rodents took doses multiple times higher than those given to treat depression.

"We are seeing effects at a dose that is close to human levels. And we are doing it exactly the way we need to determine if it presents a risk of harm to a developing fetus," says University of Utah biologist Shannon M. Gaukler, the study's lead author who recently completed a doctoral degree at the U. The study will be published in the January-February issue of Neurotoxicology and Teratology, which has posted a preprint online.

[...]

Testing Paxil

In the Paxil study, the researchers gave food laced with the antidepressant to 20 breeding pairs of mice for several weeks, until all had produced up to four litters. Doses were equivalent to about 1.8 times the level typically prescribed for people. The offspring also ate Paxil-laced chow until they reached breeding age. The researchers then released the exposed offspring into the competitive arena with the offspring of a control group of mice never exposed to Paxil. Groups consisted of eight males and 14 to 16 females, creating population densities comparable to those seen in the wild. The researchers started five such populations and kept them going for six months.

Males exposed to Paxil were about half as likely to control a territory. They also lagged behind control males in body weight throughout the weeks of competition and were more likely to die. Exposed males produced 44 percent fewer offspring. Exposed females showed no significant weight or mortality differences, but they produced half as many offspring as control females at the initial assessment. Their fecundity rebounded at later time points.

Choosing Wisely: Five Things Physicians, Psychiatrists, and Patients Should Question

As seen on the Choosing Wisely website

Available also as a PDF

1 Don’t prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring.

Metabolic, neuromuscular and cardiovascular side effects are common in patients receiving antipsychotic medications for any indication, so thorough initial evaluation to ensure that their use is clinically warranted, and ongoing monitoring to ensure that side effects are identified, are essential. “Appropriate initial evaluation” includes the following: (a) thorough assessment of possible underlying causes of target symptoms including general medical, psychiatric, environmental or psychosocial problems; (b) consideration of general medical conditions; and (c) assessment of family history of general medical conditions, especially of metabolic and cardiovascular disorders. “Appropriate ongoing monitoring” includes re-evaluation and documentation of dose, efficacy and adverse effects; and targeted assessment, including assessment of movement disorder or neurological symptoms; weight, waist circumference and/or BMI; blood pressure; heart rate; blood glucose level; and lipid profile at periodic intervals.

2 Don’t routinely prescribe two or more antipsychotic medications concurrently.

Research shows that use of two or more antipsychotic medications occurs in 4 to 35% of outpatients and 30 to 50% of inpatients. However, evidence for the efficacy and safety of using multiple antipsychotic medications is limited, and risk for drug interactions, noncompliance and medication errors is increased. Generally, the use of two or more antipsychotic medications concurrently should be avoided except in cases of three failed trials of monotherapy, which included one failed trial of Clozapine where possible, or where a second antipsychotic medication is added with a plan to cross-taper to monotherapy.

3 Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia.

Behavioral and psychological symptoms of dementia are defined as the non-cognitive symptoms and behaviors, including agitation or aggression, anxiety, irritability, depression, apathy and psychosis. Evidence shows that risks (e.g., cerebrovascular effects, mortality, parkinsonism or extrapyramidal signs, sedation, confusion and other cognitive disturbances, and increased body weight) tend to outweigh the potential benefits of antipsychotic medications in this population. Clinicians should limit the use of antipsychotic medications to cases where non-pharmacologic measures have failed and the patients’ symptoms may create a threat to themselves or others. This item is also included in the American Geriatric Society’s list of recommendations for “Choosing Wisely.”

4 Don’t routinely prescribe antipsychotic medications as a first-line intervention for insomnia in adults.

There is inadequate evidence for the efficacy of antipsychotic medications to treat insomnia (primary or due to another psychiatric or medical condition), with the few studies that do exist showing mixed results.

5 Don’t routinely prescribe an antipsychotic medication to treat behavioral and emotional symptoms of childhood mental disorders in the absence of approved or evidence supported indications.

There are both on and off label clinical indications for antipsychotic use in children and adolescents. FDA approved and/or evidence supported indications for antipsychotic medications in children and adolescents include psychotic disorders, bipolar disorder, tic disorders, and severe irritability in children with autism spectrum disorders; there is increasing evidence that antipsychotic medication may be useful for some disruptive behavior disorders. Children and adolescents should be prescribed antipsychotic medications only after having had a careful diagnostic assessment with attention to comorbid medical conditions and a review of the patient’s prior treatments. Efforts should be made to combine both evidence-based pharmacological and psychosocial interventions and support. Limited availability of evidence based psychosocial interventions may make it difficult for every child to receive this ideal combination. Discussion of potential risks and benefits of medication treatment with the child and their guardian is critical. A short and long term treatment and monitoring plan to assess outcome, side effects, metabolic status and discontinuation, if appropriate, is also critical. The evidence base for use of atypical antipsychotics in preschool and younger children is limited and therefore further caution is warranted in prescribing in this population.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

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Maglione M, Ruelaz Maher A, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T; Southern California Evidence-Based Practice Center. Off-label use of atypical antipsychotics: an update. Rockville, MD: Agency for Healthcare Research and Quality; 2011 Sep 437 p. Report No.: HHSA290-2007-10062-1.

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Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988;45(9):789-96.

McEvoy JP, Lieberman JA, Stroup TS, Davis SM, Meltzer HY, Rosenheck RA, Swartz MS, Perkins DO, Keefe RS, Davis CE, Severe J, Hsiao JK, CATIE Investigators. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006;163(4):600-10.

Maglione M, Ruelaz Maher A, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T; Southern California Evidence-Based Practice Center. Off-label use of atypical antipsychotics: an update. Rockville, MD: Agency for Healthcare Research and Quality; 2011 Sep 437 p. Report No.: HHSA290-2007-10062-1.

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Ballard CG, Waite J, Birks J. Atypical antipsychotics for aggression and psychosis in Alzheimer’s disease. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003476.

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Maglione M, Ruelaz Maher A, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T; Southern California Evidence-Based Practice Center. Off-label use of atypical antipsychotics: an update. Rockville, MD: Agency for Healthcare Research and Quality; 2011 Sep 437 p. Report No.: HHSA290-2007-10062-1.

Nasrallah HA. Atypical antipsychotic-induced metabolic side effects: insights from receptor-binding profiles. Mol Psychiatry. 2008 Jan;13(1):27-35.

Richter T, Meyer G, Möhler R, Köpke S. Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database Syst Rev. 2012 Dec 12;12:CD008634.

Schneider LS, Tariot PN, Dagerman KS, Davis SM, Hsiao JK, Ismail MS, Lebowitz BD, Lyketsos CG, Ryan JM, Stroup TS, Sultzer DL, Weintraub D, Lieberman JA; CATIE-AD Study Group. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med. 2006;355(15):1525-38.

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Maglione M, Ruelaz Maher A, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T; Southern California Evidence-Based Practice Center. Off-label use of atypical antipsychotics: an update. Rockville, MD: Agency for Healthcare Research and Quality; 2011 Sep 437 p. Report No.: HHSA290-2007-10062-1.

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Psychiatry is Broken

A very interesting blog post slash column entitled "When Psychiatrists Distrust Their Patients, Their Patients Can Only Respond In Kind" by Rebecca Vipond Brink

She reviews the problems she has had with Psychiatrists when they become arrogant, and do not take seriously what their patients are saying. Unfortunately this is all too common.

Here are some snippets

The worst psychiatrist I had, on the other hand, seemed awesome when we started — our initial appointment was an hour long, and she probed into my family’s medical history for clues about mine. It seemed holistic. As time went on, though, appointments became sparser and shorter — she was constantly double-booked, she got to the point that she was doing five-minute refill appointments, and I was eventually on four different medications in an attempt to treat anxiety and what we thought was depression in the fallout of PTSD. When I disputed her original diagnosis at my last appointment, she responded, “That’s just not what I know about you from our work.” Our work? She had only spoken to me for a grand total of maybe two hours at that point, while I had been out in the world living my life with my emotions. I wanted to be trusted that I was the best possible source of information about my well-being, not a brief description of a few symptoms and the DSM-V.

