The Bitter Pill

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Tracking the American Epidemic of Mental Illness – Part IV by Evelyn Pringle

Tracking the American Epidemic of Mental Illness – Part IV
by Evelyn Pringle

Non-Profit Advocacy Groups

As a main component of the Psychopharmaceutical Industrial Complex, the so-called “patient advocacy” organizations have become the leading force behind the American epidemic of mental illness over the past two decades.

Drug makers, and their foundations, funnel millions of dollars to these non-profits every year. In return, the leaders recruit their members as foot soldiers to carry out the latest marketing campaigns and to provide a fire-wall so that no money trail can be tracked back to the drug companies.

Gigantic Pyramid

The psychiatric front groups form a gigantic pyramid and once pharmaceutical money enters the system through a major organization, it gets channeled into a huge spider-web that weaves through many groups, making it nearly impossible to keep track of where it came from or where it all went. Often, when the grant reports of the drug companies list a large donation to one organization, the annual reports of the other groups will show smaller gifts from that same organization.

The “charity” groups are exempt from income tax and the “contributions” funneled through them are tax deductible. The money is used for disease mongering campaigns to both market disorders and pressure public health care programs and private insurers to pay for expensive treatments.

“Presenting themselves as patient advocacy groups is highly disingenuous not only to their membership, many of which may have a sincere desire to help a loved one or a family member with mental problems, but to legislators, the press and the American public — for they have consistently lobbied for legislation that benefits the mental health and pharmaceutical industries which fund them, and not patients they claim to represent,” according to Citizens Commission on Human Rights International, a mental health watchdog group.

In a June 2, 2010, commentary titled, “Psychiatric Fads and Overdiagnosis,” on the Psychology Today website, Dr Allen Frances points out that it “is too bad that there is no advocacy group for normality that could effectively push back against all the forces aligned to expand the reach of mental disorders.”

The leaders of the supposedly “non-profits” earn outrageously high salaries, along with excellent benefit packages, while many of the patients they claim to represent are encouraged to seek federal disability payments of under $700 a month, and apply for public housing, food stamps, and Medicaid, to make ends meet.  The top officials will often move from a leadership role in one organization to a higher position in another.

The drug makers rely on the front groups to do their bidding any time profits are threatened.  For instance, if the FDA is considering adding a black box warning about a deadly side effect to a drug’s label, which may result in a drop in sales, representatives of front groups will show up at the FDA advisory panel hearings to testify against adding the warning.

They will also lobby FDA panels whenever there is a chance to increase profits, such as enlarging the drug customer base. In June 2009, the Psychopharmacologic Drugs Advisory Committee was set to meet to evaluate AstraZeneca’s Seroquel, Pfizer’s Geodon and Eli Lilly’s Zyprexa for use with 13 to 17 year-olds diagnosed with schizophrenia, and 10 to 17 year-olds diagnosed with pediatric bipolar disorder.

On June 8, 2009, nine front groups issued a joint statement urging the panel to vote to approve all three drugs for kids. The groups signing the letter included the American Academy of Child and Adolescent Psychiatry, American Foundation for Suicide Prevention, American Psychiatric Association, Child and Adolescent Bipolar Foundation, Children and Adults with Attention-Deficit/Hyperactivity Disorder, Families for Depression Awareness, Mental Health America, National Alliance on Mental Illness, and the National Council for Community Behavioral Healthcare.

“As advocates for people living with mental illnesses, we strongly urge the FDA to carefully consider the importance of viable treatment options for bipolar disorder and schizophrenia in pediatric and adolescent populations,” they wrote. “Access to safe and effective treatments, including more information about all treatment options, is crucial to treating these serious and complex conditions in children and adolescents.”

In an obvious attempt to downplay the serious side effects of the antipsychotics, the groups stated: “Other treatments for grave childhood illnesses such as cancer can cause hair loss, nausea, compromised immune systems and even death. However, few people question the necessity of these aggressive forms of treatment.”

“Like cancer,” they wrote, “aggressive treatment may be needed for some patients with bipolar disorder and schizophrenia, diseases with a higher risk of death than some forms of cancer.”

The National Council for Community Behavioral Healthcare only recently began showing up in public pharma campaigns with the other front groups.  Last year it was listed as a supporter of one of the most evil customer recruitment schemes ever devised, targeting the roughly four million pregnant women who give birth in the US each year, through passage of federal legislation known as the “Mothers Act.”

On its website, the Council is described as “a non-profit association representing 1,300 mental health and addictions treatment and rehabilitation organizations.” But a review of the few grant reports available on drug companies found this non-profit received over a half a million dollars since 2008, from Eli Lilly and Wyeth alone.

Lilly’s grant reports shows a $440,000 donation in 2008, and another $25,000 grant in 2009. The Council also received  $20,000 in 2008, and $10,000 in 2009, from Wyeth (now owned by Pfizer). For the first quarter of 2010, Lilly’s lists two grants to the Council totaling $90,000.

The front groups all have “experts” serving on advisory or scientific boards and committees from major universities and government agencies, who have financial relationships with drug makers of one kind or another. Some organizations even have drug company officials, often from marketing and sales departments, sitting on boards and committees. Many of the same people will serve in multiple groups within the pyramid.

For example, Dr Herbert Pardes, a former director of the NIMH, is president of the scientific board of the National Alliance for Research on Schizophrenia and Depression (NARSAD). He is also a past president of the American Psychiatric Association, and served as chairman of the APA’s Council on Research for several years.  A bio on the internet says he is a regular advisor to the National Alliance for the Mentally Ill (NAMI), the Anxiety Disorders Association of American, and Mental Health America. He has also served on the board of TeenScreen and is a charter associate member of the Depression and Bipolar Support Alliance.

Collapse of the Pyramid?

For several years, with Iowa’s Republican Senator, Charles Grassley, leading the charge, the US Senate Finance Committee has been investigating pharmaceutical industry funding, as it relates to marketing practices, involving Continuing Medical Education, consulting arrangements, publications in medical journals, the non-profit professional and patient advocacy organizations, and the conflicts of interest among academics who receive federal funding from the National Institutes of Health through research grants to major universities.

The Committee oversees spending in public health care programs, such as Medicaid and Medicare, for coverage of more than 100 million Americans, including mental health treatment and prescription drugs.

The “drug industry’s most powerful means of boosting the bottom line is funding research, which allows companies to control, or at least influence, a great deal of what gets published in the medical journals, effectively turning supposedly objective science into a marketing tool,” Shannon Brownlee explained in an April, 2004, Washington Monthly report titled, “Doctors Without Borders.”

“By penetrating the wall that once existed around academic researchers,” she says, “drug companies have gained access to the “thought leaders” in medicine, the big names whose good opinion of an idea or a product carries enormous weight with other physicians.”

“Companies target academic KOLs, or Key Opinion Leaders, in the lexicon of marketing, and woo them with invitations to sit on scientific advisory committees, or to serve as members of speakers’ bureaus, which offer hefty fees for lending their prestige to a company and touting its products at scientific meetings and continuing medical education conferences,” she reports.

Grassley’s investigations at major universities turned up more conflicted academics in the field of psychiatry than in any other specialty. His chief investigator, Paul Thacker, developed a system where he would request conflict-of-interest records on psychiatrists from their universities and simultaneously ask drug companies to provide reports on what they paid the same researchers.

Some of the biggest names  in the field appear on the list of psychiatrists who failed to disclose all their financial benefits from drug companies, which thus far includes three from Harvard, Joseph Biederman, Thomas Spencer and Timothy Wilens; Charles Nemeroff and Zachery Stowe from Emory; Melissa DelBello at the University of Cincinnati; Alan Schatzberg, outgoing president of the American Psychiatric Association, and chair of psychiatry at Stanford; Martin Keller, a former chair of psychiatry at Brown; Karen Wagner and Augustus John Rush from the University of Texas; and Fredrick Goodwin, of George Washington University, and also the host of a radio show called “Infinite Minds,” that was broadcast for years by National Pubic Radio.

All of the above “KOLs” have served as officials, or on boards and committees, of major front groups, and many have received awards, consulting and speakers fees, and research funding from various organizations.

Ensuing Outrage

The revelation that millions of dollars have been flowing from drug makers to academics in psychiatry, undetected for a decade, has drawn outrage and demands for more accountability in the entire field. “Financial transparency and full disclosure is not just an advocacy position anymore,” says anti-drugging proponent, Vince Boehm. “This is rapidly becoming the order of the day.”

“While the efforts of advocates were crucial in precipitating this amazing shift in public policy,” he says, “our efforts were unwittingly helped by the massive greed of our opponents and the public furor that ensued.”

“Events such as the Biederman scandal at Harvard and other equally disgusting problems of the same proportions have provoked public outrage,” he points out.

Back on June 18, 2008, Dr Bruce Levine, author of, “Surviving America’s Depression Epidemic,” issued a warning in an Alternet commentary. “If those physicians who are not drug-company shills want to save their profession they might want to start taking aggressive actions against their colleagues who are on the take,” he said.

“Perhaps it will help motivate clean physicians to be reminded that history shows that any institution — no matter how large and powerful — can arrogantly cross those lines leading to its demise,” he advised.

