Request Insert of Language of Informed Consent Bill 5007 to Bill 5353.

Ablechild is a nationally recognized 501(3)c non-profit parent’s rights organization. Ablechild was recently featured on CNN Special Projects, Perry’s Principles (Quick to Medicate) December 10, 2011. Ablechild contributed to the groundbreaking Diane Sawyer ABC 20/20 year long investigation into the drugging of foster care children which was shown to be a major problem not only within the state of Connecticut, but throughout the Nation.

Ablechild was founded by two moms, Patricia Weathers and myself, Sheila Matthews. Both our schools diagnosed our boys with ADHD through the IEP process in our school system. This diagnosis was based off a “subjective” ADD checklist. We were never informed during the entire IEP process that this ADD/ADHD checklist was subjective and was not endorsed and had never been endorsed by the Board of Education, the State or Federal Government. We have submitted below letters from the Board of Education, State of Connecticut and a Federal Document that states they do not endorse this type of identification of children.

We were never told this checklist came from the Association of School Psychologists through research: behavioral, and clinical drug trials grants. We were never at any time informed that there is no test in existence to diagnose the condition and the diagnosis itself was not based in science. We were never informed at any time that this was a psychiatric label and that we were in essence labeling our children “mentally ill.” We were never informed that there were any other treatments for this diagnosis other than drug treatment. We were never informed at any time what the risks of this recommended drug treatment were and the fact that many of the drugs recommended were not even FDA approved for children.

In fact, we were never informed that we even had a choice to “opt out” of a school psychologist and his or her testing of our child. During this whole process we were only offered mental health services and little if any educational ones. Parents must have the right to have an education or speech and language specialist test their child instead of a psychologist. All parents should have the right to educational services that are evidence based rather than subjective not only within special education but throughout the entire education system.

For the past five years, Ablechild has fought for legislation to prevent what happened to us from happening to other parents. We in many ways have been fortunate. Our children are survivors of this very risky process. Other children have not been so lucky, being injured and having died from misdiagnosis and recommended drug treatment.

Ablechild and all of its parent members continue to urge this committee to pass an informed consent bill which focuses on full disclosure to protect not only parents informed consent rights but our children’s health and safety. Each year for the last five years, a bill for informed consent has been rejected, and it is our hope this year, that you as a committee seriously consider this issue since it involves both the protection of parent’s rights and our children’s health and safety. We are requesting that you incorporate Representative Hetherington’s proposed bill #5007 last proposed in 2011, AN ACT CONCERNING PSYCHIATRIC AND PSYCHIATRIC AND PSYCHOLOGICAL TESTING OF SCHOOL CHILDREN AND PROCEDURAL SAFEGUARDS FOR PARENTS, on informed consent into the language of this bill 5353.

AN ACT CONCERNING PSYCHIATRIC AND PSYCHOLOGICAL TESTING OF SCHOOL CHILDREN AND PROCEDURAL SAFEGUARDS FOR PARENTS
http://www.cga.ct.gov/2011/TOB/H/2011HB-05007-R00-HB.htm

We cannot stress enough how important it is to incorporate the Hetherington bill language “5007″ within bill “5353“ for parent and children’s rights.

We would be happy to expand on our request and answer any questions you may have.

Thank You for Your Consideration
The Staff of Ablechild.org

On February 28, 2012 Ablechild appeared before the Select Committee on Children to Oppose Bill 5217 as Written.

It was a disappointment to see the new DCF Commissioner, Joette Katz, efforts fall short presenting bill 5217 to the committee for “technical” changes requesting the name of the embattled State run psychiatric ward, “Riverview” to be changed rather than present a bill to reform the Child Welfare System. What does a name change do? The Commissioner’s efforts can be liken to rearranging the deck chairs on a leaking ship.

Diane Sawyer’s one year long investigative report into the National problem of psychiatric drugging of children within Foster Care that aired on November 30, 2011, actually included pieces from the State of Connecticut’s DCF System supplied to ABC by Ablechild.org.

Ablechild supplied ABC’s 20/20 Diane Sawyer investigation with the Pharmacy Report from “Riverview” State psychiatric ward. In addition, we would like to point out the annual budget of $29,766,625,000 for psychiatric services for Connecticut DCF. How anyone can go before this committee and present factual data that children don’t have access to psychiatric services or request a “technical change” in current policies should be forced to look at this number and explain where the money is going and how a “technical change” will solve the harmful and expensive approach to taking care of and protecting children.

While we were waiting to testify, It was amazing to sit and listen to testimony on S.B. 156, a request concerning sibling visitation for children in the care and custody of the Commissioner. The discussion circled to who would pay for the transportation to ensure the child could make the visits, thinking of that $29,766,625.00 maybe a limo by DCF? Ablechild was compelled to support S.B. 156 after listening to the DCF victims of sibling break ups when placed into DCF custody. We thought it was disheartening to hear one of the committee members point out to a sibling testifying for visitation rights that they were lucky the Commissioner stayed to hear their testimony. We assumed it was to indicate that the Commissioner cared. We thought she was paid to do that, a pointless comment from a committee member that illustrates the lopsided power DCF seems to hold. Ablechild believes this power stems from good old fashion corruption involving behavioral vendors and drug companies. http://ablechild.org/articles/index.php/billion-dollar-drug-company-law-firm-restructures-connecticut-welfare-system-2/. they seem to have an ability to run the legislative process.

Our recommendations during our testimony was to break up the behavioral health oversight committee that reports to the Governor. The oversight committee also makes policy recommendations to the Governor as well as to legislators which includes appropriations. Ablechild sits on that committee and our recommendations continue to fall on deaf, corrupt ears. Not surprised a “technical” name change for the ailing Riverview Psychiatric Ward is all the children get. We strongly recommend empowering and incorporating speech and language specialists within that committee that do not have “behavioral health contracts” with the State or connections with the drug companies, which includes non profit front groups. Split up the behavioral budget to focus on non-drug behavioral health solutions offered by non-drug company vendors. Incorporate the MEDWATCH reporting system as a requirement for this committee to ensure training and education on the Federal Adverse Drug Reporting system, which helps regulates drug safety.

Just a quick refresher flashback to October 20, 2008, testimony before this very same committee from then Attorney General Blumenthal. “if we want real reform at DCF — as we all do — we need a different approach. The General Assembly should mandate.

“A partial breakup of the agency, a complete overhaul of existing management, and the most important a comprehensive outside, objective review” The Attorney General went on to say, “The legislature should require recommended changes by dictating through its appropriations authority how funds are used, linking dollars to sweeping administrative reform.”

Everything this proposed bill doesn’t do.

The point the Attorney General drives home in his testimony in which Ablechid.org agrees. “The agency cannot be both contractor and regulator.” Attorney General Blumenthal, “DCF must better perform in the best interest of children. Rearranging the deck chairs cannot right this leaking, listing ship.”

Ablechild recommends that calls be placed to the Select Committee on Children to opposed 5217 as written or incorporate Ablechild.org recommendations. A name change just won’t protect children. http://www.cga.ct.gov/asp/menu/MemberList.asp?comm_code=KID

A shocking $700 million from the federal “race to the top education program” was given two years ago in exchange for a push for a teacher evaluation program in the State of New York. We are now told a deal has been struck between New York State and the teacher’s union, but more details need to be worked out to break the two year blockage. OMG!

Let’s keep it simple. If you ran a hotel or restaurant and were looking to improve your services and attract new clients, you would ask for feedback to evaluate your current services through an evaluation card or survey. The customer or client would be able to evaluate their experience and rate the service. It is done all the time without spending $700 million dollars.

The New York Governor indicates that he believes holding over the teachers union heads a 4% percent increase in the State education financing penalty combined with the threat of losing federal money will be enough to get the two sides to end the two year blockage? Wait a minute, didn’t the $700 million bribe do that? Parents should be alarmed at the notion of a $700 million dollars tax bill for yet another failed education program “race to the top” that has achieved nothing at the end of two years.

The New York Governor is typically endorsed by the teacher’s union. The union is holding off on that endorsement http://www.crainsnewyork.com/article/20100813/FREE/100819910.
Can anyone spell M.O.N.O.P.O.L.Y? Who cares if the union endorses the Governor or not? Since when should we allow tax paid vendors, i.e. teacher’s union, to call all the shots and even pay off our politicians anyway with endorsements? If the unions serve the people with services, they shouldn’t be in the business of endorsing our lawmakers and gatekeepers that make decisions on their contracts. They should focus their attention on improving the quality of their services.

Things will only change when parents and children have a “mutiny on the bounty” and create a source website that gives other parents and children the heads up on bad quality teachers and bad programs. They are public teachers right? Why not make their reviews public? Send the $700 million dollar in federal money back. This will help us stop having to play class warfare to pay these endless Monopoly driven tax bills.

We should all be allowed to pass go and collect our $200. We are all sick and tired of landing on the luxury tax space. It is time to check the rules on the inside of the box. Let’s go rogue and create our own teacher evaluation program. I am sure it won’t cost $700 million dollars.

AbleChild Co-founders Interviewed by CNN’s Steve Perry!

CNN education contributor Steve Perry interviewed Patty and Sheila yesterday for a program, “Quick to Medicate,” that will air in early December!

In this two-part episode of “Perry’s Principles,” a CNN Weekend segment examining challenges facing today’s schools, CNN profiles a family using behavioral drug treatment and commentary by Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven & Alexandra Cohen Children’s Medical Center of New York of the North Shore-Long Island Jewish Health System in New Hyde Park.. Patty and Sheila shared their experiences and offered AbleChild support and resources to parents with issues regarding their child’s ADHD/ADD diagnosis and/or drugs recommended to treat it.

CNN’s Steve Perry interviews AbleChild co-founders Sheila Matthews (left) and Patricia Weathers.

Patty described the pressure she felt from the school system and doctors to treat her energetic, outgoing son with drugs. “I thought maybe they knew more than I did; these were educated people, with degrees.” Stimulants made him withdrawn and listless; adding an antidepressant made him “psychotic.” His increasingly erratic behavior prompted Patty to take him off the drugs and seek alternative solutions. “Parents often aren’t told that there are other solutions to behavioral issues because drugs are a quick fix.”

Sheila offered two key pieces of advice to parents: “First, remember that federal legislation now prohibits schools from recommending or requiring children take controlled substances. Second, it’s critical to document any adverse effects drugs have on your child through Medwatch, the FDA’s reporting system so the agency can regulate their use and consumers receive more accurate information.”

After a break to eat pizza, Perry interviewed Patty and Sheila’s younger sons, Brett and Nick. Brett related how he refused to fill out a behavioral survey administered during math class. “It asked questions like whether I ever had thoughts about hurting anyone. There was no reason for me to fill it out so I didn’t.”

Nick, who receives private tutoring through Chyten Educational Services, discussed the support he receives through public special education to serve his speech and language gaps. “Special education services help me organize my work and review with me what projects I am working on and when they are due.” Nick describes himself as a normal 16-year-old with a passion for music. His work is available on the Oven Fresh Beats YouTube channel.

AbleChild co-founder Sheila Matthews and her son Nick chat with CNN’s Steve Perry over pizza during a break from filming.

Don’t forget to tune in next month when “Quick to Medicate” airs: part one on December 3, and part two on December 10, from 7 – 8PM EST!

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Would you like statins with that?

A British doctor has recently raised howls of protest for suggesting that fast food restaurants should serve statin drugs along with their fatty foods, to help counteract the harmful health effects of those burgers and fries.

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Writing is the latest link the drug manufacturers and psychiatric gatekeepers plan on using to lure families into psychiatric drug use. Perfect timing as children start school. Tuesday, August 23 (HealthDay News) reports that Children diagnosed with ADHD have a much higher risk of developing written language disorder, a new study indicates. The findings don’t eliminate the ADHD label or give way to the fact that millions of children have been misdiagnosed with ADHD that had underlying writing issues. The study wants to ensure children are Co-labeled.