I told her that I wanted to get off of my medications because they just weren’t working — I was still having massive, debilitating anxiety attacks, nightmares, insomnia, paranoia. I had had a full-on nervous breakdown while on medications. And I didn’t feel like anti-depressants were appropriate, because with a lot of reflection, I landed on the opinion that debilitating anxiety looks a lot like depression but is not the same thing. All of my feelings and neurotic impulses were still very intense, and yet here I was, taking more and more medications in higher and higher doses to treat them, to no effect. Instead of weaning me off of anything, she prescribed two more medications. I found out later that some of the medications she wanted me to take had unsavory interactions that she didn’t disclose to me.

[...] All of this has left me feeling more than a little suspicious about psychiatry. I felt like my psychiatrist had dismissed my opinions in her care plan, and had distrusted me and my word without me having given her any reason over the course of my treatment to do so. I felt like I had had no control over my care, and that feeling of a lack of control over what was a major part of my life was devastating — I have PTSD because of abuse and rape. Control over my body is important to me.

Much more at the the link.

Just another data point of evidence that Psychiatry is Broken

VA to look into overmedication reports at Tomah center

From an AP Report in the San Francisco Chronicle

The U.S. Department of Veterans Affairs is launching an investigation into reports of overmedication and retaliatory management practices at the VA Medical Center in Tomah, the agency said Thursday.

Veterans Health Administration specialists plan to visit the western Wisconsin facility within two weeks to review medication prescription practices, the federal agency said in a statement Thursday afternoon. They also plan to send representatives from the Office of Accountability Review to look into allegations of retaliatory behavior.

"My sense is that this isn't just unique to Tomah," U.S. Rep. Ron Kind, a Democrat whose district includes Tomah. "We have a system-wide issue that needs to be addressed when it comes to pain management with our veterans."

Kind and other Wisconsin lawmakers had sent requests to Veterans Affairs Secretary Robert McDonald this week seeking an investigation

Tomah VA spokesman Scott Farley said in a statement the medical center will fully cooperate with the investigation.

A recent story from The Center for Investigative Reporting noted the number of opiates prescribed at the Tomah VA had more than quintupled between 2004 and 2012, even as the number of veterans seeking treatment there has declined. Health care professionals have complained about the medical center's practices for several years.

Here is more info from The Center for Investigative Reporting Looks like the main culprite is, of course, another damn psychiatrist Dr. David Houlihan

Politicians from both parties and government bureaucrats are rushing to look into allegations of rampant overmedication, retaliatory management practices and preventable overdose deaths at the U.S. Department of Veterans Affairs Medical Center in Tomah, Wisconsin, that The Center for Investigative Reporting revealed last week.

In the story’s wake, the VA has begun “actively reviewing allegations of retaliatory behavior and overmedication at the Tomah VA Medical Center,” said agency spokesman James Hutton. He said the facility’s chief of staff, psychiatrist Dr. David Houlihan, has been temporarily reassigned to the VA regional office while an internal investigation takes place.

But the problems disclosed should not have surprised politicians or federal officials: Health care professionals at the hospital have complained for at least five years about Houlihan’s prescription practices and his retaliatory management style – filing numerous reports with those in charge of oversight.

“It’s about time,” said Robin Weeth, a former social worker at the hospital who wrote to the VA inspector general in 2012 with a long list of allegations, including that “veterans are overmedicated and have been driving while impaired, fallen asleep while smoking and set themselves on fire.”

Today, Weeth reports that he never heard back from the inspector general.

The CIR story reported that the number of opiates prescribed at the Tomah VA had more than quintupled between 2004 and 2012, even as the number of veterans seeking care at the hospital declined. It included details of the August death of a 35-year-old Marine Corps veteran, who overdosed while in the hospital’s inpatient psychiatric ward.

[...]

The VA inspector general had closed an investigation into the Tomah VA before Baldwin even got in touch, in March 2014. The inspector general’s report noted that Houlihan’s narcotic prescriptions were “at considerable variance compared to most opioid prescribers” and “raised potentially serious concerns” that should be brought to the attention of the federal agency’s leadership. But the report suggested no punishment.

Weeth said he believed that Jason Simcakoski, the 35-year-old former Marine who fatally overdosed in the Tomah VA psychiatric ward in August, still would be alive today if the inspector general had come down harder on Houlihan.

[...]

Much more information at the links

[BOOK] Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Psychopharmaceutical Complex

Renowned psychiatrist Peter Breggin documents how psychiatric drugs and electroshock (ECT) disable the brain. He presents the latest scientific information on potential brain dysfunction and dangerous behavioral abnormalities produced by the most widely used drugs including Prozac, Xanax, Halcion, Ritalin, and lithium. Even though this book was published a few years ago, it is still a highly relevant and import work

Many of Breggin's earlier findings have improved clinical practice, led to legal victories against drug companies, and resulted in FDA-mandated changes in what the manufacturers must admit about their drugs. This greatly expanded second edition, supported by the latest evidence-based research, shows that psychiatric drugs achieve their primary or essential effect by causing brain dysfunction, and they tend to do far more harm than good.

Author's website

Available through Amazon.com here.

Author's description of the book:

"For those who have been following my work or who wish an introduction to my lifetime reform efforts and scientific investigations in the field of psychiatry, the newly published second edition of Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex (Springer Publishing Company, 2008) has recently been published. It is a thorough and up-to-date presentation of my overall critique of modern psychiatry, including the latest medications and treatments.

"The new edition describes general principles for the safe withdrawal from psychiatric drugs with specific examples of withdrawal problems related to each type of psychiatric medication, including antidepressants, tranquilizers, stimulants, mood stabilizers and neuroleptic (antipsychotic) drugs. For interested professionals, patients and clients, it presents guidelines for how to conduct psychotherapy and counseling without resort to psychiatric drugs, even for the most emotionally distressed people.

"The new edition of the book presents evidence confirming many of the first edition’s most controversial conclusions. Research continues to demonstrate that antidepressants are ineffective in treating depression and instead increase the risk of suicidality. As another example, additional studies have shown that stimulants offer no long-term positive effects on the behavior of children and that these drugs suppress growth and make children prone to cocaine abuse as young adults. Recent reports continue to confirm that electroshock causes permanent brain damage and cognitive dysfunction.

"The scientific premise of the book is that all psychiatric treatments—drugs, electroshock and lobotomy—have their 'therapeutic' impact by disabling the brain. They do not improve brain function or correct biochemical imbalances, they cause brain dysfunction and biochemical imbalances. These brain-disabling interventions are then considered effective when the doctor, family, patient or society views impaired brain dysfunction in the target individuals as a desirable or beneficial effect. Because psychiatric drugs in reality do more harm than good, the psychopharmaceutical complex must devote billions of dollars to exerting its power and influence in the political, professional and public arenas.

"'Antipsychotic' drugs such as Risperdal, Zyprexa, Seroquel and Geodon are used literally to chemically lobotomize millions of adults and children because the resulting apathy and indifference are seen as an improvement over their previously distressed and distressing state of mind or behavior. Millions more adults take 'tranquilizers' like Xanax, Ativan, Klonopin and Valium, suppressing their overall brain function in order to reduce feelings of anxiety. A large percentage of our nation’s children have their spontaneity reduced or even crushed by stimulant drugs such as Ritalin, Concerta, Adderall and Strattera, causing them to become more docile and more obsessively attentive to rote work.

"Despite all the propaganda, antidepressants such Prozac, Paxil, Zoloft and Cymbalta have no scientifically demonstrable effectiveness and are proven to cause suicidality, as well as violence and mania. They too 'work' by causing mental disabilities such as apathy and euphoria that are misinterpreted as improvements. Meanwhile, their continued widespread use is determined in part by the fact that withdrawal produces severe psychiatric symptoms, including anxiety and depression. In short, it is too difficult and painful for people to stop taking them.

"All psychiatric drugs have the potential to cause withdrawal reactions, including the antidepressants, stimulants, tranquilizers, antipsychotic drugs and 'mood stabilizers' such lithium. When the individual’s condition grows markedly worse within days or weeks of stopping the psychiatric drug, this is almost always due to a withdrawal reaction. However, misinformed doctors and misled parents, teachers and patients think that this is evidence that the individual 'needs' the drug even more, when in fact he or she needs time to recover from withdrawal effects.