On the Health Care Renewal website, Dr Bernard Carroll, former head of Duke’s   psychiatry department, says the leaders of the major professional and scientific organizations, like the American Psychiatric Association, the American College of Psychiatrists, the American College of Neuropsychopharmacology, and the Society of Biological Psychiatry, may not be stepping up to the plate publicly because “perhaps they are confounded by the awkward fact” that some of the exposed individuals “are current and past presidents of these very organizations.”

They may also be confounded by the “awkward fact,” that all the medical journals, textbooks and other literature put out by the so-called “professional” groups in the field of psychiatry are filled with ghostwritten infomercials, fraudulently crediting the shills on Grassley’s list as authors, with major universities following their names, and nothing short of a mass book burning event will erase all the false advertising.

About a year ago, Grassley asked eight leading medical journals to describe their policies and practices regarding ghostwriting as part of a “broader effort to establish transparency with regard to financial relationships between the pharmaceutical industry and medical professionals,” according to his July 2, 2009 press release.

In a June 16, 2010, letter to the editor of the Miami Herald, Dr John Nardo, a former faculty member in Emory’s Department of Psychiatry, alluded to this problem while complaining about the fact that the University of Miami has “hired a a chairman for the Department of Psychiatry, Dr. Charles Nemeroff, who has become the poster child for what’s wrong with academic medicine in our country.”

“Nemeroff was relieved of his chairmanship at Emory University in Atlanta for failing to disclose conflicts of interest in his publications and presentations,” he said. “That means that he was a well-paid frontman for a number of drug manufacturers.”

“Now it has been revealed that many of his articles were ghost-written by the drug companies and that he recommended a drug, Paxil, as safe for pregnant women when, in fact, it can cause congenital heart defects in newborns,” Nardo wrote.

“One has to wonder what the people at UM are thinking?” he said. “Or if they’re thinking at all?”

Nardo’s letter is related to the latest scandal, in the seemingly never-ending Charles Nemeroff saga, which now involves the Director of the National Institute of Mental Health, Thomas Insel, who apparently worked behind the scenes to help Nemeroff get hired at the University of Miami, after he was kicked off the chair of psychiatry thrown at Emory, according to a June 6, 2010, article by Paul Basken in the “Chronicle of Higher Education.”

Bernard Carroll, who was Nemeroff’s boss for over 6 years while Nemeroff was a professor at Duke, says Nemeroff probably called in some markers. Because back in 1994, Nemeroff found Insel a position at Emory when Insel was facing nonrenewal of a research job at NIMH. And, in addition to being Insel’s boss at Emory, Nemeroff also lobbied for Insel’s appointment as NIMH director, and soon after Insel moved to the NIMH, he appointed Nemeroff as an advisor, Carroll says.

In a November 5, 2009, press release, UM announced Nemeroff’s hiring and described him as “one of the world’s leading experts in the field of psychiatry.”

Although not a peep was said about his fall from grace or the problems Nemeroff caused at Emory, the release stated: “He moved to Emory in 1991 as chairman of psychiatry. There he took an average department to become one of the top ten in the country.”

On January 4, 2010, Ed Silverman posted a Pharmalot blog under the title, “Charles Nemeroff and the House That Glaxo Built,” with a link to a December 30, 2009, headline for a story by BlockShopper, in South Florida, that read: “Psychiatrist spends $1.91M on Miami 6BD.”

“Dr. Charles B. Nemeroff and Gayle Nemeroff bought a six-bedroom, seven-bath home at 1780 Espanola Dr. in Miami from David and Carolyn Shulevitz for $1.91 million on Dec. 4, ” BlockShopper reported.

In addition to pointing out that Nemeroff had taken a new job at UM, Silverman wrote, “the new home appears big enough to house plenty of consulting materials.”

The next day, he informed readers that the first house that Glaxo built for Nemeroff in Atlanta was up for sale at a price of $1.25 million. “This one sports just five bedrooms, but still plenty of room for storing consulting materials,” he wrote.

The Emory investigation found Nemeroff was paid more than $960,000 by Glaxo, from 2000 through 2006, but he listed less than $35,000 on disclosure forms. All totaled, he had earnings of $2.8 million from drug companies between 2000 and 2007, but failed to disclose at least $1.2 million, according to Grassley’s reports.

The real outrage toward Insel stems from the reporting that Pascal Goldschmidt, dean of the UM’s medical school, told Baskin that Insel guaranteed him Nemeroff would be allowed to apply for NIH research grants, even though Emory had suspended Nemeroff’s work on an NIH grant, and in December 2008, placed a 2-year ban on Nemeroff applying for NIH funding. Goldschmidt claimed Emory’s ban “was an immediate reaction to the political pressure that the university was under.”

Further fanning the flames, was the Chronicle’s revelations that Nemeroff is serving on the NIH expert panels that help decide “which grant applications win federal financing,” at a time when there is still an ongoing investigation into the NIH’s lack of oversight of Emory and conflicts of interest involving Nemeroff, by the Department of Health and Human Services Office of Inspector General.

After reading Baskin’s article, Grassley fired off a letter to Daniel Levinson, the Inspector General, on June 7, 2010. “I was extremely disturbed to read a story today in The Chronicle of Higher Education,” he told the IG.

“For almost a year,” he wrote, “Dr. Charles Nemeroff has been under investigation by your office for failing to fully disclose his conflicts of interest regarding his grants from the National Institute of Mental Health (NIMH).”

“During this same time, The Chronicle of Higher Education reports that the Director of the NIMH was assisting Dr. Nemeroff in obtaining a new job and made assurances that Dr. Nemeroff would be able to apply for new NIMH grants,” he said. “I ask that you look into this matter and proceed as you deem appropriate.”

On June 7, 2010, Grassley sent a letter to UM president, Donna Shalala, basically stating the same thing except he told her: “I was also troubled by Dr. Goldschmidt’s comments that a ban against Dr. Nemeroff from receiving NIH grants was ‘an immediate reaction to the political pressure that the university was under.’”

“President Shalala,” he wrote, “I hope that you would agree–contrary to Dr. Goldschmidt’s views that disciplining researchers for failing to disclose conflicts of interest is merely a political issue–that enforcing federal conflict of interest policy involves ethical and legal issues that ensure taxpayer trust.”

In response to the letter, Grassley asked her to provide “all emails and communications by Dr. Goldschmidt,” regarding Nemeroff’s conflicts of interest and Nemeroff’s work and/or grants with the NIH, and “all emails and communications by Dr. Nemeroff,” regarding the same, along with all conflict of interest forms filed by Nemeroff with UM.

Money Laundering Operation

Dr Daniel Carlat, author of the Carlat Psychiatry Blog, and the new book, “Unhinged: the Trouble With Psychiatry,” explains that “much of the continuing medical education (CME) industry in the United States is a legalized money laundering operation,” in a June 10, 2008 blog.

“Rather than paying doctors directly to give accredited CME courses (which is illegal), drug companies pay third party companies to create the courses,” he says. “The checks are actually written by the education company, but the ultimate source is clearly the sponsoring pharmaceutical company.”

The Harvard scandal represents the “perfect storm” of the CME industry money laundering operation, Carlat reported on his blog.

It’s clear that “the majority of money received by these doctors did not come directly from drug companies, but indirectly from various third party companies,” he says. “And this is likely the key to the mystery of why the doctors assumed they could ethically hide these payments.”

After going through the list of payments posted in the Congressional Record, Carlat found it appeared that “the vast majority of the money eventually reported by the Harvard Trio, a combined $4.2 million over 7 years, was drug company money that was laundered and processed to seem like it wasn’t drug company money.”

“The most glaring example,” he says, “comes from Dr. Wilens disclosures.”

Grassley posted slightly more than a third of Wilens’ payments ($612,303 out of a total of $1.6 million). Only $69,915 of this (11%) came directly from drug companies. Most of the money ($542,388) came from various third party companies, many, possibly all of which, are CME companies, Carlat reports.

“The biggest tool the industry has for off-label promotion is continuing education,” says Adriane Fugh-Berman, an associate professor at Georgetown University Medical Center, involved with a program called PharmedOut, created to educate doctors about the prescribing influences of big drug companies, in the Star-Ledger on June 6, 2010.

“Physicians have freedom of speech and aren’t under the same constraints as industry employees,” she explained.

When drugs are prescribed for off-label or unnecessary uses, public health care programs not only have to pay for the drugs, they must also pay the prescribing doctors’ fees and the cost of medical care for any injuries caused by the drugs.

Government spending tied to psychiatric drugs has gone through the roof in the past two decades due to the bilking of public programs. And no doubt as a result, pharma CEOs are earning over the top pay packages.  In 2008, the head of J&J pulled in $29.1 million, Abbott Labs’ CEO took home $28.3 million, the top dog at Bristol-Myers earned over $23 million, Lilly’s CEO pulled down close to $13 million, Pfizer’s took home over $15.5 million, Wyeth’s CEO earned nearly $26 million, and Forest Labs’ top official was paid more than $6.5 million, according to the AFL-CIO’s “Executive Pay Watch” website.

American Psychiatric Association

Early on in his investigation, Grassley asked the “American Psychiatric Association,” for an accounting of money received from drug companies and foundations created by drug companies.  In 2006, the industry accounted for about 30% of the Association’s $62.5 million in financing, or about $18.75 million, according to the New York Times.

The 38,000 member APA describes itself as “a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses.”

The outgoing president of the APA is Alan Schatzberg, the same guy whose name appears on the Grassley list.