What you will find with any ADHD study, the ADHD label is often linked with human actions, i.e., walking, talking, listening, eating, sleeping, crying, laughing and now writing. To validate the label they take those actions and link it to “a much higher risk of developing” problems and across it over to whatever obtains them more clientele. For example, Monday, July 25, 2011 big news (Reuters Health) reported that Children with ADHD are more likely to misjudge risk of walking across the street. The findings, researchers say it may explain why children with the disorder have a higher than average risk of being hit by a car. This approach to taking a verb and associating it with risk and linking with your child becomes alarming. Simple tasks become a concern, something for you to look for to become proactive about. This has created an industry that feeds off our children’s behaviors. Giving cause to analyse it all and cure it. OMG!

As school starts, know the facts and stay in the solution. Writing problems exist, but they can be solved without a ADHD Label or drugs. The recommendation should not be to Co-label a child with ADHD and a writing disorder, but to look at ensuring that schools continue to focus on the connection between writing and the development of the brain.. Thus the research they are not providing to you or mentioning in this breaking news study is a key ingredient for you to make an informed decision. Ablechild gives you a battling study for your review and a breaking news story that illustrates the failure to teach writing at the important developmental ages.

Research.

News Coverage

Stay in touch with your own reality, not what the psychiatric and drug companies want your reality to be for your child. Visit us at www.ablechild.org and let us provide you with more information so that you may make an informed decision relating to your child’s health and well-being.

Have a great start to the new school year!

Sheila Matthews
Cofounder www.ablechild.org

Image: 2.cdn.turner.com

By Bob Fiddaman and Shelia Matthews

For some time now, Sheila Matthews has been suspicious about her home state of Connecticut’s treatment of its most vulnerable children. As a mother of two children and co-founder of Ablechild, her instincts led her to scrutinize the dubious relationships among Connecticut’s Department of Children and Family Services [DCF], the pharmaceutical industry and a billion dollar law firm who has defended the likes of Pfizer Inc and Merck & Co., among others.

Sheila’s investigation has led her on a journey that links a non-profit children’s advocacy group, with assets over $15 million [2009] with nationally-renowned mass tort and class action defense law firms, to the Connecticut DCF – an $865 million bureaucracy, as described by the Connecticut Mirror.

The Connecticut DCF serves approximately 36,000 children and 16,000 families across its four Mandate Areas:

1.Child welfare;
2.Children’s behavioral health;
3.Juvenile Services; and
4.Prevention.

Sheila’s Ablechild has been questioning the Connecticut DCF since 2003, when Ablechild demanded that the Connecticut DCF immediately ban the use of the antidepressant Paxil in its treatment of mental disorders after multiple studies confirmed Paxil increased the risk of suicide in children and adolescents. This was more than a year prior to America’s Food & Drug Association (FDA) announcement that all antidepressants, including Paxil, should bear a black box warning regarding this suicide risk. Ablechild was disturbed that children in state custody were being prescribed this dangerous psychotropic medication. Ablechild’s public pressure paid off, and the Connecticut DCF deemed Paxil unsafe for children and adolescents, and according to the DCF drug approval list, Paxil has not been approved for use in over eight (8) years.

In August 2003, less than one month later, Ablechild reported that the commissioner of the Connecticu DCF held a ‘behind closed doors‘ meeting with Glaxo officials. This meeting was reported by the Associated Press, who wrote:

The maker of the anti-depressant Paxil plans to meet this week with Connecticut officials, weeks after the State stopped using the drug to treat young people in its care.

GlaxoSmithKline, a British pharmaceutical company, is sending its regional medical director and a medical team to meet with officials from the Department of Children and Families. [Source]

Despite repeated requests from Ablechild, the Connecticut DCF refused to inform the public what was discussed at this secret meeting.

Eight years later, Sheila and Ablechild continue to raise concerns and investigate potential wrongdoings and conflicts within the Connecticut DCF. Last month, in February 2011, Sheila attended a meeting sponsored by the Connecticut Behavioral Health Partnership [CBHP], where its medical director, Dr Steven Kant, presented the Husky Behavioral Pharmacy Data. The CBHP is a state vendor that provides mental health services to DCF children. These services are paid, in part, by the State-run insurance program, HUSKY. Incredibly the pharmacy data presentation showed that dangerous psychotropic drugs, like Paxil, are still being prescribed to thousands of children and adolescents. In fact, the Pharmacy Data presentation showed that the HUSKY program, financed by taxpayer dollars, paid drug companies over $60 million for psychotropic drugs for Connecticut’s children and adolescents in 2009 alone – many of which are not approved by the FDA for use in the pediatric population and all of which carry the most serious warning possible regarding the risk of suicide.

According to the pharmacy data presentation: [Which can be downloaded as a Powerpoint presentation HERE]

More than 50% of HUSKY Youth Behavioral med utilizers are on stimulants.
Close to 30% of HUSKY Youth Behavioral med utilizers are on antipsychotics.

The pharmacy data also revealed the following:

Most Frequently Used Behavioral Meds for DCF-Involved Youth

Medications for ADHD

Ritalin (10%)

Adderall (5%)

Vyvanse (4%)

Strattera (3%)

Atypical Antipsychotics

Abilify (11%)

Risperdol (10%)

Seroquel (8%)

Anti-anxiety

Hydroxyzine (2.5%)

Antidepressants

Prozac (4.5%)

Zoloft (4%)

Zyban (3%)

Desyrel (2.5%)

Celexa (2%)

Mood Stabilizers

Lithum (3%)

Depakote (3%)

Lamictal (2.5%)

Curiously, none of the above medications are on the Connecticut DCF list of approved/unapproved drugs listed in its DCF PMAC document.

With this in mind, Sheila Matthews contacted Dr Steven Kant and inquired as to whether any of the above drugs were approved by the Connecticut DCF for use in children.

Dr Kant replied:

… the answer to your question is not that straight forward.. . . Medications may be indicated by age and/or by specific treatment needs so it is not either a simply “yes” or “no”. Also, some medications may have the age indication but for a totally different condition, such as anti epileptic condition. . .Also FDA indications are static, they do not change over time though medical practice is constantly evolving…

Contradicting the very document that lists Connecticut’s approved and unapproved drugs, a “check-off” list that verifies the status of medications, Dr Kant replied, “I don’t think a “check off” for each medication would work in terms of verifying their status.”

With such an ambiguous response from Dr. Kant, we found the DCF Approved Medication List on the Internet. This particular version was revised in 2009.

It appears that the DCF has approved drugs in children that have not been approved for children by the FDA. In fact, the FDA has issued multiple advisories and alerts since 2004 about the increased risk of suicide in children, adolescents and young adults up to age 25 who are treated with psychotropic medications.

And while Fluoxetine (Prozac) is the only medication approved by the FDA for use in treating depression in children ages 8 and older, it still carries a black box warning regarding the risk of suicide.

In contrast, the DCF seems to be ignoring the conclusions of the FDA. Its list of approved medication in children and adolescents include every single antidepressant except paroxetine [Paxil] and venlafaxine [Effexor].

Forest Lab’s citalopram [Celexa] – APPROVED

Forest Lab’s escitalopram [Lexapro] – APPROVED

Solvay Pharmaceuticals’ fluvoxamine [Luvox] – APPROVED

Pfizer’s sertraline [Zoloft] – APPROVED

GlaxoSmithKline’s bupropion [Wellbutrin -also marketed as an anti-smoking cessation drug under the name of Zyban] – APPROVED [1]

Alarmingly, the DCF has produced a guide entitled, “MEDICATIONS USED FOR BEHAVIORAL & EMOTIONAL DISORDERS – A GUIDE FOR PARENTS, FOSTER PARENTS, FAMILIES, YOUTH, CAREGIVERS, GUARDIANS, AND SOCIAL WORKERS” where it writes, “Most of the side effects from the medications are mild and will lessen or go away after the first few weeks of treatment.” The guide also points out possible side effects of SSRI’s/SNRI’s:

SSRIs and SNRIs:

Headache
Nervousness
Nausea
Insomnia
Weight Loss

One of the most dangerous side effects of these medications, suicidal thoughts/ideation, doesn’t even make the 5 bullet-pointed list. The Guide does, however, add the following: “Watch for worsening of depression and thoughts about suicide.”

The DCF Approved Medication List writes:

“The DCF Approved Medication List is a list of psychotropic medications that has been carefully established by the Psychotropic Medication Advisory Committee, a group of DCF and community professionals.”

Sheila has since investigated other advocacy groups that were concerned about the off-label prescribing of psychiatric medications to youths in state custody. This is where she stumbled upon Children’s Rights, a non-profit charity based in New York City.

In 2005, Children’s Rights employed ten (10) attorneys and a staff of 31. It claims to use its expertise to change child welfare red tape and scrutinize failing systems. If the child welfare system fails to respond, Children’s Rights files a lawsuit. If successful, it enforces reform and then monitors its implementation.

In 1989, Children’s Rights had in fact filed a suit against William O’Neill and the Connecticut state Department of Children and Youth Services [DCYS].

The suit charged that an overworked and underfunded DCYS failed to provide services including abuse and neglect investigations, adoption, foster care, mental health care, caseloads and staffing. The case has been pending for over twenty (20) years, and while there have been numerous arguments that DCYS should be more inclusive or has failed to provide certain services, the issue of massive off-label prescription of psychotropic medications has never been brought to the court’s attention.

Children’s Rights is chaired by Alan C Myers, a partner at Skadden, Arps, Slate, Meagher and Flom, a billion dollar law firm which represents the pharmaceutical industry in mass torts and class actions. Myers is also co-head of the firm’s REIT Group [Real Estate Investment Trust].

Also, listed on the Children’s Rights website are individuals and law firms that have served as co-counsel on Children’s Rights’ legal campaigns to reform America’s failing child welfare systems, including:

Missouri - Shook Hardy & Bacon – Eli Lilly Co. and Forest Labs, defended the original Wesbeker Prozac trial in Kentucky and still defend Prozac, Celexa and Lexapro.

New Jersey – Drinker Biddle & Reath – GlaxoSmithKline attorneys – defended Paxil as local counsel in Philadelphia cases.

Oklahoma – Kaye Scholer LLP – provides work in Pharmaceutical Products Liability defense and employs an attorney who was former General Counsel of Pfizer, Inc.

A particular success for Skadden Arps occurred in 2010 when it secured a summary judgement ruling for Pfizer Inc. in a suit filed by two insurance companies who sought $200 million in damages for Pfizer’s predecessors alleged “off-label” marketing of its epilepsy drug, Neurontin.

Furthermore, in February 2011, Skadden Arps secured the dismissal of over 200 cases in a multi-district litigation pending against their client, Pfizer Inc. The plaintiffs had alleged injuries related to the use of Pfizer’s anti-epilepsy drug, Neurontin.

Neurontin, the generic version is called gabapentin, is prescribed by psychiatrists for a variety of “off-label” indications. It is often tried as an alternative treatment, when patients are unable to tolerate the side effect of more proven mood stabilizers such as lithium. [2]

Gabapentin has also been associated with an increased risk of suicidal acts or violent deaths.

This is a drug that has been known to cause behavioral problems, which include unstable emotions, hostility, aggression, hyperactivity or lack of concentration.

Children dependent on child welfare systems have rights and, according to its web page, Children’s Rights is dedicated to protecting them.

It should come as no surprise that the site fails to discuss the off-label prescription of non-approved psychotropic medications to children and adolescents, unless this falls under the ‘abuse and neglect’ category?

If Children’s Rights’ motive was to accomplish fixing the child welfare system then why hasn’t it investigated why thousands of children under state care are prescribed “off-label” psychiatric drugs? With a partner in a billion dollar pro-pharmaceutical law firm as its Chair, and supporters who also defend pharmaceutical products, is it safe to assume that its stance on the drugging of children is one that is being ignored?

Children’s Rights push to remove abused and neglected children into safety.