"People commonly use alcohol, marijuana and other non-prescription drugs to dull their feelings. Usually they do not fool themselves into believing they are somehow improving the function of their minds and brains. Yet when people take psychiatric drugs, they almost always do so without realizing that the drugs “work” by disrupting brain function, that the drugs cause withdrawal effects, and that they frequently result in dangerous and destructive mental reactions and behaviors.

"Most consumers of psychiatric drugs do not realize how much these chemical agents disrupt the function of the brain and mind. As a result, their treatment in effect becomes involuntary. Many other adults are physically forced to these drugs in hospitals and even under outpatient commitment that allows for enforced drugging in the home. Because children cannot control their lives, or understand the implications of taking drugs, they are always involuntary participants in these brain-disabling treatments. Our society needs to stop forcing psychoactive drugs on its citizens, young and old.

"Electroshock provides a more obvious illustration of the brain-disabling effects of psychiatric treatment. Shock treatment is simply closed-head injury caused by an overwhelming current of electricity sufficient to cause a grand mal seizure. When the patient becomes apathetic, the doctor writes in the hospital chart, 'No longer complaining.' When the patient displays the euphoria commonly associated brain damage, the doctor writes, 'mood improved.' Meanwhile, the individual’s brain and mind are so drastically injured that he or she is rendered unable to protest. They are easily led to take repeated shock treatments. In many cases, family members must intervene to stop the destructive 'treatment.'

"The brain-disabling principle of psychiatric treatment is not a speculation. It is a solid scientific theory based on hundreds of evidence-based reports, clinical experience, and common sense observations. I believe it will stand the test of time."

"The new edition of Brain-Disabling Treatments in Psychiatry introduces the concept of medication spellbinding—the capacity of psychoactive drugs to blunt the individual’s appreciation of drug-induced mental dysfunction and, at times, to encourage a misperception that they are doing better than ever when they are, in fact, doing worse than ever. In the extreme, medication spellbinding drives individuals into bizarre, out-of-character destructive actions, including suicide and violence. Medication spellbinding is an aspect of the brain-disabling principle that explains why so many individuals take drugs of all kinds, from antidepressants to alcohol, when they are causing them great harm and even destroying their lives.

"The power of the psychopharmaceutical complex, a concept that I introduced in 1991 in Toxic Psychiatry, has now received confirmation from innumerable books by disenchanted members of the medical establishment. The new edition of Brain-Disabling Treatments in Psychiatry reviews some of these other books and articles, and presents details about how the drug companies continue to rule the world of psychiatry; they control research and journal publications, dominate medical education, collaborate with insurance companies and federal agencies, and finance organized psychiatry and medicine.

"This new edition of Brain-Disabling Treatments in Psychiatry has a long history, originating in the 1983 publication of Psychiatric Drugs: Hazards to the Brain and then evolving into the initial 1997 edition of Brain-Disabling Treatments in Psychiatry. The concepts and information—contained 16 detailed chapters and 85 pages of scientific bibliography—provide a mountain of information about what’s wrong with modern psychiatry and what’s needed to correct it."

In 2000, a study was done in which 20 healthy non-depressed volunteers were given the SSRI antidepressant Zoloft (Sertraline). Two weeks into the study two volunteers became dangerously suicidal.

As reported in the Guardian on Sunday 21 May 2000

Much more info at the link

Alarming evidence from a new British study shows that the Prozac class of antidepressants can make healthy men, women and children with no history of depression feel suicidal.

The research undermines the claims of Eli Lilly, makers of Prozac, that people who kill themselves while on the tablets do so because of their depression, and that the disease, not the drug, is to blame for their suicide.

Its findings are particularly worrying because of the increasing numbers of people, including children, who are being given the drugs by their GP for mild depression, and who are not seriously clinically ill.

[...]

It found that two out of 20 healthy volunteers on an antidepressant in the Prozac class called Lustral (or Zoloft in the USA) became dangerously suicidal, compared with none of them when they were put on an antidepressant of a different class called reboxetine.

One 30-year-old woman who took part had a nightmare about having her throat slit after one week and by the end of a fortnight, was suicidal. "She felt hopeless and alone. It seemed that all she could do was to follow a thought that had been planted in her brain from some alien force. She suddenly decided she should go and throw herself in front of a car, that this was the only answer.

"It was as if there was nothing out there apart from the car, which she was going to throw herself under. She didn't think of her partner or child," says the study, published in the journal Primary Care Psychiatry.

Later she completed a diary entry, describing herself as jumpy, anxious and suspicious. "Her mind was racing and spiraling out of control. Then it went blank except for the clear thought that she must kill herself violently by throwing herself beneath a car or a train."

Drug Shills Dispensing Pills A psychiatrist questions Big Pharma’s influence on her profession.

A recent article by Jean Kim in the magazine IN THESE TIMES

Jean Kim is a psychiatrist and writer in Washington, D.C., who is finishing her M.A. in nonfiction writing at Johns Hopkins University

In 2009, as an eager young psychiatry professor at New York-Presbyterian Hospital, I presented to faculty on the need for a moral dimension to psychiatric diagnoses. I was laughed out of the room.

One psychiatrist, a schizophrenia specialist, said he didn’t see the point. The acting medical director said he felt I’d called him immoral. A top research psychiatrist said, incredibly, “Morality and psychiatry should be kept separate.”

So a few years later, when ProPublica launched its Dollars for Docs database to track the drug company money doctors were taking, I typed in their names. The acting medical director received $12,550 in 2010 and 2011 for speaking gigs. The researcher received more than $212,489 between 2009 and 2012 for speaking gigs and consultations. The schizophrenia specialist made more than $323,300. And the database only includes disclosures from 17 of the more than 70 drug companies in the world. According to Dollars for Docs, hundreds of thousands of doctors have raked in a total of more than $4 billion since 2009, with the top earner, psychiatrist Dr. Jon Draud, netting at least $1.2 million.

As a psychiatrist who “grew up” in the last decade, I was not surprised.

I started my residency training in New York City in 2000. Lunches and dinners provided by drug company reps were astaple of my diet. For a hungry, harried resident on a paltry salary, a free pit stop at a steaming Chinese buffet was heaven. All around me in Manhattan, investment bankers and freshly minted lawyers were living it up, and I admit that I wanted a piece of the pie as well. By mid-decade, academic psychiatry had become glamorous. A resident might schmooze with a drug rep and get invited to a trendy spot—Nobu, Olives, Tao—where we could imbibe Sex and the City-style cocktails and sample the freshest sushi. Drug reps, selected for their looks and charm, were the popular, beautiful best friends we geeky docs never had.

In 2003, I won a free ride to the American Psychiatric Association annual meeting in San Francisco as part of an Aventis-sponsored fellowship for women in psychiatry. An industry-sponsored gala featured an open bar and a Brobdingnagian spread: tables loaded with huge flower displays, chocolate fountains, petit fours and gourmet hors d’oeuvres. The conference also hosted a Disney-esque exhibit hall full of brightly colored drug company displays with touchscreen computer stations. I filled my free tote bag with gifts—pens, laser pointers, candy, textbooks. My favorite was the Xanax XR clock, whose hands rested on a bed of clear turquoise fluid, to simulate the feeling of floating on a summer pool.

I graduated from residency training and became an attending psychiatrist myself. Back then, it was viewed as a symbol of academic prowess to be on a drug company’s speaker’s bureau. So when an enthusiastic new drug rep from my alma mater invited me, a lowly junior attending, to a speaker training session, I was flattered and accepted. On an all-expenses-paid two-day training trip to Chicago, I stayed at a posh hotel on Michigan Avenue and sat through lectures about the then-new antipsychotic drug Geodon. I was paid $2,500 for going, and another $1,000 for giving a “talk” for about seven minutes a few weeks later at a dinner with a handful of colleagues. Persuaded that I needed to gain experience with Geodon so that I could be a better presenter, I began prescribing it more often. Then I began to see that it was less reliable than other medications. I quit the speaker’s bureau, realizing I had been manipulated into writing more Geodon prescriptions. In fact, the drug rep’s salary depended on such performance increases. Drug companies can track all physicians’ prescriptions—a 2011 Supreme Court decision upheld their right to do so, citing data as “free commercial speech.”