The “American Psychiatric Foundation,” is the charitable and public educational arm of the APA, according to its website.  In 2009, the Foundation’s 15 member board of directors included four Vice Presidents from the drug companies Pfizer, Eli Lilly, and J&J’s Janssen Pharmaceutica division.

On its website, the Foundation identifies drug companies that donate but does not give the exact amount. For example, AstraZeneca, Bristol-Myers, Lilly, Forest, Janssen, and Wyeth are listed as giving “$40,000 and above.” However, the few grant reports publicly available show drug companies may be giving more than ten times that amount. Lilly donated $450,000 to the Foundation in 2007, in addition to the $400,000 given to the American Psychiatric Association.

The Foundation also received one grant from Lilly for $241,915 in 2009, and another $20,000 donation to fund the Foundation’s Newsletter. The Foundation received $102,961 from Pfizer, and $205,400 from Wyeth, in 2009, as well.

In the first quarter of 2010, the Foundation received grants from Lilly of $36,000, $10,000 and $18,000. Pfizer gave the Foundation $20,000 in the first quarter of 2010.

Pfizer’s 2008 grant report shows donations of more than $700,000 to the American Psychiatric Association. Lilly gave the APA grants totaling more than $600,000 in both the first and second quarter of 2008. Wyeth donated $43,831 in 2008.

Lilly’s 2009 report shows the APA received four grants of $154,575, $142,575, $142,575, and $154,575. Pfizer gave the group $250,000 in 2009.

The American Psychiatric Institute for Research and Education (APIRE), is another philanthropic arm of the APA, established in 1998 “to establish the leadership role of the APA in contributing to the scientific base of psychiatric practice and policy,” with a stated mission to “improve the quality of psychiatric care through research, education, health policy analysis, and dissemination.”

For the March 6, 2010, paper, “Pharmaceutical Philanthropic Shell Games,” in Psychiatric Times, Lisa Cosgrove, PhD and Harold J. Bursztajn, MD, investigated the financial relationships of the APIRE board members with pharmaceutical companies that manufacture psychiatric drugs and found 9 of the 16 board members have industry ties.

“The fact that over half of APIRE’s board has financial ties to industry is problematic, and it is noteworthy that this percentage is a highly conservative estimate,” they wrote.

“Current disclosure policies do not require reporting of pooled industry monies (eg, when companies give large sums of money to academic departments, units, hospitals, and medical schools)—even when direct benefit, such as salary, may be derived from pooled funds,” they point out.

In addition, one board member who reported “no disclosure” in an APA publication “was found to be on the speakers’ bureau of multiple pharmaceutical companies,” they note.

The APA is currently revising psychiatry’s billing bible, the DSM-V.  “Approximately 68% of the members of the DSM-V task force reported having industry ties, which represents a relative increase of 20% over the proportion of DSM-IV task force members with such ties,” Cosgrove and Bursztajn report.

“Also, of the 137 DSM-V panel members who have posted disclosure statements, 77 (56%) have reported having industry ties, such as holding stock in pharmaceutical companies, serving as consultants to industry, or serving on company boards—no improvement over the 56% of DSM-IV members who were found to have such industry relationships,” they point out.

The APA also issues “Clinical Practice Guidelines,” with recommendations for the use of specific drugs for mental disorders. “Ninety percent of the authors of 3 major clinical practice guidelines in psychiatry had financial ties to companies that manufacture drugs explicitly or implicitly identified in the guidelines as recommended therapies for the respective mental illnesses,” according Cosgrove and Bursztain.

They also found the corporate advisory council of the Foundation “is made up of pharmaceutical companies that contribute significant funding to APF and that manufacture medications recommended in the APA’s CPG.”

On June 11, 2010, the Wall Street Journal reported that the APA “has seen a $7.5 million decrease in pharmaceutical industry dollars over the past year – a more than 10% cut in revenue, which funds its research and education activities.”

“The biggest changes at the APA have come at its money making annual meeting,” the Journal said. “Over the past three years it has been phasing out industry sponsored symposia – dinners and talks.” This translated to a loss of $1.8 million to $1.9 million in industry funding between 2008 and 2009, an APA official told the Journal.

However, according to Martha Rosenberg’s coverage of the group’s annual meeting in a May 31, 2010, Scoop article, although 200 protestors were chanting “no drugging kids for money,” and “no conflicts of interest,” at the convention hall, “polarizing figures” were still present at this year’s event.

For instance, she writes: “Sitting next to outgoing APA president Alan F. Schatzberg, MD, even as protestors chanted outside, was Charles Nemeroff, MD, former psychiatry chairman at Emory University who was investigated by Congress.”

“And a paper presented about attention deficit hyperactivity disorder (ADHD) was co-written by Harvard’s Joseph Biederman, MD, also investigated by Congress for pharma financial links and considered the father of the pediatric bipolar disorder craze,” she reports.

“Nemeroff was signing the Textbook of Psychopharmacology which he co-edited with Schatzberg, also investigated by Congress. Schatzberg, psychiatry chairman at Stanford, consults to seven drug companies, owns stock and patents with others and is on Sanofi-Aventis’ Speakers Bureau according to the meeting’s Daily Bulletin,” she wrote.

National Alliance on Mental Illness

Last year, the National Alliance on Mental Illness became the first patient advocacy group to come under investigation by Grassley’s Committee. In a letter to Michael Fitzpatrick, Executive Director of NAMI, in April 2009, Grassley asked for “an accounting of industry funding that pharmaceutical companies or foundations established by these companies have provided,” to NAMI since January 2005.

“Based upon reporting in the New York Times,” Grassley said, “I have come to understand that money from the pharmaceutical industry shapes the practices of non-profit organizations which purport to be independent in their viewpoints and actions.”

“Specifically, it is alleged that pharmaceutical companies give money to non-profits in an attempt to garner favor in ways that increase sales of their products,” he explained.

The disclosures provided to Grassley revealed that the National NAMI group receives nearly two-thirds of its funding from the pharmaceutical industry.  Between 2006 and 2008, drug companies, and their foundations, gave the group almost $23 million.

After receiving Grassley’s letter, NAMI’s executive director sent out an email to many NAMI supporters and stated in part:  “NAMI does not engage in product promotion, endorsement, licensure or certification of any product, service or program owned by a corporate sponsor.”

However, Philip Dawdy pointed out the falsity of that claim on his Furious Seasons website. “Fitzpatrick has certainly engaged in product pimpery for J&J/Janssen,” he wrote in his daily blog. To substantiate the “pimpery” charge, Dawdy provided a link to a blog he wrote on December 21, 2006, in response to a J&J press release put out to promote its Risperdal’s me-too drug, Invega, with Fitzpatrick praising the drug using his official title of “Executive Director, National Alliance on Mental Illness.”

“New and efficacious treatment options, like INVEGA, provide significant opportunities for more people with schizophrenia to manage their disease as they work with their treatment teams to live more fulfilling and productive lives,” Fitzpatrick stated in the press release.

In her book, Side Effects, Alison Bass tells a story of how James McNulty, NAMI president from 2002 to 2004, failed to disclose that he was being paid thousands of dollars by drug companies to promote their products to NAMI members, and others, at speaking engagements. “In a particularly intriguing twist,” she notes on her website, “McNulty laundered this drug company money through a state chapter of NAMI.”  Bass further explains how the scheme worked for funneling the cash to McNulty:

“He would be paid thousands of dollars to speak about the benefits of various antidepressants — McNulty himself suffered from depression — and rather than pay him directly, companies such as Eli Lilly, the maker of Prozac, Pfizer, the maker of Zoloft, and GlaxoSmithKline, which made Paxil, would give his speaking fees to the Rhode Island chapter of NAMI, which would then cut McNulty a check.”

On May 8, 2008, when the APA announced the members of the work groups who would develop the DSM5, James McNulty was listed as a task force member with an expert qualification of “President Emeritus,” of NAMI.

Each year, NAMI gives awards to “Exemplary Psychiatrists,” at its annual banquet.  In 2008, a May 5,  press release reported that “support for the awards” is provided by Eli Lilly and Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.

NAMI was named as a defendant, right along with Pfizer, in a Medicaid fraud lawsuit filed by whistleblower, Mark Westlock, involving the illegal promotion of Geodon. Pfizer “conspired” with NAMI to act as a front organization in the off-label promotion of Geodon, the complaint says. Pfizer turned “NAMI into a Trojan Horse for the illegal marketing scheme to promote Geodon,” for use with children on the NAMI website.

Laurie Flynn, the former executive director of NAMI, and current leader of Columbia University’s TeenScreen, even went so far as to claim that with the advent of atypical antipsychotic medicines “the long-term disability of schizophrenia can come to an end,” the complaint alleges.

In addition to Geodon, the drugs currently marketed by Pfizer, through NAMI and the pyramid of front groups, include the antidepressants Zoloft, Nardil, Sinequan, Effexor and Pristiq, Xanax for anxiety, the anticonvulsants, Neurontin and Lyrica, and the anti-smoking drug, Chantix, and the ED drug, Viagra.

In September 2009, the US Department of Justice announced that Pfizer would pay the largest single criminal fine, and largest combined federal and state health care fraud settlement in the history of the DOJ. The company agreed to pay $2.3 billion, with $1.3 billion in criminal fines, “to resolve criminal and civil health care liability relating to fraudulent marketing and the payment of kickbacks,” according to the government’s “Stop Medicare Fraud Website.”