The basic question always comes down to trust. When power, money and a good cause is mixed, it is imperative to check motives. We would be less of a society if we didn’t check out all the facts. Abuse and neglect exist, always has and always will, but society is obligated to ensure those victims are not transformed into “good cause victims” and expensed out. There is no doubt we have a right to question the system and those who claim to promote change for the good of the children within it.

Children’s Rights Chairman, Alan C. Myers, Medical Director of Connecticut Behavioral Health Partnership, Steven Kant and the Connecticut Department of Children and Families may get their knickers in a twist with regard to an advocate of Ablechild and a blogger from Birmingham, UK questioning their motives but hey, what’s the downside of shinning a light on all these players, be they good or bad players?

Sheila’s concern is that Children’s Rights with its multi-million dollar budget and with the help of its billion dollar law firms, will continue to ignore the risks of these unapproved and dangerous medications, under the guise of helping our nation’s most vulnerable children. The question remains: how can the lawyers who defend pscyhotropic drugs also be the same lawyers who advocate for abused and neglected children to get into state welfare programs which place these children on the same drugs? The conflict is clear and obvious – and it poses an unmistakable danger to children who truly need our help.

[1] Bupropion [also known as Wellbutrin, Zyban] is a non-tricyclic antidepressant.
[2] Gabapentin

Bob Fiddaman is the author of the Seroxat Sufferers blog and the book, “The evidence, however, is clear… the Seroxat scandal.” Chipmunka Publishing.

Sheila Matthews is the co-founder of Ablechild and a mother of two children.

By Jennifer Thomas, HealthDay Reporter

Source: BusinessWeek

MONDAY, Jan. 4 (HealthDay News) — The rate of children aged 2 to 5 who are given antipsychotic medications has doubled in recent years, a new study has found.

Yet little is known about either the effectiveness or the safety of these powerful psychiatric medications in children this age, said researchers from Columbia University and Rutgers University, who looked at data on more than 1 million children with private health insurance.

“It is a worrisome trend, partly because very little is known about the short-term, let alone the long-term, safety of these drugs in this age group,” said study author Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University in New York City.

Prescribing antipsychotics to children in the upper range of that age span — ages 4 and 5 — is justifiable only in rare, intractable situations in which all other treatments, including family and psychological therapy, have been tried and are not working, Olfson said.

And it’s questionable whether 2- and 3-year-olds should ever be prescribed antipsychotics, Olfson said.

The study is published in the January issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

Presumably, only children with the most severe mental problems would be given the potent drugs. Yet, less than half of children on antipsychotics had received any mental health services, including a mental health assessment or treatment from a psychotherapist or psychiatrist, the study authors noted.

“You don’t see the kinds of mental health services you would expect to see if we were dealing with the most profoundly disturbed toddlers,” Olfson said, raising the question of whether doctors had done everything they could to help the child before turning to medications.

The overall numbers of children prescribed antipsychotics remains small, at less than one half of one percent of the national sample. But the numbers are rising. In 1999-2001, about one in 1,300 were being treated with antipsychotics. By 2007, that had risen to one in 630, according to Olfson.

For 5-year-olds, about one in 650 were being treated in 1999-2001. That doubled, to one in 329, in 2007, he noted.

Research published online in December in the journal Health Affairs by the same research team suggested children on Medicaid are even more likely than children with private insurance to be prescribed antipsychotics.

The most common antipsychotic drug prescribed to children was risperidone (Risperdal), which accounted for nearly three-quarters of antipsychotic prescriptions. In adults and teens, risperidone is used to treat schizophrenia and bipolar disorder. Risperidone is also approved by the U.S. Food and Drug Administration to treat unstable mood or irritability in children with autism aged 5 and up.

Children who were most likely to receive risperidone were male and aged 4 or 5, according to the report. The most common diagnosis was pervasive developmental disorder or mental retardation, attention deficit/hyperactivity disorder or disruptive behavior disorder.

Previous research has shown children on the drugs may experience metabolic and endocrine abnormalities. Little is known about their impact on the developing brain, Olfson added.

“I don’t want to minimize the problems children can have at this age, but there are psychological treatments that have been proven to help parents and the kids that emphasize the quality of the parent-child relationship,” Olfson said.

One reason for the uptick may be increasing numbers of children diagnosed with autism and some research showing risperidone may help with autism-related irritability, the researchers noted.

Dr. Peter Jensen, co-director of the division of child psychiatry and psychology at the Mayo Clinic, agreed that the trend is concerning. “We have no doubt there are prescribing practices out there that are very, very worrisome,” Jensen said.

It’s imperative that children receive a full mental health assessment before getting these drugs, to understand the family situation and school environment and if there is a family history of psychiatric problems, as well as undergoing a physical exam to rule out other medical problems.

“These agents should not be used as an adjunct to a family stressed to the max,” Jensen said. “With kids who are 2 to 5, most can be managed without these medicines. Rarely a 5-year-old goes on them. But a child of 2 or 3, in my experience, I have never had to put them on [an antipsychotic]. There is so much else that can be done.”

The stress and difficulty of coping with a child who has significant mental health issues, the need to have a child behave well enough to be permitted to attend school, as well as lack of adequate coverage for family therapy and mental health services, may push doctors and parents into believing they have little choice other than medicating the child, Jensen said.

More information

The U.S. National Mental Health Information Center has more on children and mental health issues.

SOURCES: Mark Olfson, M.D., M.P.H., professor, clinical psychiatry, Columbia University, New York City; Peter Jensen, M.D., co-director, division of child psychiatry and psychology, Mayo Clinic, Rochester, Minn.; January 2010, Journal of the American Academy of Child & Adolescent Psychiatry

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Source: New York Times

WASHINGTON — A majority of the donations made to the National Alliance on Mental Illness, one of the nation’s most influential disease advocacy groups, have come from drug makers in recent years, according to Congressional investigators.

The alliance, known as NAMI, has long been criticized for coordinating some of its lobbying efforts with drug makers and for pushing legislation that also benefits industry.

Last spring, Senator Charles E. Grassley, Republican of Iowa, sent letters to the alliance and about a dozen other influential disease and patient advocacy organizations asking about their ties to drug and device makers. The request was part of his investigation into the drug industry’s influence on the practice of medicine.

The mental health alliance, which is hugely influential in many state capitols, has refused for years to disclose specifics of its fund-raising, saying the details were private.

But according to investigators in Mr. Grassley’s office and documents obtained by The New York Times, drug makers from 2006 to 2008 contributed nearly $23 million to the alliance, about three-quarters of its donations.

Even the group’s executive director, Michael Fitzpatrick, said in an interview that the drug companies’ donations were excessive and that things would change.

“For at least the years of ’07, ’08 and ’09, the percentage of money from pharma has been higher than we have wanted it to be,” Mr. Fitzpatrick said.

He promised that the industry’s share of the organization’s fund-raising would drop “significantly” next year.

“I understand that NAMI gets painted as being in the pockets of pharmaceutical companies, and somehow that all we care about is pharmaceuticals,” Mr. Fitzpatrick said. “It’s simply not true.”

Mr. Fitzpatrick said Mr. Grassley’s scrutiny, which he described as understandable given the attention paid to potential conflicts of interest in medicine, had led his organization to begin posting on its Web site the names of companies that donate $5,000 or more. And he predicted that other patient and disease advocacy groups would be prodded by Mr. Grassley’s investigation to do the same.

“Everyone I talk to wants to have more balanced fund-raising,” Mr. Fitzpatrick said.

In a statement, Mr. Grassley praised the alliance for its disclosures. “It’d be good for the system for other patient groups to do what NAMI has done,” he said.

Mr. Grassley’s scrutiny has been unnerving for patient and disease advocacy groups, which are often filled with sincere people who are either afflicted with serious illnesses themselves or have family members who have been affected. Many join the groups in the hope of making sense of their misfortune by helping to find a cure or raising awareness of a disease’s risks and frequency.

Drug makers are natural allies in these pursuits since cures may come out of corporate laboratories and the industry’s money can help finance public service campaigns and fund-raising dinners. But industry critics have long derided some patient organizations as little more than front groups devoted to lobbying on issues that affect industry profits, and few have come under more scrutiny for industry ties than the mental health alliance.

For years, the alliance has fought states’ legislative efforts to limit doctors’ freedom to prescribe drugs, no matter how expensive, to treat mental illness in patients who rely on government health care programs like Medicaid. Some of these medicines routinely top the list of the most expensive drugs that states buy for their poorest patients.

Mr. Fitzpatrick defended these lobbying efforts, saying they were just one of many the organization routinely undertook.

The close ties between the alliance and drug makers were on stark display last week, when the organization held its annual gala at the Andrew W. Mellon Auditorium on Constitution Avenue in Washington. Tickets were $300 each. Before a dinner of roasted red bell pepper soup, beef tenderloin and tilapia, Dr. Stephen H. Feinstein, president of the alliance’s board, thanked Bristol-Myers Squibb, the pharmaceutical company.

“For the past five years, Bristol-Myers has sponsored this dinner at the highest level,” Dr. Feinstein said.

He then introduced Dr. Fred Grossman, chief of neuroscience research at Bristol-Myers, who told the audience that “now, more than ever, our enduring relationship with NAMI must remain strong.”

Documents obtained by The New York Times show that drug makers have over the years given the mental health alliance — along with millions of dollars in donations — direct advice about how to advocate forcefully for issues that affect industry profits. The documents show, for example, that the alliance’s leaders, including Mr. Fitzpatrick, met with AstraZeneca sales executives on Dec. 16, 2003.

Slides from a presentation delivered by the salesmen show that the company urged the alliance to resist state efforts to limit access to mental health drugs.

“Solutions: Play Hard Ball,” one slide was titled. “Hold policy makers accountable for their decisions in media and in election,” it continued.

The alliance’s own slides concluded by saying, “We appreciate AstraZeneca’s strong support of NAMI.”

Mr. Fitzpatrick said that the alliance frequently had such meetings and that the organization would fight for better access to mental health drugs “even if we had no relationship with pharmaceutical companies.”

Tony Jewell, an AstraZeneca spokesman, said that the company was “committed to improving health through partnerships with nonprofit organizations” and that “includes striving to ensure people can access our medicines through formularies managed by state Medicaid agencies.”

Source: http://www.lawyersandsettlements.com/blog/generation-of-kids-hooked-on-psych-drugs-0449.html

Campbell Brown anchors a daily prime-time news program on CNN. On June 17, 2009, in a segment of the program called the “Great Debate,” the question was, Ritalin, Prozac, Adderall, are we “pushing pills on our kids and raising a generation hooked on meds.”

Featured in the debate were, Kelly O’Meara, author of the book, “Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills that Kill,” and Dr Charles Sophy, a psychiatrist in private practice in Los Angeles, who serves as medical director of the LA County Department of Children and Family Services. They were each given 30 seconds for an opening statement.

“It’s a two-part problem,” O’Meara explained.

“It’s the diagnosis itself that’s not based in science or medicine,” she pointed out. “There is no objective test that you can give children or adults to prove that you actually have some sort of psychiatric abnormality.”

“And the second part, of course, is the drugging,” she said, “the prescription drugs that are doled out to treat these so-called disorders.”

“I would say that we’re at epidemic levels,” O’Meara stated. “And it’s been going on for a long time.”

Sophy then responded with his opening remarks.

“I would say that I think it’s very important to understand that these are really true symptoms that these children are — are suffering from,” he said.

“Whether they are attached to a true disorder is an issue that maybe can be a debate for science,” he continued.

“However,” he said, “there’s a lot of research behind those disorders.”

“And, remember,” Sophy added, “the medications are used to treat symptoms, to get them out of the way, so those children and those families can benefit from other treatments that will last them lifelong time.”

“Well, I would argue,” O’Meara said, “that the FDA, when they looked at all the clinical trial data for all of the psychotropic drugs, the SSRIs, what they found was that patients did just as well on a placebo as they did on the drug.”

She pointed out that ADHD drugs are stimulants in the category of a Schedule-2 drug.

“The government considers that one of the most serious drugs you can take,” she stated. “It’s up there with morphine, heroin, cocaine.”