In November 2007, as the economy imploded, a prominent psychiatrist, Dr. Daniel Carlat, wrote a famous essay in the New York Times Magazine about a stint as a pharma shill. He concluded, “The money was affecting my critical judgment. I was willing to dance around the truth in order to make the drug reps happy. Receiving $750 checks for chatting with some doctors during a lunch break was such easy money that it left me giddy. Like an addiction, it was very hard to give up.” I read it and realized that I had been going along with the tide—that a colossal, profit-driven advertising engine was using our own psychological tactics to manipulate us.

The next year, heads began to roll. In October 2008, Dr. Charles Nemeroff, then head of psychiatry at Emory University, made the front page of the New York Times for failing to report more than $1.2 million dollars in drug company-related income to Emory, which had strict guidelines for non-academic money. He resigned and now works for the University of Miami.

Dr. Joseph Biederman of Harvard Medical School went one step farther than Nemeroff. As the Times reported in November 2008, he not only hid from Harvard that he’d taken more than $1.4 million from drug companies; he publicly advocated for diagnosing more children with bipolar disorder and prescribing them more antipsychotic medications. The rate of prescriptions for these medications skyrocketed. Antipsychotics should only be used when absolutely necessary, given their potential for serious side effects, especially in children.

Since then, FDA regulations have gotten tighter, and in 2009, the Pharmaceutical Researchers and Manufacturers of America self-imposed a code on interactions with healthcare professions. Drug company speakers can no longer ad-lib invented uses for their medications and have to include mention of “negative studies” if available. Comped dinners must be modest by local standards and include presentations. Pens and trinkets are banned. The once-charming reps can speak to you only if spoken to, not unlike vampires who cannot enter your home unless invited.

The reforms have cut down on blatant pharma influence, but prominent psychiatrists still shill shamelessly, and much research is pharma-funded. Take the October 2014 issue of the American Journal of Psychiatry, the elite scientific publication in our field. Five of the six research articles contain disclosures that one or more of the authors worked or consulted for pharma. It remains to be seen whether more data releases from ProPublica—and now from Open Payments, a federal database mandated by the Affordable Care Act and unveiled in late September—will create enough public backlash to convince these doctors that this type of income does harm. Conflicts of interest weaken the credibility of research and hurt patients by encouraging poor prescribing practices. They also undermine the crucial trust between doctor and patient by fueling the paranoiac skepticism that all psychotropic medications are mind-altering, toxic tools of profit.

The right medications, alongside psychotherapy, can save and improve lives. I have seen people frozen in psychosis or melancholia awaken, as though from a nightmare, after getting the right treatment. I have seen soldiers back from war, riddled with flashbacks, become able to do simple things again, like go to a shopping mall. I have seen people once stuck in hospitals able to work again, to finish school, to have loving relationships. Those moments fulfill me as a doctor and as a human being. But I wish my profession would recognize that our ethics are worth more than a quick buck.

Quote: A top research psychiatrist said, incredibly, “Morality and psychiatry should be kept separate.”

Sums it up nicely, no?

Psychiatric drugs responsible for 90,000 hospital emergency room visits annually

Just can across this recent report in the Formulary Journal from a few month back

Psychiatric drugs responsible for 90,000 ED visits annually

The original study is

Emergency Department Visits by Adults for Psychiatric Medication Adverse Events

Adverse reactions to antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulant drugs are responsible for almost 90,000 emergency department (ED) visits each year by US adults, according to a study in JAMA Psychiatry.

The authors estimated the number of emergency department visits for adverse drug events from the therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants using active, nationally representative surveillance data from the National Electronic Injury Surveillance System – Cooperative Adverse Drug Event Surveillance (NEISS-CADES).

They also estimated the number of outpatient visits at which those drugs were prescribed using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. They used the estimates of ED visits for adverse drug events and of outpatient prescription visits to calculate the number of ED visits for adverse events from a particular psychiatric drug per 10,000 outpatient prescription visits at which the drug was prescribed.

Almost 1 in 5 of those ED visits (19.3%) resulted in hospitalization. Sedatives and anxiolytics, antidepressants, and antipsychotics each caused 20,000 to 30,000 ED visits annually. However, relative to how often each of these types of medications was prescribed at outpatient visits, antipsychotics and lithium salts were more likely to cause ED visits for adverse drug events than were sedatives, stimulants, and antidepressants. Antipsychotics caused 3.3 times more ED visits for adverse drug events than sedatives, 4.0 times more ED visits than stimulants, and 4.9 times more ED visits than antidepressants relative to their outpatient use.

Out of the 83 specific drugs the study looked at, 10 drugs were implicated in nearly 60% of the ED visits for adverse drug events from therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants. Zolpidem was implicated in nearly 12% of all such ED visits and 21% of such ED visits involving adults aged 65 years or older, more than any other sedative or anxiolytic and more than any antipsychotic, antidepressant, lithium salt or stimulant.

“The study highlights the importance of encouraging doctors to be cautious in their prescribing of medications,” said one of the study’s leaders Lee M. Hampton, MD, of the Centers for Disease Control and Prevention's healthcare quality promotion division. “The study findings can also be used to prioritize efforts to reduce the burden of adverse events from the therapeutic outpatient use of psychiatric medications within a given managed care or healthcare system.”

[...]

Robin Williams had the Anti-Depressant Mirtazapine in His Body When He Committed Suicide, According to Coroner's Toxicology Report

Recent major news reports have said that there were no drugs in the body of Mr. Williams, according to the just released toxicology report from the Coroner. A closer reading reveals that there were no illegal drugs in his system, but that there were certainly prescribed drugs.

As seen in this Report in Radar Online

Investigators found that he had been prescribed a variety of drugs, including lansoprazole, rapaflo, finasteride, amoxicillin, quetiapine, carbidopa, and mirtazapine.

Toxicology reports showed he had mirtazapine, desmethylmirtazapine, caffeine, and theobromine in his blood at the time of his death, but no alcohol.

And also in this report from the NY Daily New

Robin Williams had no illegal drugs or alcohol in his system when he hanged himself in a shocking suicide last August, the Marin County Coroner said.

The Oscar-winning actor had only prescription medications in his body and was suffering from depression, Parkinson’s disease and a "recent increase in paranoia,” the final autopsy report released Friday and obtained by the Daily News said.

[...]

Williams also “had complained in the past about not liking the way some of his medications made him feel,” the report said.

Toxicology testing found the antidepressant Mirtazapine as well as caffeine and the Parkinson’s mediation Levodopa in his blood.

The Marin County Sheriff's office issued this short press release {PDF] which was very short on details. We have never been a fan of AntiDepressants, especially as they do not seem to address the root causes of the Depression.

We are greatly saddened by the loss of Mr. Williams, and feel he could have been better served.

A Celebrity Patient's Backing Turns Sour for Drug Company

The Wall Street Journal has published a revealing story about one of the seamier sides of the drug industry's marketing campaigns: paying patients to offer testimonials about their drugs. Despite side effects one man had to continue because the money way so good. He is now writing a book about his experience. Here's the Video.




I note in the video that they show the complete original testimonial, which sort of defeats the purpose of the original news story. Way to go WSJ!

(the embedded player is a little funky, you might have to pause and push play an extra time or to to get past the intro)

FDA Approves Depressant Drug For The Annoyingly Cheerful

A Satire from the Onion, although the way drug companies operate, it makes you wonder sometimes.


FDA Approves Depressant Drug For The Annoyingly Cheerful

More than half of all foster children in Texas above 6 are drugged, 41,3% of those who receive medication receive 3+ different classes of medicines

Who are the real child abusers here? More than half of all foster children in Texas above 6 receive psychotropic medication, 41,3% of those who receive medication receive 3+ different classes of medicines. A study published in Pediatrics, the Official Journal of the American Academy of Pediatrics

Psychotropic Medication Patterns Among Youth in Foster Care

Julie M. Zito, PhD a,b,
Daniel J. Safer, MD c,
Devadatta Sai, MS a,
James F. Gardner, ScM a,
Diane Thomas, BA d,
Phyllis Coombes, MA d,
Melissa Dubowski, BS d and
Maria Mendez-Lewis, MPA d

Departments of

a Pharmaceutical Health Services Research
b Psychiatry, University of Maryland, Baltimore, Maryland
c Department of Psychiatry and Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland
d Office of the Texas Comptroller of Public Accounts, Austin, Texas

---

ABSTRACT

CONTEXT. Studies have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate >3 times that of Medicaid-insured youth who qualify by low family income. Systematic data on patterns of medication treatment, particularly concomitant drugs, for youth in foster care are limited.