The charges included paying kickbacks to health care providers to “induce them to prescribe,” or “in connection with marketing,” for a list of thirteen drugs that included Geodon, Zoloft, Lyrica and Viagra. The six whistleblowers received a combined total of roughly $100 million for helping the government.

Brian Kenney and Tavy Deming of the Pennsylvania firm of Kenney Egan McCafferty & Young, represented the Geodon whistleblowers. The off-label marketing allegations were first made in a lawsuit filed on behalf of Harrisburg psychiatrist, Dr Stefan Kruszewski.

The antipsychotic was approved only for adults with schizophrenia or acute manic or mixed episodes of bipolar disorder, but Pfizer illegally promoted it for off-label conditions that included depression, bipolar maintenance, mood disorder, anxiety, aggression, dementia, ADHD, obsessive compulsive disorder, autism, PSTD, and for pediatric, adolescent and geriatric patients, according to the complaint.

Less than “5% of the United States population is diagnosed with schizophrenia or bipolar disorder, yet in 2008 Geodon surpassed the blockbuster benchmark of $1 billion in sales,” Attorney Deming reported in a September 2, 2009 press release.

As part of its marketing campaign, Pfizer claimed that Geodon had a safe metabolic profile when compared to other antipsychotics, such as Zyprexa, Seroquel and Risperdal, and urged doctors to switch patients to Geodon. The switching campaign “endangered patients by ignoring or materially understating Geodon’s serious, and even life threatening, side effects,” Attorney Kenney said in the press release.

On September 3, 2009, Kruszewski told the Philidelphia Inquirer that Pfizer sales representatives pushed him to prescribe Geodon to children for such symptoms as anxiety and agitation.

“Pfizer targeted pediatrics and adolescents to expand off-label use and maintained on its payroll an army of more than 250 child psychiatrists nationwide,” Kenney reported in the press release.

“Pfizer regularly paid generous speaking fees to these child psychiatrists to give what were basically promotional lectures about the benefits of Geodon to their peers, who were naturally also child psychiatrists,” he said.

Apparently, NAMI will continue on with business as usual, except now it will disclose the amounts of Pharma gifts.  In 2009, NAMI received 84 payments over $5,000 from different sources, according to an April 2010, analysis by John Mack, on his popular Pharma Marketing Blog. Of payments totaling $4,737,610, Mack found $3,836,750, or 81%, came from major drug companies, with the largest amounts coming from antipsychotic makers, including $1,255,000 from AstraZeneca, followed by Lilly with $750,500, and Bristol-Myers giving 506,250.  Wyeth’s 2009 grant report shows donations to all NAMI groups totaling $268,000.

In October 2009, Grassley sent letters to all fifty state NAMI chapters asking them to disclose income from pharmaceutical companies and their foundations. On April 26, 2010, Grassley sent a letter to the leaders of NAMI National and included a chart showing the top 10 state chapters receiving the most money from January 2005 to October 2009, totaling $3.84 million.

Also in October 2009, NAMI CEO Fitzpatrick told the New York Times:  “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,” and promised the industry’s share of NAMI fund raising would drop “significantly” in 2010.

However, NAMI’s grant report for the first quarter of 2010, shows the group received $1,247,128 from drug companies and foundations, or only $2,212 less than the $1,249,340 it received in the first quarter of 2009. So far this year, Lilly gave NAMI groups over $84,000, and Pfizer’s report shows $78,000 went to NAMI groups.

Conspicuously missing from NAMI’s 2010 first quarter report is AstraZeneca, being the Seroquel maker gave the National group $905,000 in the last quarter of 2009. It may be that Astra was too busy rounding up the more than $520 million it agreed to pay the Federal government and State Medicaid programs in April 2010, to resolve fraud allegations related to the off-label marketing of Seroquel.

“Illegal acts by pharmaceutical companies and false claims against Medicare and Medicaid can put the public health at risk, corrupt medical decisions by health care providers, and take billions of dollars directly out of taxpayers’ pockets,” said Attorney General, Eric Holder, in an April 27, 2010, DOJ press release.

But Astra can’t be hurting financially because in 2008, even though it makes up only about 5% of the world population, the US accounted for over $3 billion of the roughly $4.45 billion in world-wide Seroquel sales. It was Astra’s second-best selling drug that year, behind the heartburn drug Nexium, and the fifth top selling drug in sales overall in the US. The price of Seroquel at DrugStore.com that year was $839 for hundred middle dose tablets in December 2008. By August 23, 2009, the price had increased by $50 to $890 for the same number of pills.

“A half a billion dollar one-time settlement is just a small cost of doing business for a company that sold $17 billion worth of the offending drug in the last five years,” Dr Roy Poses points out on the Health Care Renewal website.

“This was a well thought out marketing campaign that operated on many levels,” said Brian Kenney, one of the attorneys who again represented, Dr Kruszewski, one of two whistleblowers in this case as well, in an April 28, 2010 press release.

“AstraZeneca orchestrated scientific studies, ghost written articles, and the payment of large fees to academic psychiatrists to act as ‘thought leaders’ to promote the drug off label,” he noted.

“The success can be seen in the huge numbers the campaign generated with 4.9 billion in sales in 2009,” Kenney pointed out.

“It’s particularly disconcerting that AstraZeneca successfully co-opted large portions of psychiatric academic community,” he added.

“The manipulation and misuse of Seroquel scientific data to support AstraZeneca’s off-label marketing campaign was the most disturbing aspect of the case to me,” Kruszewski said in the press release. “There were strong indications from AstraZeneca’s earliest clinical trials that Seroquel increased the risk of diabetes and induced profound sedation out of proportion to its weak antipsychotic effects.”

“In the elderly population, they basically marketed Seroquel as an expensive sleeping pill and put hundreds of thousands of patients at risk for serious medical complications, premature cardiovascular disease, pneumonias, and premature death,” he reported.

In addition to paying $520 million, Astra had to enter into a 5-year corporate integrity agreement that requires the company to post information about payments to doctors on its website, which no doubt will include payments funneled through front groups like NAMI, for Continuing Medical Education programs, speaker fees, research grants, and the various awards given out each years.

Because according to the DOJ press release, the government contends that Astra “promoted the unapproved uses by improperly and unduly influencing the content of, and speakers, in company-sponsored Continuing Medical Education programs.”

“The company also engaged doctors to give promotional speaker programs on unapproved uses for Seroquel and to conduct studies on unapproved uses of Seroquel,” it says. “In addition, the company recruited doctors to serve as authors of articles that were ghostwritten by medical literature companies and about studies the doctors in question did not conduct. AstraZeneca then used those studies and articles as the basis for promotional messages about unapproved uses of Seroquel.”

According to a recent report by Jim Edwards on BNET, former NAMI policy director and board member, Jim Dailey, was a paid consultant for Astra’s Seroquel marketing team, and was paid $600, plus airfare and limousine service, to attend one Seroquel consultant meeting in December 2003.

A picture taken at the meeting shows Daily, along with current NAMI CEO,  Fitzpatrick, and Chuck Harmon, NAMI director of corporate relations, meeting with several Astra sales executives. The agenda for the meeting was: Seroquel vision, Role of Advocacy Groups, Increasing role of State/Medicaid with MH issues and MAP initiatives, and Ensuring access for patients.

Edwards explains that “MAP” sometimes stands for “Medication Algorithm Project.” NAMI, along with J&J’s Robert Wood Johnson Foundation, is identified in a Medicaid fraud lawsuit filed against J&J by former federal fraud investigator, Allen Jones, and joined by the Texas attorney general, as participating in off-label marketing schemes to increase the sales of Risperdal, including the “Texas Medication Algorithm Project,” and “Texas Children’s Medication Algorithm Project.”

Latest Plan of Attack

On June 17, 2010, under the headline, “Psychotropic Drug Abuse in Foster Care Costs Government Billions,” Politics Daily reported that the Senate Subcommittee on Federal Financial Management, has asked the Government Accountability Office to look into the drugging of foster care children, who are typically concurrently enrolled in Medicaid.

“The investigators will attempt to account for estimates in the hundreds of millions of dollars of possible fraud arising from prescriptions for drugs explicitly barred from Medicaid coverage,” according to the report.

“Often young patients under state supervision are also prescribed three or four high-risk drugs at a time — all paid for by Medicaid,” it pointed out.

“The GAO is collecting data from Oregon, Massachusetts, Florida, Maryland, Minnesota and Texas, to search for patterns of abuse,” Politics said. “This effort marks the first time suspicion of Medicaid fraud related to psychotropic drugs has been examined at the federal level.”

Alaska attorney, and founder of the Law Project for Psychiatric Rights, Jim Gottstein, told Politics that the increase of antipsychotic use in foster care amounts to “drug companies sacrificing children’s lives on the altar of corporate profits.”

In attempt to put a stop to the rampant off-label psychiatric drugging of foster kids, and other children on Medicaid, in Alaska, Gottstein and PsychRights have filed a Medicaid fraud lawsuit against a number of prescribing doctors, drug companies, pharmacies, and insurance companies in that state.

After learning NAMI was pulling in two-thirds of its funding from Pharma, Grassley sent disclosure requests to over 30 more non-profits. The final part in this series will cover the psychiatric front groups contacted including the Depression and Bipolar Support Alliance, Mental Health America, the National Alliance for Research on Schizophrenia and Depression, Screening for Mental Health, Children and Adults with Attention Deficit/Hyperactivity Disorder, and the National Center for Mental Checkups at Columbia University, or better known as TeenScreen.