“The DEA has said that methylphenidate is equal to cocaine in its effect,” O’Meara said. “So when a parent decides to give their child a psychotropic drug or Ritalin, which is a stimulant, they have to understand, this is the closest thing that we have to cocaine.”

During the debate, CNN viewers were given a number at the bottom of the TV screen to call in their opinions and vote. Of the people who called in, eighty-one percent agreed that we are pushing pills to our kids, and 19 percent disagreed.

According to Dr Grace Jackson, author of “Rethinking Psychiatric Drugs,” and the new book, “Drug-Induced Dementia: a perfect crime,”almost all of the psychiatric drugs either sensitize the brain to other addictions, such as benzos cross-sensitizing to alcohol or stimulants cross-sensitizing to cocaine, or become addictive substances on their own.

For most patients, she says, the use of psychiatric medications ultimately fulfills four of the seven DSM criteria for drug dependence: (1) tolerance; (2) withdrawal; (3) larger amounts consumed, or longer use than intended; and (4) continued substance use despite knowledge of having a persistent problem which is due to that substance.

First, the use of all psychiatric medications is commonly accompanied by habituation or “tolerance,” she reports.

As the brain adapts to the presence of drug treatment, the efficacy of the initial dosing dissipates. It is for this reason that almost all patients return to their doctors, only to have their doses increased over time, she says.

Second, the interruption or cessation of psychoactive drugs almost always results in withdrawal or rebound symptoms such as insomnia, headache, irritability, diarrhea, tingling, and tiredness, Dr Jackson explains.

Third, many patients find that they are unable to tolerate these withdrawal symptoms and this results in chronic or maintenance therapy which lasts much longer than originally intended, she notes.

Fourth, patients find themselves continuing the drugs despite the fact that the treatments are the cause of significant suffering and disability such as impaired judgment when driving, insomnia, sexual dysfunction, or impulsivity, she reports.

Source: Article by Dan Childs and Todd Neale, ABC News

For Ann Hohmann, Oct. 21, 2004, began just about like any other day.

On that morning, the 54-year-old mother of two living in McAllen, Texas, was preparing to take her eldest son to school. She had an early appointment, so her husband, Rick Hohmann, would be dropping off younger son, 14-year-old Matthew, at his school that day.

About a month earlier, Matthew had been diagnosed with attention deficit hyperactivity disorder, or ADHD. And like an estimated 2.5 million other children in the United States, he was taking medication for the condition.

It was Ann Hohmann who gave Matthew his Adderall XR pill that morning with a glass of water. But it was her husband who later found him after he had collapsed on the bathroom floor.

“To me, he seemed fine,” she recalled. “My husband had seen him walking around, brushing his teeth. Then he walked in and found him flat down on the floor in the bathroom.

“When he turned him over, his lips were blue,” Hohmann said.

She said that her husband called her first, and then he called 911. He performed CPR until the ambulance arrived. But it was too late.

“They worked on him for a while, but he was dead,” she said.

Ann Hohmann is one of a handful of parents across the country who believes that their children’s sudden death was due to the use of drugs to control ADHD. And she said she hopes a new study released this morning, which suggests that the use of stimulants is tied to an increased risk of sudden unexplained death among children and teens, will open the eyes of the public to what she sees as the cause of her son’s demise.

“When my doctor gave this to my son, I thought it was a light dose,” she said. “I had no idea that it was going to kill him. It ruined our lives. … There was no warning.”

Findings May Add Fuel to ADHD Drug Debate

In the study of 564 children and teens who died suddenly, researchers led by Madelyn Gould of the New York State Psychiatric Institute and Columbia University in New York City found that that those who died suddenly were 7.4 times more likely than not to have been taking the stimulant medications. The results of the study are reported online in The American Journal of Psychiatry.

“Although sudden unexplained death is a rare event,” the researchers said, “this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment.”

ADHD Medication Concerns Have Arisen in Past

Reports of cases of sudden unexplained death among children taking stimulants for ADHD have raised concerns over use of the medications in the past. The U.S. Food and Drug Administration’s adverse event reporting system identified 11 sudden deaths in pediatric patients taking methylphenidate — the active ingredient in Ritalin and other ADHD drugs — from January 1995 to February 2005.

While this rate of sudden death appears very low, the researchers there may be more cases that go unreported.

In 2006, the issue saw two FDA advisory committees come to opposite conclusions regarding the need to include a boxed warning of the risk of sudden death on the labels of stimulants. Later that year, information was added to the regular warnings section of the medication labels noting the association between sudden death and stimulant use at standard doses in children with serious heart problems.

Currently, however, it appears unlikely that this new study will have an effect on the FDA’s approach to these drugs.

“Given the limitations of this study’s methodology, the FDA is unable to conclude that these data affect the overall risk and benefit profile of stimulant medications used to treat ADHD in children,” the FDA said in a statement released this morning. “Therefore, the FDA believes that this study should not serve as a basis for parents to stop a child’s stimulant medication. Parents should discuss concerns about the use of these medicines with the prescribing healthcare professional.”

The companies that manufacture these medicines maintain that these products are safe and that their risks are properly disclosed.

“Based on several reviews of these reports, the frequency of sudden cardiac death in children and adolescents taking a stimulant medication at the time of their death has not been shown to be higher than the incidence seen in the general population,” Shire Pharmaceuticals, which produces Adderall XR, said in a statement issued Friday before the study’s release.

A spokesperson for Novartis, the company that manufactures the ADHD drug Ritalin, said that a review of the company’s safety data “failed to detect an increased risk in sudden cardiac death associated with [Ritalin] use.” McNeil Pediatrics, the company that manufactures the ADHD drug Concerta, had no comment when contacted by ABC News.

Still, the findings will likely reignite a debate within the medical community over the safety and proper use of the popular medications.

“It is astonishing that these drugs are used so widely with children — 5 percent of the school-aged population on a daily basis,” said William Pelham, professor of psychology, pediatrics and psychiatry at the State University of New York at Buffalo. “When this study is published, I suspect that the professional and advocacy groups that continue to ignore the accumulating evidence showing absence of benefit on long-term outcomes will have a more difficult time defending the widespread practice of using stimulants as first line and sole treatment for ADHD in children.”

Controversy Remains Over Stimulant Drugs for ADHD

Other medical professionals said more research is necessary before making any conclusions. “As far as the study design goes, I’m reminded of the old adage that ‘correlation is not causation,’” said Jay Reeve, chief executive officer of the mental health services organization Apalachee Center Inc. in Tallahassee, Fla. “The downside of this study may be a wholesale rejection of the use of stimulants for children, which would be terrible.

“While caution is an excellent practice in child psychiatry, too many children are helped by the use of these meds … to abandon prescribing these meds entirely,” he said.

Daniel Cox, professor of psychiatry and neurosciences at the University of Virginia in Charlottesville, agreed, adding that he fears the study will have an overall negative effect on the health of these young patients if the public misinterprets its findings.

“This article cannot address a possible large question: How many lives are saved because of stimulant medications,” he said. “How many children do not impulsively run out in the street, are inattentive to a car turning into their lane of traffic, don’t climb out on a roof and fall because they are appropriately medicated and less impulsive and inattentive because of the therapeutic effects?”

Still, Ann Hohmann said that the circumstances behind her son’s death are hard to ignore.

“We didn’t know anything until we saw the death certificate, which said ’sudden cardiac death, myocarditis,’” she said. “When I saw that, it blew me away. How can a healthy 9-year-old have a heart attack?”

And while Shire noted that it provides warning language about the use of these medicines by patients with serious heart problems, Ann Hohmann said that her son had no such history.

“He had seen doctors several times prior to that, and he had a physical a year before that. The last time he saw a doctor, they listened to his heart.”

Keeping Kids With ADHD Safe

Last year, the American Heart Association recommended considering routine heart screening tests known as electrocardiograms, or ECGs, prior to starting children with ADHD on stimulant drugs and called for future studies to assess the risk of sudden death.

Reeve said that he feels such testing could go a long way in determining which children should not be taking the medications.

Some Support Heart Screenings for Kids on ADHD Drugs

“I think that the AHA recommendations on ECG screening made a lot of good sense and go along with the idea that caution should be the first standard in medicating children,” he said.

Not all doctors agreed, however. “There is no evidence that suggests doing [ECGs] on all children taking stimulant medication will decrease incidences of sudden death,” noted Dr. Francisco Xavier Castellanos, professor of child and adolescent psychiatry at the New York University’s Langone Medical Center in New York City. “What we need is to move from spasmodic concern — ‘let’s do something fast’ — to an urgency to get targeted research going that will provide crucially needed knowledge about who is at risk.”

As for Hohmann, she said that she has started telling her friends to make sure that they do not put their children on stimulant ADHD medications. She added that she would advise any parents who had children who were taking an ADHD medication to have their children’s hearts checked on a regular basis, both prior to beginning treatment with the drug and while they are taking it.

“When you lose a child, it’s the most devastating thing you could ever, ever go through,” she said. “Something needs to be done.”

ABC News’ Cathy Becker contributed to this report.

By Stuart A. Kirk, STUART A. KIRK is a professor of social welfare at UCLA. He is the coauthor of “The Selling of DSM” and “Making Us Crazy.” His most recent book is “Mental Disorders in the Social Environment”.

PSYCHIATRIC researchers recently estimated that half of the American population has had or will have a mental disorder at some time in their life. A generation ago, by contrast, only a small percentage of the American population was considered mentally ill. Are we all going mad?

Freud started this. He made us suspicious that any behavior was potentially rife with psychopathology. As a neurologist, he used the medical language of pathology to suggest that the demands of civilization on our fragile human nature were such as to make all of us somewhat neurotic.

The current psychiatric bible published by the American Psychiatric Assn., “The Diagnostic and Statistical Manual of Mental Disorders,” or the DSM, continues this tradition of making us all crazy.

Because there are no biological tests, markers or known causes for most mental illnesses, who is counted as ill depends almost entirely on frequently changing checklists of behaviors that the DSM considers as symptoms of mental disorder. In the recent research, lay interviewers asked a sample of people to respond to lengthy questionnaires based on the DSM lists. Computer programs then counted the responses to determine if those interviewed had ever had the required number of behaviors for any mental disorder at some time in their life.

We keep getting higher estimates of mental disorders in part because the APA keeps adding new disorders and more behaviors to the manual.

Since 1979, for example, some of the new disorders and categories that have been added include panic disorder, generalized anxiety disorder, post-traumatic stress disorder, social phobia, borderline personality disorder, gender identity disorder, tobacco dependence disorder, eating disorders, conduct disorder, oppositional defiant disorder, identity disorder, acute stress disorder, sleep disorders, nightmare disorder, rumination disorder, inhibited sexual desire disorders, premature ejaculation disorder, male erectile disorder and female sexual arousal disorder. If you don’t see yourself on that list, don’t fret, more are in the works for the next edition of the DSM.

Because so little is known about the causes of most mental disorders, just about any behavior can look like a symptom. Here is a selection from hundreds of behaviors listed in the DSM, behaviors that signify one disorder or another: restlessness, irritability, sleeping too much or too little, eating too much or too little, difficulty concentrating, fear of social situations, feeling morose, indecisiveness, impulsivity, self-dramatization, being inappropriately sexually seductive or provocative, requiring excessive admiration, having a sense of entitlement, lacking empathy, fear of being criticized in public, feeling personally inept, fear of rejection or disapproval, difficulty expressing disagreement, being excessively devoted to work and productivity, and being preoccupied with details, rules and lists.

For children, signs of disorder occur when they are deceitful, break rules, can’t sit still or wait in lines, have trouble with math, don’t pay attention to details, don’t listen, don’t like to do homework or lose their school assignments or pencils, or speak out of turn.

Granted, one momentary feeling or behavior will not qualify you as having a DSM mental disorder; it requires clusters of them, usually for several weeks, accompanied by some level of discomfort. Nevertheless, as Freud suggested, the signs of potential pathology are everywhere.