OBJECTIVE. The purpose of this work was to describe and quantify patterns of psychotropic monotherapy and concomitant therapy prescribed to a randomly selected, 1-month sample of youth in foster care who had been receiving psychotropic medication.

METHODS. Medicaid data were accessed for a July 2004 random sample of 472 medicated youth in foster care aged 0 through 19 years from a southwestern US state. Psychotropic medication treatment data were identified by concomitant pattern, frequency, medication class, subclass, and drug entity and were analyzed in relation to age group; gender; race or ethnicity; International Classification of Diseases, Ninth Revision, psychiatric diagnosis; and physician specialty.

RESULTS. Of the foster children who had been dispensed psychotropic medication, 41.3% received ≥3 different classes of these drugs during July 2004, and 15.9% received ≥4 different classes.

The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%).

The use of specific psychotropic medication classes varied little by diagnostic grouping.

Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of ≥2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly.

CONCLUSIONS. Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.

Full Study at the Link

SSRI Pushers under Fire

We now have another excellent story by Evelyn Pringle, as seen in the Scoop Independent News, and elsewhere.

SSRI Pushers under Fire

By Evelyn Pringle

Throughout the 1990's, most doctors who attended conferences, medical seminars and other events were not aware that the so-called "key opinion leaders" encouraging them to prescribe the new generation of antidepressants for everything under the sun, including to children as young as infants, were nothing more than highly paid drug pushers for Big Pharma.

For years, the research that showed SSRI antidepressants (selective serotonin reuptake inhibitors) were dangerous and practically useless was kept hidden, while the studies published and presented to potential prescribers painted a glowing picture of success. These days, a person would be hard pressed to find someone who does not have a family member or friend labeled mentally ill and taking drugs like Prozac, Paxil, Zoloft, Lexapro and Celexa, or their chemical cousins Effexor, Cymbalta and Wellbutrin.

About once a year, a new round of headlines about all the money made by the SSRI pushers comes and goes; but nothing really ever seemed to stick, until now.

The Senate Finance Committee, with the ranking Republican, Senator Charles Grassley, leading the charge, is investigating GlaxoSmithKline regarding new revelations in a report filed in litigation showing that the company manipulated the numbers on adverse events related to suicidality in clinical trials back in 1989, to make it appear that Paxil did not increase the risk of patients experiencing suicidal behavior when, in fact, trial subjects on Paxil were eight times more likely to attempt or commit suicide than patients taking placebos.

Quite a few of the top pushers are also under investigation by the Committee due to revelations that millions of dollars has changed hands between the SSRI makers and the academics who signed off on some of the most fraudulently reported research in the history of modern medicine. A full list of names is easy to compile by scanning the literature on SSRI studies conducted on children. The same names appear repeatedly.

In alphabetical order, the Fortune 500 team of pushers, at a minimum, includes Drs Joseph Biederman, David Brent, Jeffrey Bridge, Daniel Casey, David Dunner, Graham Emslie, Daniel Geller, Robert Gibbons, Frederick Goodwin, Martin Keller, Andrew Leon, John Mann, John March, Charles Nemeroff, John Rush, Neal Ryan, David Shaffer, and Karen Wagner.


Truth Buried in Litigation Graveyard

On February 6, 2007, the world famous historian on psycho-pharmacology, Dr David Healy, published a commentary entitled, "Why you should never trust new wonder drugs," in the UK's Daily Mail stating:

"Ten years ago, I sat faced with boxes and boxes that contained a dirty secret. Inside were thousands of confidential internal company documents about Prozac."

"The secret they revealed was that public statements about the safety of the drug were a lie; that the company knew Prozac was responsible for a raised risk of suicide and was only slightly more effective than a placebo."

Several years later, Dr Healy recounts, he was faced with the secrets of Paxil. "No one outside the two companies, and few within them," he writes, "knew what those boxes contained; I saw them because I was an expert witness in a court case."

"Documents prised out of companies by American court cases," he says, "have become the main way we have of discovering the truth about some of our best-selling drugs."

"The scientific literature, the very place doctors would look for a warning," he writes, "contained barely a hint of problems.”

"What's more, no one seems likely ever to have to answer for what appears to be fraud," he points out.

"In other organizations when evidence of disregard for public safety emerges, heads roll," Dr Healy said. "But there have been no resignations following these drug disasters - barely a flicker of embarrassment."

The UK's medicines “watchdog,” the British Medicines and Healthcare Products Regulatory Agency, he reports, "has never taken any action against the academics who make fraudulent claims in ghostwritten articles, nor doctors working for the companies who repeat such claims, even when they have been shown to be untrue."

"And no one in Britain," he points out, "has any means of finding out why their husband or child might have died."

Seven years before Dr Healy wrote this commentary, in a Prozac case for which he served as an expert witness, the plaintiff's legal team learned that Eli Lilly had withheld evidence in a jury trial when the May 7, 2007 Boston Globe reported that Lilly had agreed to pay $20 million for the rights to a patent on a new version of Prozac that would reduce "akathisia," the very side effect long believed to increase the risk of suicidal behavior, three months before the trial began.

While testifying under oath, Lilly researcher, Gary Tollefson, had told the jury, "there is absolutely no medically sound evidence of an association between any antidepressant medicine, including Prozac, and the induction of suicidal ideation or violence."

When in fact, the wording in the patent for the new formula stated "fluoxetine (Prozac) produces a state of inner restlessness (akathisia), which is one of its more significant side effects," and the "adverse effects which are decreased by administering the R(-) isomer of fluoxetine include but are not limited to headaches, nervousness, anxiety, insomnia, inner restlessness (akathisia), suicidal thoughts and self mutilation."

Patients who lived to talk about a failed suicide attempt have described the SSRI-induced akathisia, as being so unbearable that their only option for relief seemed to be death.


America’s Most Wanted

Dr Daniel Casey was a major player in the SSRI drug-push and useful in many ways to the companies promoting the drugs. He was the chairman of the very first FDA advisory committee that met in 1991, to decide whether a warning about the increased risk of suicide should be added to the label of Prozac, the first SSRI approved in the US, and voted it down. He was also the chairman of the advisory panel that voted to approve Zoloft for Pfizer later that same year.

Bob Sorenson was a sales representative for Pfizer for 21 years. He moved to Oregon shortly before Zoloft was approved. During the first week at his new location, Pfizer’s chief of marketing at the time told him he needed to start calling on a doctor by the name of Dr Daniel Casey at the V.A. in Portland because he was very important to the company.

Dr Casey worked at the V.A., but never treated patients for depression, Mr Sorenson says. "His expertise [was] psychotropic drugs and experimentation."

The chief of marketing said he was interested in finding out what Dr Casey thought of the company's new drug, Zoloft. The company tried to call on him that day, but Dr Casey was not in. Mr Sorenson called on him later in the week and learned that Dr Casey was the lead investigator on Zoloft, which was up for approval by the FDA advisory committee Dr Casey chaired.

"He said I shouldn't be there, but I did ask how it looks for the drug and he said very well," Mr Sorenson recalls.

Dr Casey ended up making a ton of money from Zoloft. "He told me personally one time that he made enough from Pfizer in one year to purchase two cars," Mr Sorenson reports.

Dr Casey became a member of Pfizer's Advisory Board for Zoloft, which meant "all expense paid trips," including honorariums, to anywhere Pfizer wanted him to advise, at any location in the world, Mr Sorenson explains.

"Many speakers were sought out that would only give lectures that put Zoloft in a positive light," he notes, "there was no room for a balanced lecture."

"Dr Casey later became one of the most sought after speakers for the Pfizer promotion of Zoloft," he says, "the reps loved him because of his positioning of Zoloft."

Mr Sorenson was often told to take information to speakers, "including Dr Casey, to have them add the information to their lectures," he reports. "I look back at it now and see how wrong it was," he states.

"As far as the suicide issue," Mr Sorenson says, "the standard company line was that parents and doctors should be monitoring these kids because after being on Zoloft they finally feel good enough that they can carry out their suicide tendencies."