Evelyn Pringle

(This series is sponsored by the International Center for the Study of Psychiatry and Psychology http://icspponline.org/index.html)

(Evelyn Pringle is an investigative journalist focused on exposing corruption in government and corporate America)

Filed under: pharmacology

Tracking the American Epidemic of Mental Illness – Part III by Evelyn Pringle

Tracking the American Epidemic of Mental Illness – Part III
by Evelyn Pringle

The Psychopharmaceutical Industrial Complex

For the past two decades, the Psychopharmaceutical Industrial Complex has been the driving force behind the epidemic of mental illness in the United States with the promotion of biological psychiatry and a bogus “chemical imbalance” in the brain theory.

The Psychopharmaceutical Industrial Complex (PPIC) is a symbiotic system composed of the American Psychiatric Association, the pharmaceutical industry, public relations and advertising firms, patient support organizations, the National Institute of Mental Health, managed care organizations, and the flow of resources and money among these groups, according to an October 1, 2009 paper in the Journal of Mental Health Counseling, by Dr Thomas Murray, director of Counseling and Disability Services at the University of North Caroline School of Art.

Murray’s paper draws parallels between cult indoctrination and PPIC techniques and notes the similarities between cult members and mental health consumers who are vulnerable to losing their identities to the PPIC.

The PPIC and “its adherence to the disease model pervades mainstream culture and greatly impacts psychotherapy,” he says. “Consequently, the effects of the PPIC may have resulted in some psychiatric consumers adopting disease-model messages in ways similar to cult indoctrination.”

“Consumer adoption of the disease model can create obstacles to treatment when hope is fundamental,” he advises.

Murray says his most difficult cases “involve clients who have in essence been drawn into the PPIC and have become resigned to the disease model with little sense of empowerment to overcome their emotional problems.”

“These are the consumers who have little self-efficacy and little hope that they have options other than to suffer,” he reports.

“Insurance companies rely on pharmaceuticals to contain costs (and limit psychotherapy sessions), and reimbursement depends on a diagnosis of a diseased brain,” Murray notes.

For psychiatrists, insurance “companies typically encourage short medication visits by paying nearly as much for a 20-minute medication visit as for 50 minutes of therapy,” according to the April 19, 2010, New York Times article, “Mind Over Meds,” by Dr Daniel Carlat, author of the Carlat Psychiatry Blog, and the new book, “Unhinged: the Trouble With Psychiatry.”

Psychiatrists have become enthralled with diagnosis and medication and have given up the essence of their profession – “understanding the mind,” Carlat reports in his book.

“We have become obsessed with psychopharmacology and its endless process of tinkering with medications, adjusting dosages, and piling on more medications to  treat the side effects of the drugs we started with,” he says. “We have convinced ourselves that we have developed cures for mental illnesses … when in fact we know so little about the underlying neurobiology of their causes that our treatments are often a series of trials and errors.”

Back in December 2003, a study in Psychiatric Services on “financial disincentives” for psychotherapy noted that psychiatrists could earn about $263 an hour doing three 15-minute “medication management” sessions, verses about $156 for a 45 to 50-minute therapy session, representing a pay cut of close to 41% per hour for doing therapy only.

The most common excuse given for the high rate of prescribing psychiatric drugs is that talk, behavioral, cognitive or other forms of non-drug treatment cost too much. However, in 2008, more than $24 billion worth of antidepressants and antipsychotics were dispensed. “Such expenditure would employ 240,000 psychotherapists earning an annual income of $100,000 to provide 6 million hours of psychotherapy averaging 25 client-hours a week,”  Murray estimates.

These figures do not include what would be possible using the additional revenue generated by the sales of antianxiety, hypnotic, and psychostimulant drugs, he says.

Drug Makers Pay Prescribing Shrinks Top Dollar

Vermont is one of the few states that requires pharmaceutical companies to disclose the money spent on marketing drugs to prescribers each year. In 2009, the report by the state’s Attorney General, showed that during the period July 1, 2007, through June 30, 2008, pharmaceutical companies spent approximately $2.9 million, in a state with a population of less than 609,000, on consulting and speaker fees, travel expenses, gifts, and other payments to or for physicians, hospitals, universities and others authorized to prescribe or dispense pharmaceutical products.

“The greatest amount of expenditures went to psychiatrists as a group, totaling nearly half a million dollars; one psychiatrist received over $112,000, the greatest amount of pharmaceutical marketing dollars spent on any single person,” the report states.

Eleven psychiatrists made the top 100 recipients list with an average payment total of $43,473.  Shrinks also received the highest pay in 2007, when 11 earned a total of $626,379, or about 20% of the total payments made that year.

The top five spenders in last year’s report were Eli Lilly, Pfizer, Novartis, Merck and Forest Pharmaceuticals, with $242,730 listed for the promotion of depression medications and $217,983 for ADHD drugs.

Lilly was the top spender in Vermont for 3 years in a row. The company’s psychiatric drug portfolio includes Zyprexa, Prozac, Cymbalta, Strattera, and Symbyax, a combination of Prozac and Zyprexa.  A list of drugs in the report shows the most marketing dollars went for Lilly’s ADHD drug Strattera and spending on its antidepressant Cymbalta was second.  Forest’s Lexapro ranked fifth and Pfizer’s atypical antipsychotic Geodon was in the thirteenth position.

The drug makers now even have general practitioners wildly writing prescriptions for psych drugs. A study in the September 2009 journal, Psychiatric Services, reported that 59% of prescriptions for mental health drugs in the US are written by family doctors, not psychiatrists.

Drug Peddling in the Military

In a joint project with Northwestern University’s Medill School of Journalism, the Center for Public Integrity reviewed travel disclosure forms filed by Department of Defense personnel from 1998 through 2007, and found the medical industry was the largest sponsor of free travel, accounting for about 40% of all trips.

According to their June 2009 report, “Pentagon Travel,” there were 8,700 trips by DOD personnel paid for by the healthcare industry, at a price tag of more than $10 million, with sponsors that included drug and device makers as well as health foundations and trade groups often funded by those companies.

“Drug companies and device manufacturers spent about $1.7 million for more than 1,400 trips taken by DOD doctors, medical researchers, pharmacists, and other health care employees over the decade, creating relationships that pose serious conflict of interest issues, according to medical ethics experts,” the Center said in a study summary titled, “Medical Industry Showers DOD with Free Travel.”

“Of special interest to the industry were DOD employees who prescribe, purchase, or recommend the use of drugs or medical equipment,” the Center notes.

DOD’s pharmacy system employees, who can influence which drugs are selected at base pharmacies, took more than 400 trips, worth over $400,000, from medical industry sources, according to the Center’s analysis.

The review found drug companies paid more than $115,000 for trips to destinations that included Orlando, Las Vegas, San Diego, New York City, New Orleans, Paris, and Rome.

Shahram Ahari worked as a sales rep for Eli Lilly in 1999 and 2000, and described how he used free meals, trips, and unrestricted grants to subtly seduce civilian physicians into prescribing Lilly’s drugs. The strategy was to make friends with doctors and pharmacists to get them talking about the drugs and then reward them with additional perks for prescribing the drugs.

“The return on dividends is phenomenal,” Ahari says in the summary. “If it costs them a thousand dollars for a dinner, that’s a [patient’s drug] payment for one month.”

“If they fly you on the Concord to Paris for five grand, even if they get one patient out of it, it’s a lifetime of cash,” he pointed out.

From fiscal year 2000 to fiscal year 2006, the Pentagon’s prescription drug spending more than tripled from $1.6 billion to $6.2 billion, according to an April, 2008 Government Accountability Office report.

The head of the DOD’s pharmaceutical program, Rear Admiral Thomas McGinnis, banned his own staff from going on company-paid trips, but other military pharmacy staff took about 400 trips, the Center points out.

Drug spending hit $6.8 billion in 2008, said McGinnis, and “the GAO expects DOD pharmaceutical spending to reach $15 billion by 2015,” according to the summary.

In a May 19, 2009, report for MSNBC titled, “U.S. military: Heavily armed and medicated, Melody Petersen pointed out that military physicians “can be swayed by the aggressive promotional efforts of the pharmaceutical industry just like civilian doctors often are.”

Military rules limit the handouts doctors can take from drug companies, she says. “A doctor can go to a dinner paid for by a drug company, but the meal’s value can’t be more than $20, and the value of all gifts received from a company over the course of a year can’t exceed $50. “

However, drug companies find ways to work around the limits. For instance, Petersen reports that when “thousands of military and federal health-care professionals met in November (2008) for the annual meeting of the Association of Military Surgeons of the United States (AMSUS), more than 80 pharmaceutical companies and other health-care firms were on hand.”

“The companies helped pay for that San Antonio event in exchange for the opportunity to set up booths in the convention hall, where sales reps pressed doctors to prescribe their products or to use their medical equipment and devices,” she notes.

The 6-day meeting also included a celebration, she reports, “15 military and federal doctors and other health professionals received awards that included cash prizes provided by various drug companies.”

On March 17, 2010, Navy Times ran the headline, “Medicating the Military,” to report a Military Times investigation that found 1 in 6 service members is on some form of psychiatric drug.