The vast broadening of the definition of mental disorders has its skeptics, myself included, who are suspicious of the motivations of the APA and the drug companies that may view the expanding sweep of mental disorders like a lumber company lusting after a redwood forest. But unlike the environment, with its leagues of watchdogs, the medicalization of human foibles has few challengers. That’s too bad: The misdiagnosis of mental illness often leaves a lasting trail in medical records open to schools, employers, insurance companies and courts.

Does it advance psychiatry to view an increasing expanse of human troubles as the expression of psychopathology rather than as part of the texture and diversity of life? Psychiatry once focused on the prevention and treatment of serious behavioral problems, of which there are plenty. But based on the metastasizing DSM, the psychiatric association appears to be caught up in a contemporary narcissistic quest for individual perfection.

The grand American experiment once was an attempt to structure our social and political institutions to create a more civil and just society. Perhaps, frustrated that we still contend with gross inequality, stinging poverty and rampant political and corporate corruption, we now embrace the perfectibility of individuals, not social institutions.

The public is being asked to swallow the view that all manner of human troubles — from anxiety, interpersonal squabbles to misbehavior of many kinds — be viewed not as inevitable parts of the human comedy, but as psychopathology to be treated, usually with drugs, as expugnable illnesses. The implicit ideal — the healthy, normal and truly happy camper — will, properly medicated, harbor no serious worries or animosities, no sadness over losses or failures, no disappointments with children or spouses, no doubts about themselves or conflicts with others, and certainly no strange ideas or behaviors. Their moods will be perfectly controlled in all circumstances, and bad hair days will be things of the past.

Is it inevitable that the rest of us, the recalcitrant, flawed resisters to the movement for individual perfection, will show up in future counts of the mentally disordered? Count me in.

On May 18, 1999, the New York Times reported that “social phobia ranks today as the third most prevalent psychiatric disorder in the United States……….affecting an estimated 19 million Americans, according to the Anxiety Disorders Association of America. Many are to bashful even to talk to therapists.” In the same week, the Boston Globe reported that “Epidemiological studies have found that acute social anxiety is the third most common psychiatric disorder in the United States………. affecting up to 13 percent of Americans. Jerilyn Ross, president of the Anxiety Disorders Association of America……she hopes a publicity blitz planned by………..SmithKline Beecham will raise awareness of social anxiety disorder and lead more people to seek help, which could include psychotherapy instead of drugs.” Why were the Boston Globe and the New York Times both writing about “social phobia disorder” in the same week, and why would a drug company spend its money to “raise awareness” of a mental-health disorder? The answer: the FDA had just approved a drug for the treatment of social phobia. As the Boston Globe put it, SmithKline Beecham makes the drug Paxil, which was “the first drug approved by the FDA specifically for treating social anxiety disorder.”

Notice how, in the media reports just quoted, the drug company isn’t claiming that the social phobia “disorder” affects millions of people. Rather, it’s an organization with a professional-sounding name, and one that appears to have nothing to do with the pharmaceutical industry: the Anxiety Disorders Association of America. If these claims were presented by a drug company they would likely appear to the public and news organizations as self-serving and biased. If, however, they are presented to the public by an organization that seems only to have the health and welfare of the public in mind, they seem objective and credible. This is certainly what drug-company executives believe, which is why they go great lengths to create and influence what are essentially front organizations for the pharmaceutical industry.

Consider the case at hand. The Anxiety Disorders Association of America, ADAA, receives so much funding and influence from the industry that it is misleading to suggest that they are not an intricate part of it. The Boston Globe and the New York Times both received much of their information for the above reports from an ADAA press release, treating it in just the manner that the industry would want: as objective information from an independent organization. As a reporter for the Chicago Sun-Times makes clear, however, the ADAA is neither neutral nor objective: “I recently received a press release from the Anxiety Disorders Association of America. It said if your child is afraid of going back to school, maybe it’s not normal, maybe your child needs drugs. The release says three children in every class have an anxiety disorder. The solution? Well, enclosed are details for a drug company-sponsored workshop showing the wonders of Paxil and similar drugs.”

With funding coming directly from Paxil’s maker, ADAA did much more than just send out press releases. The summer of ‘99 also saw a barrage of advertising by ADAA, which asked people to imagine being “allergic to people.” A poster they used had a picture of a young man staring despondently into a coffee cup while a happy “social” couple sat at the other end of the table. The implication is made clear by the caption, which reads: “Over 10 million Americans suffer from social anxiety disorder………the good news is that this disorder is treatable.” In addition to a toll free number and a website listed, the poster indicates support, not from a drug company, as it should, but from three nonprofit groups: the American Psychiatric Association, the Anxiety Disorders Association of America and Freedom From Fear, which together form what is called the Social Anxiety Disorder Coalition. Like ADAA, the other two organizations also receive substantial funding from the pharmaceutical industry. “Funding for their public awareness campaign comes from a far less visible partner: SmithKline Beecham, the pharmaceutical giant whose flagship antidepressant is Paxil,” writes Michelle Cottle in The New Republic (August 2, 1999.) Cottle also notes that the APA’s social phobia website is paid for by SmithKline, as is ADAA’s, and that, on July 19, 1999, ADAA would hold a press conference to announce the findings of a study, paid for by various drug makers, suggesting a huge impact of anxiety disorders on America’s productivity. Behind all this is ADAA’s corporate advisory board, which is made up of representatives from different drug companies.

The ties between drug companies and organizations like ADAA do not end with public ads and education. As front organizations, they also direct the public toward support groups that share their two-pronged bias, that the disorder in question is really a legitimate medical disorder in need of medical treatment, and that this treatment will most likely involve psychiatric drugs. The support group is in many ways the most important step in the process of getting people on the latest pharmaceuticals, since it is the support group that will come into direct contact with the individual or parent. At the ADAA website (www.adaa.org), for example, one finds the following description under “Self-Help Support Groups”: Self-help and support groups for anxiety disorders are a way of empowering people to help themselves, and others, on the path to recovery. Participation in a self-help group can end the painful isolation of suffering alone with a disorder that is disruptive and debilitating for the individual and those people around him/her. An effective group will help members achieve recovery through mutual support as well as provide them with updated information about causes and treatment, eliminating some of the myths about anxiety disorders. The ADAA Self-Help Support Group Network is available in nearly all states and various countries around the world. The list of support groups is provided as a service of the ADAA……….The ADAA is constantly listing new groups and updating information about current groups. Please contact– ADAA at 301.231.9350, or by email at self-help@adaa.org for additional information about self-help support groups, including: How to start a group of your own; Adding a new group to the ADAA network; Notification of any changes in a group’s status or contact information. What the ADAA website fails to disclose is that they are there first and foremost to serve the interests, not of the public, but of the pharmaceutical industry, and that the support groups they are recommending are likely to be doing this as well. Consider the case of CHADD.

CH.A.D.D., which somehow translates into “Children and Adults with Attention-Deficit/Hyperactivity Disorder,” asserts on its website (www.chadd.org) the following: With over 22,000 members in 225 affiliates nationwide, CHADD is the nation’s leading non-profit organization serving individuals with Attention-Deficit/Hyperactivity Disorder (AD/HD). Through collaborative leadership, advocacy, research, education and support, CHADD provides science-based, evidence-based information about AD/HD to parents, educators, professionals, the media and the general public.

Clearly CHADD is a powerful organization, and one that is likely to attract many if not most American parents confronting a possible diagnosis of “ADHD” in their child. What is not clear, especially to those who stray into the CHADD web of “support”, is what the organization is really about. Founded in 1987, CHADD, which estimates that 10 to 20 percent of school children have ADHD, organizes speaking events, publishes a monthly newsletter (Chadderbox) and a glossy magazine (Attention!), and operates an impressive website. CHADD claims that “No matter how many sources of information are out there, CHADD is the one you can trust.”

This “trust” depends greatly, however, on what you want from CHADD. If you want an organization that has longstanding ties with pharmaceutical interests, and that selectively recruits only scientists proven to be pro-drug to their advisory board, then you can trust CHADD; if you want an organization that unquestionably embraces ADHD as an inherited disease for which parenting and culture play no role, either as causes or solutions, then you can trust CHADD; and if you want an organization that acts as a powerful lobby for the growing population of ADHD parents and children, then you can trust CHADD. If however, you want an honest organization that acknowledges its pro-drug and pro-disease agenda to its prospective (and current) members, then you cannot trust CHADD; and if you want an organization that carefully considers, or even considers at all, the findings of scientific and epidemiological studies showing that ADHD has strong social and cultural inputs, that psychostimulants may very will cause brain damage, and that psychostimulant drugs work more for parents and teachers than they do for children, then again you cannot trust CHADD.

In October of 1995, the US public television network, PBS, aired a critical “Merrow Report” on CHADD, ADHD, and Ritalin called “Attention Deficit Disorder: A Dubious Diagnosis?”, anchored by John Merrow. The program documented in detail the deception used by the organization, including the concealment of its ties to the drug industry. Starting in 1988, more than $1 million has poured into the organization from the maker of Ritalin (then Ciba-Geigy, now Novartis); CHADD received $748,000 for Ciba/Novartis just in the years 1991-1994. The Merrow Report documented this and showed how, in turn, CHADD did the dirty work of the drug company. They do this by policing media coverage on “ADHD” by propping themselves up as “the” independent, national support organization for “ADHD”and by lobbying the US Government, including the Department of Education, on behalf of Ciba/Novartis. In one instance, CHADD worked vigorously to have Ritalin reclassified by the US Drug Enforcement Administration (DEA) as a less dangerous drug. As a Schedule II drug, Ritalin is considered a potentially addictive drug, with restrictions placed on its annual production quota and with certain states monitoring who and how much the drug is prescribed. Getting it reclassified as a Schedule III drug would mean that it could be touted as being benign and could be obtained more easily. It would also mean that prescription refills could simply be called into the pharmacy, rather than requiring a new prescription each time.

When a senior person at the US Department of Education was interviewed for this program by John Merrow, he was asked whether he knew CHADD received considerable funding from Ciba/Novartis, to which he replied that he had no awareness of such monies. By that time CHADD had obtained a several hundred thousand dollar grant from the Department to make a video about ADHD, and was also helping to author materials for the Department of Education. Yet the Department of Education had no idea of CHADD’s significant ties with the industry. The Department’s spokesperson was then asked if he thought he had been mislead by CHADD, and that the organization was doing the work of the drug company. Indeed he did.

In part because of the Merrow Report, the DEA decided against softening the classification of Ritalin. Instead, it published a report that was highly critical of CHADD. Mary Eberstadt summarizes the report in her 1999 Policy Review article “Why Ritalin Rules: Backed by scores of footnotes and well over a 100 sources in the medical literature, this report amounted to a public excoriation of CHADD’s efforts and meticulous description, alarming for those who have read it, of the realities of Ritalin use and abuse. ‘Most of the ADHD literature prepared for public consumption and available to parents,’ the DEA charged, ‘does not address the abuse liability or actual abuse of methylphenidate [Ritalin]. Instead, methylphenidate is routinely portrayed as a benign, mild stimulant that is not associated with abuse or serious effects. In reality, however, there is an abundance of scientific literature which indicates that methylphenidate shares the same abuse potential as other Schedule II stimulants.’ Ciba-Geigy, the DEA observed, ‘stands to benefit from a change in scheduling of methylphenidate.’ It further observed that……..‘abuse data indicate a growing problem among school-age children,’ that “adhd adults have a high incidence of substance disorders,” and that “with three to five percent of today’s youth being administered methylphenidate on a chronic basis, these issues are of great concern.” Eberstadt also describes how the DEA was contacted by the International Narcotics Control Board (INCB) of the United Nations, which expressed concern to them about the financial ties between CHADD and Ciba/Novartis. According to the DEA, the INCB charged CHADD with being a vehicle for marketing a controlled substance directly to the public, which is a isolation of the Controlled Substances Act of 1971, an international statute to which all signing countries, including the US, are bound.