"Another tactic was to blame Paxil and Effexor," he recalls, "it was those drugs that caused suicidal tendencies, not Zoloft."

"Finally," he notes, "the statement was made that if they didn't take Zoloft, they probably would have committed suicide anyway."

Sales reps would practice and rehearse these statements at sales meetings to be able to respond to concerns or objections raised by Doctors about Zoloft’s relationship to suicidality, he says. "There would be contests as to who could detail the drug the best with objections," he recalls.

Pfizer was able to get rid of employees and still keep them quiet, he says, by offering severance packages of up to a year's salary, while forcing them to sign a confidentiality agreement, in which they promised not to sue, or speak adversely about Pfizer, as part of the deal.

Many people were so surprised at being terminated that they felt forced to sign because Pfizer kept the pressure on, he explains. They feared they wouldn’t find another job before financial problems set in, but regretted signing the agreement later, he says.

Mr Sorenson did not sign an agreement when he was fired. His young son had developed cancer, but Pfizer expected him to continue to attend out-of-town meetings and refused to believe that his son was terminally ill, he recalls. After 20 years with the company, Mr Sorenson was let go when he insisted that he needed to remain near his dying son and distraught wife. The Sorenson's son passed away on April 1, 2005.


Going rate for Legal Drug Pushers

SEC filings for Cypress Bioscience provide a good source for estimating how much money legal drug pushers can make each year, from each company, because the names of several appear in these filings. According to its website, “Cypress Bioscience is committed to developing and commercializing pharmaceutical products and personalized medicine laboratory services that allow physicians to serve unmet medical needs.”

Drs Martin Keller and Charles Nemeroff, two of the most prolific depression-mongers, have served on the company’s board of directors, on its scientific advisory board and as consultants for this company. Under their 2004 Consulting Agreements, Cypress was required to pay them $50,000 per year for services rendered up to and including “two days per fiscal quarter.” In addition, the company could request additional services at a rate of $5,000 per day.

During 2003, Dr Nemeroff was paid $19,000 for additional services under his agreement, and Dr Keller was paid an extra $18,000. But they were only making $2,000 per day that year. As members of the Psychopharmacology Advisory Board, Dr Nemeroff earned $19,000 and Dr Keller $18,000 in 2003.

For their service as directors of the company in 2002, they each received $24,000. They were also offered stock options regularly. Cypress is only company. A bio on Dr Keller in a July 25, 2002 agenda for an annual meeting states that he is also a consultant to, "Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Janssen, Merck, Inc, Organon, Otsuka Pharmacia/Upjohn, Pharmastar, Pfizer, Inc. and Wyeth-Ayerst Laboratories."

It also shows he serves on the scientific advisory boards of, "Bristol-Myers Squibb, Cephalon, Cyberonics, Inc., Eli Lilly, Forest Laboratories, Merck, Inc, Mitsubishi, Organon, Pfizer, Sepracor, Scirex, SmithKline Beecham, Somerse, Vela Pharmaceuticals and Wyeth-Ayerst."

Dr David Dunner and a few more of the usual suspects appear in the Cypress SEC filings as advisory board members as well.

Dr Nemeroff's role in the prostitution of research is legendary. In April 2004, Shannon Brownlee, author of, "Overtreated," wrote an article in the Washington Monthly entitled, "Doctors Without Borders," after he was caught failing to disclose his financial ties to the companies whose treatments he promoted in a paper in Nature Neuroscience, and noted:

"With financial ties to nearly two dozen drug and biotech companies, Dr. Charles B. Nemeroff may hold some sort of record among academic clinicians for the most conflicts of interest.

"A psychiatrist, a prominent researcher, and chairman of the department of psychiatry and behavioral science at Emory University in Atlanta, Nemeroff receives funding for his academic research from Eli Lilly, AstraZeneca, Pfizer, Wyeth-Ayerst--indeed from virtually every pharmaceutical house that manufactures a drug to treat mental illness.

"He also serves as a consultant to drug and biotech companies, owns their stocks, and is a member of several speakers' bureaus, delivering talks--for a fee--to other physicians on behalf of the companies' products."

Dr Nemeroff stood to "reap as much as $1 million in stock" from just one company that manufactured one of the products in his Nature Neuroscience paper, she noted.

"But the drug industry's most powerful means of boosting the bottom line is funding research," Ms Brownlee writes, "which allows companies to control, or at least influence, a great deal of what gets published in the medical journals, effectively turning supposedly objective science into a marketing tool."

She notes how companies are able to routinely delay or prevent the publication of data and specifically how the majority of studies which found antidepressants to be no better than placebos, "never saw print in medical journals."

In conclusion, she states, "I'm struck more than anything by the apparent lack of shame among clinicians when it comes to this issue."

Two years later, on July 19, 2006, the Wall Street Journal reported that the journal, Neuropsychopharmacology, published by the American College of Neuropsychopharmacology (ACNP), planned to publish a correction of a favorable review of a new depression treatment device because it failed to list the ties of the eight academic authors to the device maker, Cyberonics, including lead author Dr Nemeroff, the editor of Neuropsychopharmacology at that time. The FDA had approved the VNS device in July 2005 over the objections of "more than 20" FDA scientists, Bloomberg reported a day earlier on July 18, 2006.

"This is about as classic an example as you'll ever find of conflict of interest and manipulation by thought leaders who are beholden to corporations," Dr Bernard Carroll, a member of the ACNP, told Bloomberg. "This article is a piece of a slick, skillfully coordinated PR campaign directed by the corporation," he said.

Ten days before the Wall Street Journal article, Cyberonics had sponsored a little noticed symposium on treatment-resistant depression at the annual Collegium Internationale Neuro-Psychopharmacologicum Meeting. The main presenters at the July 9, 2006 event were Drs Nemeroff, Dunner, and Keller (the lead author of the infamous Paxil “Study 329” on adolescents).

"In recent years, new treatment modalities have emerged, among them, the only FDA-approved treatment option specifically designed for this patient population, VNS Therapy," Dr Dunner stated in a press release for the event.

Dr Dunner was one of the authors vouching for the new device in the Neuropsychopharmacology paper. However, a “stamp of approval” from this guy should be taken with a grain of salt. Back in March 1995, he also vouched for Paxil as lead author of a study titled, "Reduction of suicidal thoughts with paroxetine in comparison with reference antidepressants and placebo," in the journal of European Neuropsychopharmacology. However, he later admitted that he never reviewed any of the actual data from that study.

Dr Nemeroff apparently learned nothing from the public embarrassment of the previous scandals. Last week, he was forced to step down as Chair of Emory’s psychiatry department. According to a December 23, 2008 posting by Ed Silverman, on the popular blog, Pharmalot:

"Under pressure from a US Senate Finance Committee investigation, renowned psychiatrist Charles Nemeroff is giving up the post he held for 17 years and must follow new restrictions on his outside activities, according to an Emory University statement.”

“Emory’s own investigation found Nemeroff received more than $800,000 from Glaxo, which paid Nemeroff more than any other drugmaker, but he never reported the fees. There were more than 250 speaking engagements between 2000 and 2006.”

"Moreover, Emory will not submit any National Institutes of Health grant or other sponsored grant or contract requests in which Nemeroff is listed as an investigator or has any other role for a period of at least two years,” Pharmalot reports.

All total, Dr Nemeroff earned more than $2.8 million from drug companies between 2000 and 2007, but failed to disclose at least $1.2 million to Emory, according to the Senator.

Dr Keller’s disclosure records are under investigation as well He also appears center stage in a new book by former Boston Globe reporter, Alison Bass, called, "Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial," The book contains a treasure trove of insider revelations with specifics on Dr Keller's endless conflicts of interest, along with other academics on the take. However, Ms Bass first broke the Keller story back on October 4, 1999, in the Globe, when she reported that he was forced to forfeit "hundreds of thousands of dollars" in state grant money in 1998.

She explained how in the same year that Dr Keller authored a review article in "Biological Psychiatry," and concluded that the newer antidepressants Zoloft, Bristol-Meyer’s Serzone, and Wyeth’s Effexor were more effective, he received $77,400 in personal income and $1.2 million in research funding from Bristol-Myers, as well as $8,785 in personal income from Wyeth.