“And many troops are taking more than one kind, mixing several pills in daily “cocktails” — for example, an antidepressant with an antipsychotic to prevent nightmares, plus an anti-epileptic to reduce headaches — despite minimal clinical research testing such combinations,” the Times noted.

The investigation also found that drugs originally developed to treat bipolar disorder and schizophrenia are now commonly used to treat symptoms of post-traumatic stress disorder, such as headaches, nightmares, nervousness and fits of anger.

“It’s really a large-scale experiment. We are experimenting with changing people’s cognition and behavior,” says Dr Grace Jackson, a former Navy psychiatrist and author of the book, “Drug-Induced Dementia: A Perfect Crime,” in the article.

Troops and military health care providers told Military Times that these drugs are also being prescribed, consumed, shared and traded in combat zones, despite some restrictions on the deployment of troops using those drugs.

The Times investigation of records obtained from the Defense Logistics Agency showed $1.1 billion was spent on common psychiatric and pain medications from 2001 to 2009, and the use of psychiatric drugs had increased 76% overall, since the start of the current wars.

Orders for antipsychotics rose by more than 200%, and annual spending more than quadrupled, from $4 million in 2001, to $16 million in 2009. Orders for anti-anxiety drugs and sedatives increased 170%, and spending rose from $6 million to about $17 million. Annual orders of anticonvulsants had a 70% increase, with spending more than doubled, from $16 million to $35 million.

Antidepressants orders had a 40% gain, but an overall decrease in spending, from $49 million in 2001 to $41 million in 2009, due to the arrival in recent years of cheaper generic versions of the drugs.

Collateral Damage

During the same time frame, from 2001 to 2009, the Army’s suicide rate increased more than 150%, from 9 per 100,000 soldiers to 23 per 100,000, and the Marine suicide rate increased about 50%, from 16.7 per 100,000 in 2001, to 24 per 100,000 marines in 2009.

In a June 20, 2009, commentary for Huffington Post titled, “Antidepressants Cause Suicide and Violence in Soldiers,” Dr Peter Breggin, author of “Medication Madness: The Role of Psychiatric Drugs in Violence, Suicide, and Murder,” dismisses the theory that the increased use of prescription of drugs in the military is a response to increased depression among the soldiers.

“In reality,” he says, “the use of psychiatric drugs escalates when, and only when, drug companies and their minions target new markets.”

“In this case, the armed services have been pushing drugs as a cheap alternative to taking genuine care of the young men and women in our military,” he states. “Instead of shortening tours of duty, instead of temporarily removing stressed-out soldiers from combat zones, and instead of providing counseling – the new army policy is to drug the troops.”

“During Vietnam, a mere 1% our troops were taking prescribed psychiatric drugs,” he reports. “By contrast, in the past year one-third of marines in combat zones were taking psychiatric drugs.”

In Medication Madness, Breggin evaluated more than fifty cases of suicide, violence, mania and crime induced by psychiatric medications, especially the new antidepressants.

Atypical antipsychotics produce a potentially disastrous “metabolic syndrome” that includes elevated blood sugar, elevated cholesterol, elevated blood pressure, and severe obesity, according to Breggin in a 2009 Psychiatric Drug Facts Newsletter.

“They can also cause direct harm to the function of the heart,” he says. “Overall, it’s a prescription for cardiac disease and premature death.”

As far as claiming the increase in suicides is due to increased horrors in the current wars, California neurologist, Dr Fred Baughman points out: “Who can claim that one war is any more horrible, evil or effecting than another?”

“What jumps out as different about these wars,” he says, “are veterans and soldiers saturated with psychiatric drugs, and kept on the front lines or sent back to the front lines time after time.”

“These frequent, sudden deaths occurring in the military are due to its policy of reckless, anti-scientific, psychiatric drugging,” he warns.

Veterans Dying

“Official figures regarding military “suicides” also have to be taken with a grain of salt,” Baughman says.

In 2008, after reading an article in the Charleston Gazette, titled “Vets Taking Post Traumatic Stress Disorder Drugs Die in Sleep,” Baughman began to investigate veterans dying in their sleep because the deaths did not make sense. “Young men in their twenties do not suddenly die for no reason,” he points out.

He specifically investigated the deaths of four West Virginia veterans who died unexpectedly in their sleep in 2008, including Andrew White, Eric Layne, Nicholas Endicott and Derek Johnson. At the time, Stan White, Andrew’s father, knew of eight such cases in Kentucky, Ohio and West Virginia.

Baughman learned that all four veterans had been diagnosed with PTSD and all were taking the same three-drug cocktail consisting of Seroquel, an atypical antipsychotic, Paxil, an antidepressant, and the anti-anxiety drug, Klonopin.

His investigation determined they did not commit suicide or go into a coma, as a result of an accidental mixed drug overdose, as suggested by the military. “None of the veterans who died in their sleep were drunk, drugged, or overdosed when they went to bed, they all appeared normal,” Baughman says.

Within a year, he had learned of between 70 and 80 more similar cases. “These are undoubtedly sudden cardiac deaths,” he reports, “due to the prescription of antipsychotics and antidepressants.”

“Although antipsychotics and antidepressants have been proven to increase the risk of sudden cardiac death, they are routinely prescribed together, as if no such risk is known,” Baughman warns.

He points to the January 2009 study, Ray et al, which reported that antipsychotics double the risk of sudden cardiac death, and that on March 17, 2009, Whang et al reported antidepressants, as well, increase the rate of sudden cardiac deaths.

Sudden cardiac death has been defined as the “unexpected natural death” from a cardiac cause.  Some studies suggest that 85 to 90% of these deaths result from ventricular tachyarrhythmias and medications may contribute to the risk of these underlying arrhythmias. Ray et al found atypical antipsychotics increased the risk for arrhythmias.

As of May 24, 2010, by conducting Google searches on the internet, veteran’s wife, Diane VandeBurgt, of Charleston, found 128 deaths of veterans using terms such as “dead in barracks,” “in bed,” “at work station.” Diane’s husband quit taking Seroquel, prescribed as sleep aid as part of his PTSD treatment, after experiencing many terrible side effects.

Andrew White joined the Marines because he wanted to follow in the footsteps of his older brothers.  One brother served in the army and the other in the Navy.

Andrew returned from Iraq in September of 2005 and less than two weeks later his brother was killed in Afghanistan. “Andrew had not even emptied his bags when we all had to deal with this loss,” his mother Shirley recalls. Shirley and her husband, Stan, have been on a non-stop mission to find answers for Andrew’s death and the deaths of other veterans.

The soldiers, veterans, and their families deserve the truth about this epidemic of antipsychotic-antidepressant sudden cardiac deaths in the military, Baughman states.

“Most importantly,” he says, “they cannot be allowed to continue to cover up these deaths and dole out psychiatric drug cocktails as they are doing to the exclusion of psychotherapy.”

“The number of Americans on government disability due to mental illness skyrocketing from 1.25 million in 1987 to over 4 million today is an iatrogenic, physician induced epidemic that will only mount in the future,” Dr Baughman says. “The utter, complete fraud based on the fiction of psychiatric diseases has got to stop.”

Invented Diseases

Unlike a medical diagnose that indicates a probable cause, treatment and prognosis, mental disorders are voted into existence by committees representing the American Psychiatric Association, a roughly 38,000 member professional group, that gets to decide what is normal, and what is not, for the more than 300 million other people in the US.

The APA’s “Diagnostic and Statistical Manual for Mental Disorders IV (DSM IV),” contains all the billable mental disorders and amounts to nothing much more than a bunch of checklists of symptoms. The original 1952 version contained just over 100 disorders. By the fourth edition  the number had more than tripled to over 350. The DSM5 is due for publication in May 2013.

The DSM is immensely important to drug makers because the FDA will not approve a medication to treat a disorder unless the condition is listed in the manual. For the DSM IV, fifty-six percent of of the 170 panel members, and one-hundred percent of the experts involved in writing diagnostic criteria for “mood disorders” and “schizophrenia and other psychotic disorders,” for which medication is standard treatment, had financial ties to the drug companies, according to a 2006 study titled, “Financial Ties Between DSM-IV Panel Members and Pharmaceutical Industry,” in the “Psychotherapy and Psychosomatics” journal.

The leading categories of financial interest for panel members were research funding (42%), consultancies (22%) and speakers bureau (16%).

The authors of the DSM 5 have agreed to limit their industry income to $10,000 or less per year until the completion of their work. But as Dr J Wesley Boyd, an academic psyhiatrist, pointed out in an April 11, 2009 editorial in the Boston Globe:

“Even if these individuals adhere to the stated income limits, how much pharmaceutical funding is being funneled into the authors’ respective departments by way of lectureships, endowed chairs, or sponsored research? And if the authors are free to resume their usual heavier ties to industry after 2012, how can the promise of big payouts later not influence their current work?”

In 2003, a group of psychiatric survivors went on a hunger strike in California with the goal of forcing the APA and the National Alliance on Mental Illness to acknowledge that there was no scientific proof for the claim that mental illness was biological in nature. Three weeks into the strike, the APA  issued a statement admitting that “brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive bio-markers of a given mental disorder or mental disorders as a group.”

The marketing strategy in psychiatry is to invent diagnoses out of thin air and call them diseases as a means to prescribe drugs, says Dr Baughman.