Despite the dubious nature of CHADD, the organization continues to have enormous power. In 1998, for example, the US National Institutes of Health (NIH) convened a Consensus Conference on whether “ADHD” was a legitimate disorder and whether drugs like Ritalin were effective in treating it, whatever it was. The Consensus Conference consists of a panel of scientists who, after hearing testimony from invited “experts” on the subject, assemble a report that is then published by the NIH. When the Conference was organized, CHADD played a significant role in deciding who would and would not be on the panel. As a result, the report was strongly biased in favor of the disease model of childhood, as well as the use of drugs to “cure” it. With the use of Ritalin and other stimulant drugs rising sharply in the 1990’s, people often wonder if, or believe that, drug companies are conspiring on a continual basis to put more and more kids on Ritalin and other drugs. The actual truth is a bit more complex than this. As the example of CHADD illustrates, as well as the case of “social phobia disorder,” drug companies have a more nuanced method of promoting their interests, which pay off in big dividends long after the money has been spent. Drug companies spend money in a targeted fashion, early on, planting seeds that will grow into an institutionalization of the “problem” and the “treatment” that they are so anxious to sell. Specifically, drug companies realize that they do not really need to push their drugs directly, knowing that once the so-called medical disorder–“ADHD” or “ADD”–is treated as a real medical disorder or disease, drug sales will follow.

As psychiatrist and historian David Healy remarks in his book, The Anti-Depressant Era, “When we stop by the pharmacy to pick up our Prozac, are we simply buying a drug? Or are we buying into a disease as well? Drug companies obviously make drugs, but less obviously they make views of illnesses.” In an early example of this, Healy describes how, in the 1960’s, the drug company Merck, maker of the antidepressant amitriptyline, marketed the idea of depression by buying and distributing 50,000 copies of a book that encouraged the “recognition” and “treatment” of depression in medical settings. A more recent example is a book on obsessive-compulsiveness by psychiatrist Judith Rapoport called The Boy Who Couldn’t Stop Washing. The book was a strong seller and, as Healy points out, Rapoport was featured on various television shows, essentially selling the “disorder.” Rapoport, who was also chief of the US National Institute on Mental Health’s Child Psychiatry Branch, has strong ties with the drug industry. As Peter Breggin, M.D. points out in Talking Back to Prozac, Rapoport was receiving, via a private organization called The Foundation for Advanced Education in the Sciences, considerable funds from at least two drug companies, Eli Lilly and Ciba/Novartis. The method of the pharmaceutical industry madness, David Healy suggests, is now clear: a relatively rare psychological problem is known to exist (such as depression, social phobia or hyperactivity), a drug is “discovered” to have an effect on the problem, the problem is defined as a pervasive and well-defined disorder, and from that moment on, the prevalence of the problem and the use of the drug expand exponentially. Two examples: the rate of depression in the 1950’s was estimated at about 50 million, whereas today it is estimated at 100,000 per million; in 1975, 150,000 American children were said to be “ADD” (or “ADHD”), whereas today it is estimated at about eight million children.

Drug companies sell psychiatric drugs by promoting the “awareness” of so-called mental diseases. Thus, when looking at CHADD and other support-group organizations, the first thing to notice is not how the pharmaceutical drugs are being pushed, but rather how the disorder, “ADHD,” is being sold. Few parents realize what exactly they are buying into when they accept a diagnosis of “ADD” or “ADHD”; nor do they realize that this is what CHADD-like organizations are asking them to do. What is obvious is that the labels of “ADD” and “ADHD” are applied to a diverse group of children who are viewed as having problems with attention, hyperactivity, and/or impulsivity (or are showing poor academic performance.) The label means much more, however, as is shown in casual statements like “my child has ADHD.” Here the label goes from being a loose description to a hard explanation, suggesting that “ADHD” is a physical thing–a problem existing within the child–that is the cause of the behavioral or cognitive problems. This has the effect in turn of isolating the problem within the child–it’s biological and thus a medical problem–setting the stage for the pharmaceutical solution. To be sure, this is exactly what organizations like CHADD mean by “ADHD,” arguing as they do that the problem is physiological one that can be treated but not cured. Notice, however, that there are no medical tests, and there is no proof there is anything biologically wrong with the child. All that exists are the so-called “symptoms,” which are as likely to be symptoms caused by the world of the child as they are evidence of a problem existing with his or her brain. Indeed, how else can we explain relative to earlier generations, why so many children are viewed today as being either impulsive and inattentive?

All this boils down to the following: If you’re a parent wanting unconditional and uncritical support of your choice to give Ritalin or other drugs to your child, then a group like CHADD may be right for you. And if you live in the United Kingdom rather than in the United States, all you need to do is look for the “ADD” or “ADHD” label in the name of the organization, as, for example, in ADDERS, ADDISS, LADDERS, ADDCONTACT, or ADDNET. Unlike UK organizations like Stimulants Are Not The Answer (http://www.santa.inuk.com), OVERLOAD or Successful Learning, these organizations embrace the “ADD” or “ADHD” diagnosis. In doing so they lock themselves within the assumption that “ADHD” is a thing located inside the body, like a disease–a medical disorder–rather than realizing and acknowledging that it is really a diagnosis pushed by the medical and pharmaceutical industries as a means to an unjust economic end, the selling of powerful stimulant drugs. As such these organizations are best viewed as part of the institutionalization of the medical model, whether they know it or not, grown out from root organizations like CHADD, the seeds of which were planted by the pharmaceutical industry.

If, on the other hand, you are someone who’s concerned with the future of your child (or grandchild), knowing that a quick-fix drug solution only masks the problem, then “ADD” support groups may not be for you. Trust not in “ADD” labels and organizations but rather in the belief that all children have the potential to live well-adjusted lives.

Richard DeGrandpre, Ph.D., is a psychologist and independent science writer and has been published in a great variety of both professional and popular publications, including American Psychologist, The Sciences, Common Knowledge, Psychology Today, Cerebrum, and Adbusters. He is the author of RitalinNation: Rapid-Culture and the Transformation of Human Consciousness and Digitopia: The Look of The New Digital You. He is an Associate Editor of AdBusters and resides in Vancouver, British Columbia.

MONROE, Va., July 18 /Christian Wire Service/– “Shut up and pass the Prozac.” That is the consensus of the media in the most volatile round of psycho trash talk in recent memory. Since Tom Cruise kicked it up a notch on the “Today” show with Matt Lauer, all manner of “experts” have weighed in on both sides of the debate.

One of the most articulate and credentialed critics of current psychiatric practices was notably absent, however. Dr. Peter Breggin of The International Center for the Study of Psychiatry and Psychology, was essentially shut out of the debate by the media, at one point being forced to watch a 90-minute-long exchange between Jane Pauley and CNBC’s Donny Deutche, which he was invited to join by link-up, but to which he was never asked to contribute a comment.

Such an insulting slight is beyond the pale, says Debbie Thurman, another outspoken critic of psychiatric over-drugging for so-called brain diseases. Thurman, a journalist, author and Christian family mental health advocate, knows debilitating depression from the inside out .The author of “Outsmarting Depression: Surviving the Crossfire of the Mental Health Wars” also helps other women (and men) recover from it, both individually and in small groups.

“The effectiveness of this type of structured support is as little talked about by the media as complementary and alternative medicine is,” says Thurman. Both approaches to mental health care far outstrip psychiatry’s effectiveness, but the public perception is something entirely different, thanks to slick pharmaceutical advertising.

Thurman, a contributing researcher of mental health issues to Focus on the Family, cites the overwhelming success of ministries like Celebrate Recovery, originating with Rick Warren’s mega-church community in Southern California, as proof that psychiatry is missing the boat in changing lives. “Psychiatry has become a religion unto itself, and Big Pharma is its god” she says. The trouble is, depression and anxiety have increased since the Prozac revolution began in the late ’80s. “We have medicated ourselves into a corner; the system is broken.”

Psychiatry still suffers from an identity crisis, says Thurman. Only last week, the New England Journal of Medicine ran an editorial by a Columbia University physician that appeared to suggest lobotomies actually might have helped some people. Doctors at Columbia University also formulated TeenScreen, the controversial mood assessment tool that even its own co-director says can’t really determine which kids are suicidally depressed.

It is the insidious move within the federal and many state governments to institute universal mental health screening, beginning in our schools, that rankles many pro-family advocates. “The recommendations of the President’s New Freedom Commission on Mental Health would essentially turn our schools into mental health clinics, resulting in a much higher percentage of children on dangerous psychiatric drugs,” claims Thurman. Anyone who doubts that assessment needs only to check out the Texas Medication Algorithm Project (TMAP), the “model” drugging program gushed over by the New Freedom Commission.

Thurman shares this concern with other prominent conservatives, such as Eagle Forum’s Phyllis Schlafly and Concerned Women for America’s Beverly LaHaye. Such pro-family advocates are largely ignored by the media in the mental health debate. “I think TV pseudo-journalists, the American Psychiatric Association and Big Pharma are afraid of us,” says Thurman, “and they ought to be.”

Kirstie Alley and I recently supported 20 doctors from various health care fields, including family physicians, pediatricians, psychiatrists, researchers, nutritionists and surgeons in a letter to the FDA calling on it to strengthen its warnings on stimulants and antidepressants, especially when prescribed to children.

This was in response to the FDA’s recent warning that not only do antidepressants cause hostility and suicidal behavior in children, but also stimulant drugs [June 28 FDA advisory]. The doctors’ letter states: “We can no longer sit back and let the clock tick, waiting for more deaths, suicides or people driven to violent acts by psychotropic drugs. The FDA must continue to be vigilant, to root out other substances that have — one way or the other — slipped under the radar screen, and are now wreaking havoc with the nation’s youth.”

It’s timely, then, to review Arianna’s article four years ago entitled, “’P’ is for Preschoolers and Prozac,” when she called for an “ongoing investigation into the connection between outbreaks of violence and drugs such as Prozac and Luvox,” and that legislators should do so, “before our kids are turned into a troop of drugged-out zombies.”

Parents are still largely unaware that these drugs are turning kids into walking time bombs. Eight out of the last 13 school shooters were taking prescribed psychiatric drugs, and only now is the FDA investigating the fact these drugs can cause violence. Legislators are still not waking up to the need for investigation — despite the Jeff Weise tragedy in March when the teen, after being prescribed an antidepressant, shot dead his grandparents and then classmates and school officials.

Now adding to the alarm bell we have the Partnership for a Drug Free America report that teens don’t consider these drugs dangerous because they are prescribed. However, the DEA classifies them in the same category of highly addictive drugs such as cocaine, opium and morphine. At least 10 percent of teens are abusing the stimulants,

Ritalin and Adderall. A “troop of drugged-out zombies” is frighteningly real. (Watch for Lawrence Bender’s latest movie, Chumscrubber: Meet Generation Rx — an accurate portrayal of the current epidemic of teen prescription drug abuse.)

The recent controversy over these drugs has also raised another important debate: that parents across America are administering them for conditions they have been led to believe are the result of a “chemical imbalance” in the brain or some sort of brain-based disorder. Yet, the medical doctors in their letter to the FDA make it clear that these “potentially harmful substances” are being prescribed for “disorders that have no neurobiological or physical cause.” Even the president of the APA, Steven Sharfstein, recently admitted that there is no “clean cut lab test” to determine a chemical imbalance can cause “mental illness.” This has prompted concerns about the FDA’s drug approval process and why it approves so many psychiatric drugs for what is essentially behavioral control rather than treatment of medical illness.

Perhaps its time to add another “P” to Arianna’s original article title to reflect today’s current drug dilemma: “Preschoolers, Prozac and Pandora’s Box.” The lid is coming off to show these drugs are destroying our youth. Legislators take note: psychiatric drugs, their abuse, and drug-induced violence still needs the investigation Arianna called for in 2000.

WASHINGTON, Aug. 3 — An influential Republican senator says he will propose legislation requiring drug makers to disclose the payments they make to doctors for services like consulting, lectures and attendance at seminars.