In "Side Effects," she notes that Dr Keller did not report any income to the IRS from Glaxo for 1998, but says he did receive money from the Paxil maker, and also earned $62,500 from Celexa maker Forest Labs that year.

Dr Keller published 3 studies, "with colleagues," in the Journal of the American Medical Association and the Journal of Clinical Psychiatry, touting the efficacy of Zoloft in 1998, and received $218,000 in personal income and more than $3 million in research funding from Pfizer the same year, Ms Bass reports.

The "colleagues," referred to include the all-time champion of child drugging, Dr Joseph Biederman, the main promoter of the bogus epidemic of childhood bipolar disorder. He too is under investigation for taking $1.6 million from drug companies between 2000 and 2007, and only disclosing a fraction of that amount to Harvard. On December 30, 2008, Harvard’s teaching hospital, Massachusetts General announced that Dr Biederman was no longer participating in several industry-funded trials and had agreed to “not to participate in any outside activities that are paid for or sponsored by industry, such as consulting activities or speaking engagements.”

In most of the SSRI trials conducted on children, "colleagues," will also include Dr Graham Emslie of Prozac fame, and the Zoloft Czar, Dr Karen Wagner, both from the University of Texas.

Back in April 2004, the British Medical Journal published a paper by a research team led by Dr Jon Jureidini, head of the department of psychological medicine at Women's and Children's Hospital in Australia, after a review of the clinical trial data on the safety and efficacy of antidepressant use with children. The review included the published trials, along with some unpublished data made public by the Committee on Safety of Medicines in the UK.

The Australian team was extremely critical of the published papers on the major trials of Prozac, Paxil and Zoloft, with Emslie, Wagner and Keller listed as lead authors. "In discussing their own data," the team wrote, "the authors of all of the four larger studies have exaggerated the benefits, downplayed the harms, or both."

"It is vital," they wrote, "that authors, reviewers, and editors ensure that published interpretations of data are more reasonable and balanced than is the case in the industry-dominated literature on childhood antidepressants."

Seven months later, the New York Times ran a report by Barry Meier on November 29, 2004, throwing another spotlight on the trail of corruption within the SSRI research factories, and zeroed in on Dr Wagner. He noted that, from 1998 to 2001, she was one of several researchers participating in more than a dozen industry-funded pediatric trials of antidepressants and other drugs, and that some of the results were published, but many were not.

In her Zoloft study, Dr Wagner acknowledged that she had received "research support" from several drug makers including Pfizer, which paid $80,000 to the center in connection with the test, Mr Meier reports. But she did not state that she received “sizable payments” from Pfizer for work related to the study, he says.

The same month that patients were first recruited for the Zoloft trial, in a financial filing with the school in December 1992, Dr Wagner reported that she received more than $10,000 from Pfizer, with no further details. A lawyer for the school told Meier that Dr Wagner said Pfizer had paid her $20,500 during the course of the Zoloft trial. But records for payments she received in speaking and consulting fees could not be located.

In September, Dr Wagner’s name was added to the Senator Grassley’s investigative roster, along with Dr John Rush. Between 2000 and 2005, Glaxo alone paid Dr Wagner $160,404, but only $600 was disclosed to the University, according to the Senator. She was also paid over $11,000 in 2002, by Eli Lilly, and that money was not disclosed either. Lilly paid Dr Rush $17,802 in 2001, but he only reported $3,000, Senator Grassley said.

Dr Emslie’s financial trail to the drug makers gained media attention last summer due to his prominent role in the “Texas Children's Medication Algorithm Project,” and the creation of a drug formularies for children. He was chairman of the panel that wrote guidelines instructing doctors to prescribe SSRIs off-label to kids for depression in 1998. On August 18, 2008, the Dallas Morning News ran the headline: “Conflict of interest fears halt children's mental health project.”

“A state mental health plan naming the preferred psychiatric drugs for children has been quietly put on hold over fears drug companies may have given researchers consulting contracts, speakers fees or other perks to help get their products on the list,” the News reported. University disclosure forms indicate that Dr Emslie “has made at least $130,000 in drug company speakers fees and consulting contracts since 2002,” the paper noted.

In discussing the investigation of Dr Wagner on the Senate floor, Dr Grassley pointed out that she was a co-author on Paxil Study 329. In 2001, when the study was published, Glaxo “reported paying her $18,255,” he said. “Study 329 was cited in a New York case where GlaxoSmithKline was charged with ‘repeated and persistent fraud,’” the Senator added.

Dr Emslie was also a co-author on the Paxil study and a check of the full list for 329, reveals that 5 of the co-authors appear with Dr Emslie on the guidelines for the “Children's Medication Algorithm Project,” including Karen Wagner, Boris Birmaher, Barbara Geller, Neil Ryan and Michael Strober. Dr Rush’s name is also on the Texas guidelines but he moved to Singapore last August.

********

Evelyn Pringle

epringle05@yahoo.com

(Written as part of the SSRI Litigation Round-Up, Sponsored by Baum, Hedlund, Aristei & Goldman’s Pharmaceutical Litigation Department at http://www.baumhedlundlaw.com)

(Evelyn Pringle is a columnist for Scoop Independent News and an investigative journalist focused on exposing corruption in government and corporate America)

Are Antidepressant Drugs Actually Worth Taking? A psychologist says secret corporate documents show how ineffective the drugs really are.

As Seen in Discover Magazine

THE STUDY
"Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration" by Irving Kirsch et al., published online on February 26 in PLoS Medicine.

THE QUESTION
Irving Kirsch no longer sends patients to seek out antidepressants. "As a clinical psychologist," he says, "I used to refer patients to colleagues who were psychiatrists to get these medications." But his research over the years has soured him on the drugs, suggesting they work only marginally better in the average patient than a placebo pill. Kirsch recently analyzed the numbers behind a multitude of studies to answer the question: Do
antidepressants work?

THE METHODS
For the analysis, Kirsch and his colleagues were reluctant to rely solely on published drug trials. Those that get published, other researchers have found, tend to show medications in a more positive light than trials that go unpublished. To circumvent that influence, known as "publication bias," Kirsch's team used the Freedom of Information Act (FOIA) to solicit records from the Food and Drug Administration. That gave them access to data from all manufacturer-sponsored trials of the six antidepressants approved between 1987 and 1999—including some trials the manufacturers had never published.

Even then, the data did not reflect everything the researchers would have liked to know. For two of the drugs, for example, there was no indication as to how much the average patient's symptoms improved during treatment. So the researchers ignored those drugs and focused on the other four—fluoxetine (Prozac), paroxetine (Paxil), enlafaxine (Effexor), and nefazodone (formerly sold in the United States as Serzone). In all, they analyzed 35 trials, each of which involved a group of patients who took a placebo and at least one group who took one of those four antidepressants. Kirsch's team considered how sick each group of patients had been before treatment, how much they improved during treatment, and whether they'd gotten a real drug or an inert pill.

THE RESULTS
Just as one would hope, taking an antidepressant typically improved a person's depressive symptoms, the trials showed. But so did taking a placebo. In fact, the overall difference between medication and placebo was so small that it was "clinically insignificant" for all but the most depressed patients, Kirsch says, a point that was consistent with his past findings. Moreover, antidepressant therapy improved symptoms by the same degree in both mildly and moderately ill patients. "There seems little evidence to support the prescription of
antidepressant medication to any but the most severely depressed patients," says Kirsch, "unless alternative treatments have failed to provide benefit."

THE MEANING
In the end, the researchers found that most patients who take antidepressants may glean little from them other than a placebo effect. However, the initial severity of a patient's depression did influence the placebo effect. Placebos seem to help very depressed patients less than they help those with moderate symptoms. As a result, says Kirsch, antidepressants proved substantially more effective than placebos in — and only in — trials involving the most down-and-out patients. Blair Johnson, a social psychologist at the University of Connecticut in Storrs and co-author, recommends that doctors look at all of the alternative therapies—including psychotherapy, exercise, light therapy, omega-3 fatty acid supplements, and various others — first for all but the most depressed patients.