“They take entirely normal people and create patients by diagnosing them with fictional diseases,” Baughman says. “It’s a total fraud.”

To validate this point, he tells how he helped a father in Canada, whose son had been diagnosed with multiple disorders, write a letter to Health Canada, an agency similar to the FDA, asking for information on ways to validate a diagnosis of mental illness.

In a November 10, 2008 response letter, Health Canada stated: “For mental/psychiatric disorders in general, including depression, anxiety, schizophrenia and ADHD, there are no confirmatory gross, microscopic or chemical abnormalities that have been validated for objective physical diagnosis. Rather, diagnoses of possible mental conditions are described strictly in terms of patterns of symptoms that tend to cluster together.”

Baughman then wrote a similar inquiry to the FDA Commissioner, and forwarded a copy of Health Canada’s letter. Donald Dobbs, from the Center for Drug Evaluation and Research, consulted with the FDA’s new drug review division, and responded to Baughman’s inquiry by stating: “…they concurred with the response you enclosed from Health Canada. Psychiatric disorders are diagnosed based on a patient’s presentation of symptoms that the larger psychiatric community has come to accept as real and responsive to treatment. We have nothing more to add to Health Canada’s response.”

“The entirely bogus stigmatizing labels are a barcode on the forehead of a child, and once a label gets in a record, it sticks,” Baughman warns. “These children are going to have problems getting health insurance and trouble finding employment.”.

As a neurologist, “I would say that a third to a half of all the patients I saw had no organic disease,” he says. “Now contrast that with a 2002 survey of child psychiatrists, where 91% of the kids were given a drug.”

“It’s not just psychiatry, it’s pediatrics, neurologists, family practitioners, and psychologists all across the country,” he states. “They have all become members of the child drugging establishment.”

An alarming study by researchers from Thomson Reuters and the US Substance Abuse and Mental Health Services Administration reviewed 472 million prescriptions for psychiatric drugs from August 2006 and July 2007, and found general practitioners wrote more than half of prescriptions in two main classes of drugs, 62% of antidepressants and 52% of stimulants. Family doctors also wrote 37% of prescriptions for antipsychotics, and 22% of anti-mania drugs, the study showed.

The researchers were especially concerned over antipsychotics being prescribed by general practitioners. The fact that antipsychotics may be more complex to prescribe, have some potentially serious side-effects, “emphasizes the need to understand the adequacy of care being provided by a GP,” said Tami Mark, director of analytic strategies for the healthcare and science business of Thomson Reuters.

Attack on Child Drugging

The massive drugging of America’s children, particularly poor, disadvantaged children and youth through Medicaid and in foster care, is an unfolding public health catastrophe of massive proportions, according to Alaskan attorney, Jim Gottstein, the leader the Law Project for Psychiatric Rights. Gottstein and PsychRights have made attacking this problem a priority.

In letters to several federal lawmakers in May 2009, Gottstein reported the massive Medicaid Fraud involved in the prescribing of psychiatric drugs to children covered by Medicaid. Copies of the letters were also sent to Kathleen Sebelius, Secretary of Health & Human Services, Kerry Weems, Acting Administrator, CMS, and Joyce Branda, Director of the Department of Justice Commercial Litigation Branch (Frauds).

“The fraudulent activities of drug companies in promoting off-label pediatric use of psychiatric drugs … has begun to be exposed, but the psychiatric drugging of America’s children and youth goes on unabated,” Gottstein advises in the letters.

While preparing the filing of a lawsuit to prohibit the State of Alaska from paying for psychiatric drugs prescribed off-label to children covered by Medicaid in Alaska, Gottstein led an investigation that determined the vast majority of psychiatric drugs prescribed to kids on Medicaid constitute fraud. A tremendous percentage of the prescriptions did not qualify for reimbursement the letters point out:

“For example, no anti-convulsants masquerading as “mood stabilizers,” such as Depakote or Tegretol, have been approved for pediatric psychiatric use or supported by any of the compendia. However, these drugs, especially Depakote, are routinely paid for by Medicaid without any apparent consideration that the practice has been prohibited by Congress.

“With respect to the second generation neuroleptics, no pediatric use of Seroquel, Zyprexa or Geodon is approved by the FDA or supported by any of the designated compendia. Risperdal is approved for very narrow uses, as is Abilify, but even when prescribed for these indications, they are almost always prescribed concurrently with another drug(s), which is not FDA approved or supported by any of the designated compendia.”

In 2007, through a state FOI request, PsychRights found Alaska Medicaid was paying approximately $123,000 per month for anticonvulsants prescribed to kids and $288,000 for second generation neuroleptics for a “total averaging approximately $411,000 per month in improper Medicaid payments in Alaska alone.”

“Extrapolating this to the entire country,” the letters state, “there is over $2 Billion in Medicaid payments for psychiatric drugs to children and youth that Congress has explicitly prohibited.”

“In truth,” Gottstein says, “this is the smallest amount because typically two or more of these drugs are administered concurrently, in what is called polypharmacy, none of which has been approved by the FDA for pediatric use or supported by any of the designated compendia.”

“It is hard to come up with an adjective that adequately conveys the horror this is inflicting on America’s children and youth,” he states. “Suffice it to say that when the country wakes up to the carnage this has caused, it will be recognized as the largest iatrogenic (doctor caused) public health disaster in history.”

In January 2010, PsychRights announced the unsealing of a major Medicaid Fraud lawsuit against psychiatrists, their employers, pharmacies, state officials, and a medical education and publishing company for their roles in submitting fraudulent claims to Medicaid. The complaint was filed on April 27, 2009, under the federal False Claims Act which allows private parties to bring fraud actions on behalf of the Government, but was kept under seal until January 2010. The defendants include more than a dozen child psychiatrists, Alaska officials, health care agencies, and pharmacies.

PsychRights has also developed a streamlined model Qui Tam Complaint for use by interested attorneys around the country. The complaint is drafted for former foster children to bring the lawsuits and receive the whistleblower’s share of the recovery, but anyone with knowledge of specific offending prescriptions, such as parents and mental health workers, can bring suit.

Last fall, Gottstein gave presentations on how to file and conduct these types of cases at the national conventions of the National Association for Rights Protection and Advocacy (NARPA), and the Internation Center for the Study of Psychiatry and Psychology.

While PsychRights is not bringing these cases for the money, such lawsuits represent a tremendous financial opportunity for attorneys to do well by doing good. “These are about as open and shut as cases can get,” Gottstein says, “it is Medicaid fraud to cause or submit prescriptions to Medicaid for reimbursement if they are not for a medically accepted indication. End of story.”

(Part IV of this series will cover the role of Patient Support Organizations in the American Epidemic of Mental Illness)

Evelyn Pringle

(This series is sponsored by the International Center for the Study of Psychiatry and Psychology http://icspponline.org/index.html)

(Evelyn Pringle is an investigative journalist focused on exposing corruption in government and corporate America)

Filed under: pharmacology

URGENT – Our Chance to Stop Funding of The MOTHERS Act

URGENT – PLEASE CALL YOUR SENATOR TODAY OR TOMORROW!!

You can find your Senators’ phone numbers here:

http://www.senate.gov/general/contact_information/senators_cfm.cfm

Your Rep’s number can be found here:
http://www.house.gov/htbin/zipfind

A document for you to print and fax is here:

http://www.box.net/shared/i26tmogzs5

An older PDF of Senate Fax numbers and phone numbers is here (if your Senators’ numbers are out of date you can also look them up online – I think this may just be missing Al Franken and Scott Brown):

http://www.box.net/shared/90h42i1nvu

Here are a few of the Reps’ fax numbers, you can also look yours up on your Representative’s website or on Congress.org. This list may be a bit outdated. http://www.box.net/shared/b3hhqymcvm

Information:

Menendez has his vultures asking people to call to support appropriations / funding for programs which will be for “delivery of essential services” in “the postpartum depression initiative” a.k.a. The MOTHERS Act. The relevant portions of the Health Care Reform bill which pertain to The MOTHERS Act are: Section 2952 of The Patient Protection and Affordable Care Act, plus screening for pregnant and new moms via the Mikulski Amendment for Women’s Health (same bill).

The “public service” awareness campaign and “research” are supposedly already going to be automatically budgeted, according to PSI’s Susan Stone. But as you know, the additional grants to entities will be essentially unchecked and unmonitored funds to God-knows-who (probably the same people who are already under investigation).

So what we need is for everyone to call (and fax if possible) your Senators and your Rep. and ask them not to support any appropriations for The MOTHERS Act – not to fund something that has absolutely no oversight and no checks and balances as to which entities will receive funding and what those programs will be. Here are the talking points.

# The bill cites various “entities” that will be eligible for grants and for participating in research and/or development of screening methods and/or treatments and delivery. Who or what are these “entities?” Are they pharmaceutically funded? Do they have conflicts of interest? There are ongoing investigations of various “non-profit” organizations who heavily promote or conduct screening. For example, Screening for Mental Health, Inc., and its sub-organization Signs of Suicide, who heavily promote and conduct mental health screening, received $4,985,925 from pharmaceutical companies prior to 2008. The National Alliance for the Mentally Ill (NAMI) receives 56% of its funding from pharmaceutical companies. Ten leading psychiatric researchers (many from prominent universities) have been exposed in the last year for failing to disclose millions of dollars in pharmaceutical payments — yet this bill contains no provisions for full disclosure of conflicts of interest for any “entity” receiving federal taxpayer funded grants.