The lawmaker, Charles E. Grassley of Iowa, the senior Republican on the Senate Finance Committee, cited as an example the case of a prominent child psychiatrist, who he said made $180,000 over just two years from the maker of an antipsychotic drug now widely prescribed for children.

Mr. Grassley is one of several lawmakers to propose a federal registry of such payments. Minnesota, Vermont and Maine already have similar registries, and other states are considering them.

The proposals are a response to growing concerns that payments from drug makers can affect doctors’ prescribing habits, increase the cost of health care and, in some cases, endanger patients’ health.

The drug industry opposes such registries, saying they would discourage doctors from receiving needed education. John Bentivoglio, a lawyer in Washington who represents drug makers, said the registries would be a burden for the companies and might be misinterpreted.

“One of the concerns is that these payments are seen as bribes,” Mr. Bentivoglio said. “That’s not the case. The vast majority are lawful payments for services.”

In a speech on the Senate floor on Thursday, Mr. Grassley said he had started an investigation into these practices. Noting that most universities require academic researchers to disclose such payments, he said, “I have sent letters to a handful of universities to understand how well such a reporting system actually works.”

These letters have uncovered several problems, Mr. Grassley said. First, universities do not verify the information filed by their professors, so “the only person who knows if the reported income is accurate and complete is the doctor who is receiving the money.”

Also, the universities generally keep this information secret from patients, who have no way of knowing whether their doctor is on a drug maker’s payroll, he said.

“So if there is a doctor getting thousands of dollars from a drug company — payments that might be affecting his or her objectivity — the only people outside the pharmaceutical industry who will probably ever know about this are the people at that very university,” he said.

Mr. Grassley said that he had asked how much the child psychiatrist, Dr. Melissa DelBello at the University of Cincinnati, made from AstraZeneca, the London-based drug giant that manufactures the antipsychotic Seroquel.

Dr. DelBello’s studies of Seroquel in children have helped to fuel the widespread pediatric use of antipsychotic medicines. Those studies were inconclusive, but she has described them as demonstrating that Seroquel is effective in some children.

Asked in a past newspaper interview how much she was paid by AstraZeneca to help market Seroquel, she had said, “Trust me, I don’t make very much.” Mr. Grassley said this week that her disclosure forms at the University of Cincinnati show she received $100,000 from AstraZeneca in 2003 and $80,000 in 2004. Dr. DelBello consults for seven other drug makers as well. She did not respond to requests for comment this week.

Richard Puff, a university spokesman, said he did not know how much Dr. DelBello made in combined payments from all eight drug makers. Asked if the institution did anything to verify its professors’ financial disclosures, he replied, “We do trust our faculty when they’re making these disclosures.”

Mr. Grassley said he would propose that drug makers make public any payments made to doctors who bill the federal Medicare and Medicaid programs, which would include nearly all doctors.

Noting that voters can easily look up the contributions made to elected officials, he asked, “Shouldn’t we hold doctors to similar standards?”

Ryan used to have one to three violent tantrums a day. My husband and I have tried many things to help him recover from this condition. The most effective ones have been:

- Good nutrition and eliminating what he is allergic to. The allergies were determined by tests and simple observation.

- Getting the mercury removed from my son’s body. This is the “toxic brain” Doman mentioned.

- Homeschooling Ryan with the National Association for Child Development program.

Ryan is still autistic, but he can help around the house, feed and dress himself. His academic skills and speech continue to improve. He is also very well-behaved. I can take him anywhere in public.

My husband and I totally altered our lives to do what was best for our son. Drugging him would have made my life easier but would not have benefited my son. Our society is educated into “have a problem, take a pill.” It is a heartbreaking situation when pharmaceutical companies and doctors care more about their profit margin than the well-being and future of a child.

Kitty Young, Clearwater

A dangerous experiment

I commend Robert Farley for his article The atypical dilemma. There is a recklessness involved with the prescribing of antipsychotic drugs. They are being used for purposes and symptoms not approved by the Food and Drug Administration and it’s affecting our growing children – the future of our society.

Such drugs are, in effect, being used in an experimental fashion on the general public, except that it is being done in a completely unscientific manner. This experiment doesn’t even have the same controls nor has it been given the same respect that would be given to an experiment with laboratory rats. The statistics will be found in our future – good or bad.

Have we become a “pill popping” society only looking for a quick fix for our problems? Do we no longer have the time to handle our most prized possessions – our children?

Shouldn’t the FDA be controlling this issue?

Tobie Greenberg, Clearwater

Drugs are not a solution

Thanks for shedding some light on medication as a disastrous solution to educational and behavioral challenges.

I was a second-year teacher in Minnesota when I saw my first drugged third-grader. His parents had put him on medication because he was “nervous.” What seemed strange in 1969 had become the usual by 2000.

Instead of fixing problems that children have with their schools, homes or their bodies, the kids are medicated. It’s thalidomide for the brain for all we know.

Sharon Hillestad, Clearwater

Diet makes a difference

As an educator, I read your cover feature on atypical drugs with dismay, but not surprise. Given the amount of processed junk food, sugar and caffeine consumed by a typical American child on a daily basis, it could be worthwhile to try an alternative that doesn’t solely rely on dispensing dangerous drugs.

On the other hand, there’s not much money to be made with that approach. Therein lies the problem.

Gary Compton, Wesley Chapel

By Robert Farley, Times Staff Writer

More and more, parents at wit’s end are begging doctors to help them calm their aggressive children or control their kids with ADHD. More and more, doctors are prescribing powerful antipsychotic drugs.

In the past seven years, the number of Florida children prescribed such drugs has increased some 250 percent. Last year, more than 18,000 state kids on Medicaid were given prescriptions for antipsychotic drugs.

Even children as young as 3 years old. Last year, 1,100 Medicaid children under 6 were prescribed antipsychotics, a practice so risky that state regulators say it should be used only in extreme cases.

These numbers are just for children on fee-for-service Medicaid, generally the poor and disabled. Thousands more kids on private insurance are also on antipsychotics.

Almost entirely driving this spiraling trend is the rise of a class of antipsychotic drugs called atypicals.

These drugs emerged in the 1990s and replaced the older, “typical” antipsychotics like Haldol or Thorazine, which are often associated with Parkinson-like shakes.

The atypicals were developed to treat schizophrenia and bipolar disorder in adults. But once on the market, doctors are free to prescribe them to children, and for uses not approved by the Food and Drug Administration.

There is almost no research on the long-term effects of such powerful medications on the developing brains of children. The more that researchers learn, the less comfortable many are becoming with atypicals.

Initially billed as wonder drugs with few significant side effects, evidence is mounting that they can cause rapid weight gain, diabetes, even death.

They’re also expensive. On average last year, it cost Medicaid nearly $1,800 for each child on atypical antipsychotics. In the last seven years, the cost to taxpayers for atypical antipsychotics prescribed to children in Florida jumped nearly 500 percent, from $4.7-million to $27.5-million.

Medicaid and insurance companies have fed the problem, encouraging the use of psychiatric drugs as they reimburse less and less for labor-intensive psychotherapy and occupational therapy.

Another factor: Doctors have been influenced by pharmaceutical companies, which have aggressively marketed atypicals.

Whatever the reasons for the soaring use of psychiatric drugs in children, things have gotten out of whack, according to Dr. Ronald Brown. Last year he headed an American Psychological Association committee that looked into the issue.

“The bottom line is that the use of psychiatric medications far exceeds the evidence of safety and effectiveness,” Brown said.

“What people need to do is what’s in the best interest of children instead of what’s in the best interest of people’s pocketbooks. But children don’t vote.”

* * *

The ever-increasing number of kids who come through the doors of pediatrician Esther Gonzalez’s office lead chaotic lives. There’s more divorce and more drug use, more domestic violence and physical and sexual abuse. Working parents are overwhelmed.

“Some parents are so stressed out, they come in seeking a pill,” Gonzalez said. It is easy to medicate kids; “it is very hard to change environment.”

At her practice in Crystal River, she starts with a thorough screening. A child might need occupational, physical or speech therapy. Sometimes, it takes psychiatric drugs.

Despite her concerns about prescribing such medications, Gonzalez has no doubt they have saved many a child from juvenile detention.

Not prescribing drugs to a child who needs them, she said, “it’s like seeing someone dying and not giving them CPR.”

Among her patients is 7-year-old Matthew Peck of Brooksville. His 13-year-old brother and 16-year-old sister show scars on their arms and legs where he has bitten them. He flies into rages, kicks, scratches and pulls hair. He destroys furniture and punches holes in the wall.

His mom, Cathy Peck, said Matthew’s doctors are “leaning toward” a diagnosis of oppositional defiance disorder. And he has attention-deficit hyperactivity disorder (ADHD).

Matthew has taken a 5 mg dose of the atypical Abilify for over two months now. He says “the blue pill” makes him feel like a different person, someone nice.

Peck, a single mother on disability from the Army National Guard, says she worries the drugs may become addictive. And diabetes runs in the family, so that’s a concern. Then again … a few months ago Matthew got hold of a steak knife and destroyed a chair.

“Am I afraid of what the medications might do to him? Yes,” Peck said. “But I am also afraid of what his life would be like without them.”

Matthew and his brother are playing. Suddenly Matthew raises a hand to hit him.

“Gather!” Cathy Peck yells, the trigger word to help Matthew calm himself.

He lowers his hand, shambles over to his mother, curls up behind her. Crisis avoided.

Matthew’s 13-year-old sister, Marradith, said the Abilify works. “He’s a different person. He’s more fun to be around. He doesn’t attack me anymore.”

The meds help, Mom says, but therapy is integral to Matthew’s treatment. She was taking him to eight sessions a week of occupational, speech and language therapy.

Matthew recently had his last occupational therapy session – but not by choice. After six years, Sensations Pediatrics Therapy in Brooksville closed shop on June 15.

That last day of business, Sensations owner Jeff Leonbruno lamented how hard it is for therapists to stay afloat. Particularly with pediatric therapy sessions, he said, there is a high cancellation and no-show rate, often four or five a day. If they don’t show, he can’t charge.

“It’s difficult to make a living at it,” Leonbruno said.

Insurance companies and Medicaid don’t pay enough for therapy, he said. They do, however, pay to reimburse for psychiatric medications.

Over the years, he said, Medicaid priorities have shifted toward the elderly in nursing homes. That has put a pinch on services like occupational therapy for children with behavioral disorders.

“There’s no AARP for kids,” he said.

* * *

Before the FDA approves a new drug, pharmaceutical companies must demonstrate its safety and efficacy. The trials generally are done on adults.

But once the drugs are on the market, doctors are free to prescribe the drug “off label,” outside the scope of the FDA’s indicated use. They also can prescribe it to children.

Except for Risperdal, none of the antipsychotics is FDA-approved for children. The overwhelming majority are prescribed “off label.”

“It is alarming how frequently that is being done,” Brown said. “It’s of concern that it is being done at all.”

A child’s brain and central nervous system are still developing, so drugs work differently on kids than adults, Brown said. “There are no studies that have shown they (atypicals) are safe, or for that matter, that they are effective for children.”

Drug companies have little incentive to invest in such studies, given that their products already are widely prescribed to children off label.

The antipsychotics are FDA-approved for adults with schizophrenia and bipolar disorder, which used to be known as manic depression. But a study by the University of South Florida found that just 8 percent of Florida children prescribed antipsychotics last year had a primary diagnosis of schizophrenia, and 8 percent had major depression. The most common diagnosis, 38 percent, was ADHD.

Even with bipolar disorder, there is considerable debate in the mental health community about whether it is overdiagnosed, particularly in younger children.

Dr. Mark Olfson of Columbia University studied the use of antipsychotics in children and concluded that only a small percentage had psychotic disorders. Most were used to treat mood disorders, depression, anxiety and ADHD – by families and doctors who have tried everything else and are ready to step outside the well-established treatments and take more risks.