SECOND OPINION
Even if the drugs are effective, you would expect these results because the majority of depressed patients do not get better on the first antidepressant they are prescribed, say numerous critics including members of the pharmaceutical industry and physicians. Darrel Regier, the American Psychiatric Association's director of research, says this is probably why so many patients did not improve significantly. If the unresponsive patients had been tested on two or three antidepressants back-to-back, say critics of this analysis, then more improvement would have been seen.

Moreover, critics say a study like Kirsch's should focus on how many individual patients improve with treatment, not whether the average improvement is clinically significant. By averaging outcomes, the study dilutes some patients' large improvements with others' unchanged symptoms. "That's true," says Kirsch, but if some people improve more than the average, he says, some must improve less—or even be harmed. "Medications have side effects," he says. "One of the side effects [of antidepressants] is increased risk of suicide."

[...]

• More prescriptions are dispensed for antidepressants—232.7 million nationwide in 2007—than for drugs of any other type, according to the data firm, IMS Health.

• U.S. sales of antidepressants totaled $11.9 billion in 2007, IMS Health reports.

[...]

Antidepressants may damage male fertility

As reported via Reuters

Common antidepressant drugs may reduce some men's fertility by damaging the DNA in their sperm, according to scientists.

A study of 35 healthy men given paroxetine - sold as Paxil or Seroxat by GlaxoSmithKline - found that, on average, the proportion of sperm cells with fragmented DNA rose from 13.8 percent before treatment to 30.3 percent after just four weeks.

Similar levels of sperm DNA damage have been linked to problems with embryo viability in couples trying to have children. The research by Peter Schlegel and Cigdem Tanrikut of the Cornell Medical Center in New York was reported in New Scientist magazine and is due to be presented in November at a meeting of the American Society for Reproductive Medicine.

A copy of the study abstract was made available to Reuters.

"The fertility potential of a substantial proportion of men on paroxetine may be adversely affected by these changes in sperm DNA integrity," the experts concluded.

The study adds to concerns voiced by the same doctors in 2006, after finding that two men had developed low counts of healthy sperm following treatment with two different selective serotonin-reuptake inhibitors (SSRIs).

SSRIs like Paxil/Seroxat and Eli Lilly's Prozac, both of which are now available generically, are the most commonly prescribed class of antidepressant.

Glaxo said it was reviewing the investigators' findings, since the study was not conducted by the company.

"These medicines remain an important option, in addition to counselling and lifestyle changes, for treatment of depression and this study should not be used to cause unnecessary concern for patients," a spokeswoman said.

"Patients should discuss their situation with their doctor before stopping use of their medicine."

Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield, said the apparent increase in sperm DNA damage was "alarming", although he noted the level at which damage becomes clinically significant was open to debate.

"It is a shame that the authors appear not to have conducted a randomised controlled trial which would be the most scientific way to investigate the drugs effects, but I agree that the results are of concern and need to be investigated further," he said.

SSRIs have long been known to depress libido in some men and previous research has also found that women taking the medicines are more likely to have a low birth weight baby.

Placebo Effect In Depression Treatment Much Larger Than Previously Thought

From a study in the August Journal of Psychiatric Research, seen via the Furious Season Weblog. here is the Abstract of the Paper

Our objective was to assess the persistence of the placebo response during at least 12 weeks of continued placebo administration in depressed patients who have responded to 6–8 weeks of acute placebo treatment. We identified 8 placebo-controlled antidepressant trials with a total of 3063 depressed patients in which, after acute phase placebo treatment, placebo was continued for more than 12 weeks. The number of patients entering the continuation phase and percentages relapsing during this phase were determined.

Based on the total number of patients entering the continuation phase 79% of placebo responders remained well (did not meet relapse criteria) during this phase compared to 93% of antidepressant responders.

Although significantly more patients on placebo than on antidepressants relapsed in the continuation phase, 4 out of 5 placebo responders stayed well. The widely held belief that the placebo response in depression is short-lived appears to be based largely on intuition and perhaps wishful thinking.

As one commentator noted

"So yeah, people on drugs did a bit better, but about 4 in 5 people taking a freaking sugar pill were still doing well in the long-term. Anyone still want to seriously argue that the vast majority of the antidepressant effect is not the placebo effect?"

A red flag about medicating young children

A column from the Monadnock Ledger-Transcript by Bonnie Harris

World-renowned Harvard child psychiatrist and director of the research team at Mass General Hospital Dr. Joseph Biederman has been found by Sen. Chuck Grassley of Iowa to have failed to report millions of dollars he has received over the years from the drug companies that make the drugs he prescribes for ADHD and bipolar disorder. Biederman and his research team are responsible for putting the diagnosis of bipolar disorder, previously thought to start in young adulthood, on children as young as three.

The reported diagnosis of bipolar disorder grew 40-fold between 1994 and 2003. And that data is five years old. Biederman is the number-one influence on doctors nationwide who diagnose and medicate children with bipolar and attention-deficit disorder. Antipsychotic drugs previously prescribed for adults are now being given to children as young as three -- one of whom died at age 4 from an overdose her mother gave her desperately trying to control her behavior.

According to Medco, a pharmacy benefits manager, 500,000 children and teenagers were given at least one prescription for an antipsychotic in 2007, including 20,500 who were younger than 6 years old. Biederman claims, "The average age of onset is about four .... It's solidly in the preschool years."

Another 3-year-old was reported by his mother to have violent and explosive outbursts. After a year of treatment, his mother says a psychiatrist told her he thought her son was bipolar. As the boy's mother reported, "He would tell us, you know, 'You donlove me.' ''You don't like me.' 'I don't like myself.' 'I hate myself.' 'I'm stupid.' 'Nobody likes me.' 'I wanna die.' Four-year-olds don't talk like that." After the boy was put on a fourth medication, the family decided that was enough and took their son to Seattle Children's Hospital, where they were told he was not bipolar. He now takes medication for hyperactivity and a sleep disorder. And he's learning to deal with his explosive moods through a behavioral program. The family claims there is no comparison to the child they are parenting today compared to the one diagnosed as bipolar.

Dr. John McClellan, familiar with this boy's case, says the children's psychiatric hospital he runs in the state of Washington is filled with kids who have been misdiagnosed as bipolar. He says it has become a catchall for aggressive and troubled children.

Please, let this report be a red flag to all who have children too quickly diagnosed with ADHD, bipolar disorder, oppositional defiant disorder and others.

A young child claiming that no one loves him, that he's stupid, hates himself, or wishes he could die is often a child who is crying out for acceptance and attention from the influential adults in his life who have yet to understand him and his problems. With that understanding, adjusted expectations, removal of damaging behavior modification techniques such as punishment, many children, even those with chemical imbalances and disorders, can have appropriate behavior without medication. So many children in today's world react strongly to being told what to do and how to do it, to feeling disrespected with regular criticism and punishment, to not fitting in to a schoolroom full of other children who seem to be able to "get it" more easily, to being easily overstimulated or misunderstood for the reasons beneath their behavior.

Children who feel misunderstood are capable of highly inappropriate behavior that is trying to signal their need. They don't know how to say "Hey, this isn't working. My needs are not getting met." So they act it out -- louder and more dramatically the longer the misunderstanding. One of the children diagnosed with bipolar disorder had a father who had been accused of abuse. This factor was not part of the equation of the diagnosis.

We must look to the reasons -- the root causes -- of why our children don't, won't or can't do what we ask. Diagnoses often feel validating and relieving when our attempts at control don't work to get our children to comply. We can shift the blame onto to "problem" and we don't have to change how we parent.

Let me be absolutely clear that I do not consider the parent to blame. It is the culture in which we live that does not support parents to support their children. We are still in a children-must-do-as-we-say mentality and if they don't -- well now we can medicate them and we don't have to deal with it. Let me also say that are many cases in which medication is helpful and necessary.

But please lets start to put more effort into understanding children, their temperaments, the reasons for their behavior, their need for acceptance and compassion, their desire to get it right and their frustrations when they can't.

Let's not medicate those frustrations before thorough evaluations can be conducted by several professionals looking at the behavior from different perspectives.

And please let's take some responsibility for what we, their parents and teachers, are presenting to our children that become triggers for disruptive behavior.

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Bonnie Harris, M.S.Ed,. is the director of Connective Parenting. Past columns can be found on her Web site, http://www.connectiveparenting.com. E-mail questions or topic requests to bh@bonnieharris.com.