“Most child psychiatrists would probably tell you it does work,” Olfson said. “But there is a real need for research, clinical experiments, to determine whether in fact it does work. Given the number of young people, it is a matter of urgency.”

Mental health practitioners say they use more antipsychotics now in part because they are better able to identify some mental illnesses, including autism.

Never mind that the National Autism Association warns against the overuse of atypicals for children with autism. Last year, when Risperdal became the first and only atypical approved for use in children – specifically for irritability associated with autism – the association warned against potentially serious side effects, including lactation in boys, weight gain and development of an often irreversible movement disorder.

Rita Shreffler, the autism association’s executive director, said antipsychotics should be used only for dangerously aggressive children, and even then only for a short “leveling off period.”

Dr. Randall Stafford, an associate professor of medicine at Stanford Prevention Research Center, says off-label prescribing allows doctors the latitude to innovate.

But Stafford was the lead author of a study that concluded that most off-label medication occurs without enough scientific support.

Some prescriptions have become so common, he said, “You have to ask, ‘Where is the data to support this use of the drug?’ It’s not that these off-label uses are dangerous. It’s that we just don’t know.”

* * *

Kate Malloy knows what people will think: Every kid throws tantrums; parents just need to discipline their children.

But with 10-year-old Ryan, she said, the outbursts were beyond aggressive. He seemed outside himself.

A psychologist diagnosed bipolar disorder and recommended they see a psychiatrist.

“You are under the impression that when you go to the doctor you’ll be fixed,” she said. “And that isn’t how it works. They don’t, by any means, have all the answers.”

The ADHD medication Ryan was prescribed only inflamed things, and therapy fell flat. They tried atypicals, first Risperdal. Then Zyprexa. Then Seroquel.

“In the beginning, when the meds weren’t working, I hated them,” she said. “I hated that they were the only option.”

She took Ryan off all the medications and tried an alternative doctor, who recommended dietary supplements. That worked, but only for a while.

She went to Dr. Mark Cavitt, medical director of pediatric psychiatry at All Children’s Hospital in St. Petersburg.

He says mental health practitioners operate in gray areas. The unknowns of the long-term effects of psychotropic drugs have to be balanced against the risk of not treating.

Studies show that atypicals can be effective in modifying aggressive behavior, he said, and that kids who are treated for depression and schizophrenia are less likely to fall prey to pitfalls like drug abuse and teen pregnancy. Then again: “We have to be concerned. There is no such thing as a benign psychiatric medication.”

Dr. Cavitt prescribed Risperdal for Ryan. He couldn’t tell when he was full and gained 15 pounds. When Risperdal stopped working, they switched to Abilify.

Mom hates to think about the possible long-term effects but has more immediate concerns, like, “Will he jump out of a moving car?”

“There are certainly downsides to medications,” she said. “But when medications don’t work, we are pretty much screwed. There are not a lot of options.”

* * *

At the Suncoast Center for Community Health in Clearwater, the focus is on therapy. Drugs are a last resort.

Renee Kilroy, the clinical director, said the sharp increase in psychotropic medications to children is unsettling. “It’s not my belief we need to put more kids on medications. They are still growing and changing.”

Therapy costs more in the short term, she said, but a lifetime of medications is costlier. Suncoast can afford to take the longer view thanks to subsidies it gets from the county’s Juvenile Welfare Board.

More and more, she said, they get referrals from the school system for disruptive kids. Parents tell her that the school has told them their children need to be put on psychiatric medication before they can come back – even though state law specifically forbids that.

* * *

Children younger than 6 generally should not be given psychotropic drugs. According to guidelines from the Florida Agency for Health Care Administration, it should “only be considered under the most extraordinary of circumstances.”

Last year, 1,111 Florida Medicaid children younger than 6 were prescribed antipsychotics.

There is no recommendation for the use of antidepressants in children younger than 6 – yet 629 children were prescribed antidepressants last year.

Using stimulant medications for ADHD should be “rare” for kids younger than 4, the guidelines state, “and only after a failed behavioral intervention such as parent training.” Last year, 367 toddlers 3 and younger were prescribed ADHD medications.

Cavitt said 3-year-olds put on psychotropic medications typically are autistic, mentally retarded or brain injured. They are extremely self-injurious or physically aggressive to others, he said.

Robert Whitaker, a journalist and author of the book Mad in America, says there is no circumstance where it makes sense to prescribe an antipsychotic drug to a 3-year-old.

“It is not a scientific use of drugs,” Whitaker said. “It is an experiment. There is no data showing that they are helpful in a 3-year-old kid. None. Zero. Zip.”

Rather, he said, it is using medication as a controlling device. Whitaker blames a system of “assembly line medicine,” where psychiatrists are afforded less and less time with patients. Atypicals provide a shortcut to dealing with unruly children.

“It mutes your ability to respond to the world, emotionally and physically,” he said. “They make them easier to manage, to others.”

The pharmaceutical companies also help to shape the prescribing patterns, he said. The law forbids them from openly marketing to children off-label, but as any child psychiatrist will tell you, pharmaceutical reps for the atypicals are regular visitors.

Psychiatrists like Cavitt say the reps know the line: They are there only to provide company research and to solicit feedback on the use of their medications.

But Whitaker said it’s clear why the reps for atypicals are in the offices of child psychiatrists: “They do it because they know it’s effective in promoting off-label uses of their drugs.

“They are publicly traded companies trying to maximize their revenues. It increases off-label use, and doctors should quit pretending otherwise.”

Minnesota is the only state that requires public reports of all drug company marketing payments to doctors. A recent New York Times analysis of those records found that doctors who took the most money from makers of atypicals tended to prescribe the drugs to children the most.

* * *

The support group for people whose relatives have committed suicide was unveiling a quilt with squares in memory of each person.

Kathy Pingleton was seated in a plastic chair in the back row when her son’s name was called.

“Brandon Lee Pingleton.”

Her husband, Ken, put his arm around her and they made their way to the front.

Kathy stole a glance at the section of quilt she made in honor of Brandon, a 15-year-old sophomore at Largo High School.

She worried that she made the square too busy. Lots of pictures and buttons to show Brandon’s love of football, soccer and karate.

Kathy reached out a hand to light a candle in his memory. On one finger was a ring made of a guitar string that Brandon used. It reminds her of his artistic side.

Nearly four years ago she and Ken found Brandon hanging in his bedroom, just feet from where they were.

Diagnosed with ADHD, Brandon had landed in a county crisis center after he overdosed on Robitussin and told authorities he was depressed.

When he was released from the center, mom remembers taking him to a psychiatrist. After 5 minutes of evaluation – “How are you sleeping? How is school?” – the doctor doubled his dosage of the atypical antipsychotic Seroquel.

She remembers wondering why he was taking the drug when the Web site said it was for schizophrenia and bipolar disorder.

She hated what the drugs did to him, as did Brandon. He said it made him feel like a zombie.

Seroquel now carries a black box warning that antidepressants may increase the risk of suicidal thoughts in children and teenagers, and that patients should be watched closely.

Those warnings didn’t come until 2004. Brandon hanged himself in 2003.

* * *

Alan Levine ran the state’s Agency for Health Care Administration in 2005. He became so alarmed by the spike in antipsychotics prescribed to children that he contracted with USF to study the trend.

The study found that from mid 2002 to mid 2004, the cost of psychotropic drug prescriptions for kids increased 60 percent. Pacing that increase was an 82 percent jump in spending on atypical antipsychotics.

“It has very quietly grown as a problem,” Levine said.

He wanted to reel it in, but not in a knee-jerk way that might hurt kids who need medications. “There needs to be a more sane and evidence-based approach when prescribing these drugs to children.”

The use of antidepressants and ADHD medications dropped and the growth of antipsychotics slowed over a two-year period, starting in April 2004.

By then, said Robert Constantine at USF’s Louis De La Parte Mental Health Institute, any psychiatrist would have been aware of the metabolic side effects of the new antipsychotics, and, for those taking antidepressants, the dangers of suicidal feelings.

As part of the $3-million state grant, USF was charged with sending out letters to physicians who were regularly prescribing outside the accepted guidelines.

For example, in the first quarter of this year, 315 children on Medicaid got antipsychotics at higher-than-recommended dosage levels.

Another common problem, Constantine said, was the practice of prescribing more than one antipsychotic at a time. Some doctors swear it works, but there isn’t much scientific evidence to back that up. The first three months this year, 274 children were prescribed two or more antipsychotics for an extended period.

Joanne Mills’ 12-year-old son was on 16 medications. At the same time.

“At the time we decided to put him on each one of them there was a good reason for it, or else we wouldn’t have done it,” said Mills, a mother of six in Homosassa.

In the last year, by integrating therapy, she said they have cut her son’s 16 medications to three, including the atypical Seroquel.

He has been diagnosed with ADHD and occasionally explosive behavior. For three years, she had to hold him for three hours a night so he could sleep.

Frustrated to the nth degree, she says you walk into the doctor’s office with a bubble of hope, and walk out 15 minutes later with a handful of prescriptions, for drugs you’ve tried before without any lasting benefit.

“The doctors throw their hands up in the air and say, ‘I don’t know what else to try.’ ”

Times computer-assisted reporting specialist Connie Humburg contributed to this report. Robert Farley can be reached at (727) 893-8603 or farley@sptimes.com.

About the numbers

Most of the statistics in this story are derived from Medicaid data provided by Florida’s Agency for Health Care Administration.

The agency provided the same data to the University of South Florida, which was contracted by the state to study prescribing patterns. As a public service, USF prepared an analysis of the state’s data for the St. Petersburg Times.

The numbers include only children on fee-for-service Medicaid. They do not include children in Medicaid HMOs or those with private insurance.

Some 720,000 children were in the fee-for-service Medicaid program last year, out of some 4.5-million children in Florida. That means the statistics in this story vastly underestimate the entire picture of antipsychotic medications prescribed to children.

The Medicaid numbers were used because the program is taxpayer-funded and the information is public.

The atypicals

A new class of drugs emerged in the 1990s, touted as a better and safer way to treat schizophrenia and bipolar disorder. Here are the atypicals now on the market.

Trade name Drug name Marketed by

Clozaril Clozapine Novartis

Zyprexa Olanzapine Eli Lilly and Co.

Risperdal Risperidone Janssen Pharmaceutica

Seroquel Quetiapine AstraZeneca

Geodon Ziprasidone Pfizer

Abilify Aripiprazole Otsuka Pharmaceutical Co.

Invega Paliperidone Janssen Pharmaceutica

For the past three years, the controversy over antidepressants has largely centered on exploring links between the pills and suicidal behavior, particularly in youngsters. But there has also been considerable chatter about homicidal thoughts.

Several killings around the country have prompted defense lawyers to blame an antidepressant for a killing. Most famously, this occurred in South Carolina, where 12-year-old Chris Pittman claimed Pfizer’s Zoloft prompted him to kill his grandparents. And one of the Columbine killers was prescribed Luvox.

Drugmakers deny such links. And antidepressants remain popular, because psychiatrists say depression can lead to suicide, possibly masking the affects one of these pills may have. And despite FDA black box warnings, many simply feel a potential benefit outweighs a potential risk.

Now, though, the Virginia Tech shooter, Cho Seung-Hui, may cause drugmakers a new round of grief over the antidepressants as reports surface that he was being treated for depression and had been prescribed a medication for psychological problems.

Coincidentally, this tragedy occurs just as JAMA releases a study saying the pills may not be as closely linked to teenage suicide as some say. For drugmakers, this is welcome news. And for the moment, the full details of the Virginia Tech shooting remain unclear and speculative.

However, any indication that the shooter was, indeed, taking an antidepressant while on his rampage is going to reignite the debate over these drugs. And drugmakers should be prepared. Despite the JAMA report, which downplayed the risks, any sign one of these pills may have contributed to the shooter’s mindset could open a whole new chapter on the controversy.

Report on Cho Seung-Hui in The New York Times (registration required);
This week’s JAMA study (subscription required);
Report on Pittman case and Zoloft;
Report on Columbine killer;