# Given that the Senate Finance Committee recently exposed the financial conflicts of interest of the top ten psychiatric researchers in the U.S., it is no small issue that The MOTHERS Act provides no research guidelines for public disclosure. See Wall Street Journal article on Emory psychiatrist considered “leading expert” on use of antidepressants in pregnant women who was being funded tens of thousands of dollars by Pharma while doing federal research about the use of antidepressant drugs on pregnant women; http://online.wsj.com/article/SB124460466072501139.html and http://www.fiercepharma.com/story/second-emory-doc-fesses-conflicts/2009-06-10

# Under The MOTHERS Act’s current language, research will be conducted without peer review — no checks and balances, no one to validate the integrity of the research which then will be used to determine a woman’s mental health status.

# Simultaneously, without allowing any checks and balances whatsoever on the research, it promotes a national “public education” campaign to include Public Service Announcements and television and radio advertisements, essentially giving Pharma an opportunity for free, federally-funded advertising.

So please call your two Senators and your Representative for your district by tomorrow, June 22!

Filed under: pharmacology

PSI, Texas Red Dirt, and The Pursuit of Unhappiness

I interrupt my regularly scheduled blogcasting for the following, self-indulgent announcement. If you don’t know anything about country music you may want to fast forward. Unless you love to hate Postpartum Support International or anyone who supports pregnant and new moms taking dangerous psychotropic drugs, or unless you enjoy making fun of the DSM (“Diagnostic” and “Statistical” Manual of mental disorders, a.k.a. the billing bible of psychiatry), in which case you may wish to humor me.

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

What is psychiatry if not the pursuit of unhappiness? The logic of those who want to screen the entire population and find those “at risk” of mental illness is basically this: that people can’t be left to their own devices, people cannot ask for help if they need or want it, and that it is the job of our government to ensure that all people are targeted by psychiatry and offered preemptive “help.”

I’d like to take this opportunity to announce that lately I have been very depressed. Why, might you ask am I admitting to this on my Bitter Pill blog? Shouldn’t I be afraid that someone will come and try to give me meds?

No, because quite honestly the cure for this depression has already been discovered and administered in my case. It’s amazing. I have the world’s shortest case of depression ever. In fact I’m not really sure if depression is the best word for it. I think after poring through my copy of the DSM IV (funny how much that reminds me of actual I.V. bags) I’ve decided that none of the four thousand and fifty disorders listed fits me, and I’d like to propose an entirely new disease.

“Scientists” are being called tomorrow to develop the proper brain scan and hormone theories for this one. I know what really causes it but I’d like to know which brain chemicals are associated and therefore which medication I can market to my fellow critics who may soon contract this disease.

Name and abbreviation nominations for this disorder are now being accepted on The Bitter Pill blog. Let me give you a rundown of this disease and its symptoms, along with the cure that has worked for me so far. Whoever submits the winning entry will receive one frosty mug of Shiner, or in the alternative, a piece of pizza.

Symptom one: extreme disappointment

Symptom two: frustration

Symptom three: sadness

Symptom four: denial

Symptom five: anger

Symptom five: changing the station

Criteria: these symptoms are intense and can last for between two weeks and several years or longer.

If you are confused, here is a chronological explanation.

***

1987:

- Prozac hit the market.

- Postpartum Support International was founded.

2001:

- Melanie Stokes was drugged with four triple drug cocktails within a period of about 3 months and electroshocked until she eventually jumped off a building.

- Andrea Yates killed her children under the influence of Effexor.

- A couple of Congressmen decided to introduce The MOTHERS Act.

2004:

- I had my run-in with Zoloft and psychiatry because I was considered “at high risk” of postpartum depression due to a screening I was never told was being conducted on me. Hmm, that reminds me of a certain screening / drugging program…

- Manie McNamee was born, and almost died due to Paxil.

- The FDA issued a black box suicide warning on antidepressants.

2008:

- I started fighting the MOTHERS Act along with thousands and thousands of other people. Published a YouTube video with my story that has had to this date over 44,000 views on YouTube alone, not counting embedded views.

- The MOTHERS Act fight was covered all over the media on TV, internet news, radio, and in various newspapers.

- The MOTHERS Act was slipped into an omnibus package which was subsequently killed.

- Indiana Delahunty died from Effexor.

- Wade Bowen, a modern Texas Red Dirt semi-legend, held a golf tournament and concert which raised $84,000 for Postpartum Support International in one day, along with Stoney LaRue, Cross Canadian Ragweed, and the Randy Rogers Band and others. He then posted what is, in my opinion, an incredibly lame YouTube video with a song called Turn on the Lights. The video does remind me a little bit of my own YouTube video except that it’s about 100 times less interesting and the slides keep repeating the same photos over and over, and the music isn’t as good. This song would never make it onto my iPod playlist. Sorry Wade.

Some reporter from a local Texas paper actually called me prior to the fund raising event to ask for my reaction. At the time I was upset about The MOTHERS Act, but had no idea who Wade Bowen was so I just assumed he was a famous golf star and philanthropist with mental health problems who wanted others to take drugs too.

I had heard of Cross Canadian Ragweed and decided to put them on my short list of people not to support, which includes a few obligatory and fun nicknames for each person or group on the list.

To the reporter I simply stuck to The MOTHERS Act, but had I known how much I would one day like to listen to country music I might have thrown in an “aww shucks” or a “dangit” as well regarding these musicians.

- The MOTHERS Act died with the end of the Congressional session.

2009:

- TIME Magazine covers The MOTHERS Act, with a paragraph about my story.

2010:

- The MOTHERS Act passed in the Health Care reform bill (Despite a total lack of consent of the governed, this highly controversial program was passed within another bill – health care reform – which was hotly contested and is currently the subject of lawsuit after lawsuit based on allegedly unconstitutional provisions. The MOTHERS Act arguably had far more people protesting it than supporting it, but that’s not going to stop it from becoming law thanks to back room deals.)

- Wade Bowen buys a new website for Postpartum Support International.

***

By this point in time I must confess it has been really difficult to avoid Cross Canadian Ragweed. Although I really like their music, I force myself to change the station if I realize that they are playing. Fortunately or unfortunately for me, since I boycotted them two years ago, I don’t actually know which songs are really theirs so, at times I can plead ignorance with my conscience.

It’s kind of like how I can’t listen to Queen in the car because I had a car accident while listening to “We Are The Champions” by Queen when I was sixteen. Call it OCD if you want. I don’t care. This avoidance of bad luck serves me well.

I had forgotten all about Wade Bowen until I read that he purchased a new website for Postpartum Support International (check it out and tell me it does not look like they ripped off the look from some drug company website or drug ad), and by this point in time I knew who he was from listening to Texas Red Dirt music on 95.3 The Range in Dallas.

Last weekend, I am happy to say that I attended a concert at the Fort Worth Stock Yards featuring Stoney LaRue, and I had one last hurrah enjoying “Oklahoma Breakdown” performed live.

A couple of weeks ago, however, I went to a concert with the Randy Rogers Band and Wade Bowen. The entire time I was there I kept thinking, “I can’t believe I am here giving money to Wade Bowen.” Then I left after 45 minutes of being bored and annoyed, partly because I felt like I was listening to a lamer version of my iPod, and partly because I felt an intense inner ethical conflict that practically forced me to put my pool stick down and walk out.

Only two days ago did I stumble again onto the article about the Wade Bowen benefit concert and realize that both Stoney LaRue and the Randy Rogers Band were at that event. Now not only do I have an intense disliking for Wade Bowen (not as a musician), but I also now have to contemplate that both the Randy Rogers Band and Stoney LaRue were at that benefit concert in 2008. Now every time I listen to “Oklahoma Breakdown,” instead of being happy I will have to be sad. And when I listen to “In My Arms Instead” I will have to decide whether to continue listening to one of my favorite songs or go change the station.

Like so many other problems that I have a duty to discuss on this blog, this particular, albeit minor, problem can be blamed almost entirely on psychiatry. This just adds to the already long list of diseases, excuse me, disorders, that they have created.

===

Dear Stoney LaRue,

Once upon a time, I stood two feet from you and requested Oklahoma Breakdown for some old lady’s birthday, and you did not oblige. Given that this is your biggest song, I just don’t get you. But I do know how to quit you. It’s Friday and you’re gettin’ tore up, goin’ down by the river in the back of my truck, remember one time, you said it was alright, gonna get juiced down by the riverbed tonight.

(Translation: I have taken your albums and thrown them in the river. I am now drinking a Shiner.)

===

Dear Randy Rogers,

Why is it that I love your music so much on the radio / iPod, yet I was so incredibly bored at both of your concerts I attended, that I left after 45 minutes? Maybe you should consider spicing it up a bit.

Regardless,  I’m deleting you from my facebook account as a band I like. I’m gonna break these chains around my broken heart – not gonna let you wear your crown this time around. There will have to be no more “Kiss Me In The Dark,” I swear I’m gonna change the station or hit forward on my iPod. I am also trashing that guitar chords printout I have for “In My Arms Instead.” And we both know it’s not worth another try, but it’s worth one more goodbye.

===

Dear Wade Bowen,

I actually don’t know any of your songs to parody. Sorry.

===

Dear Cross Canadian Ragweed,

You are great. Truly great. However since I don’t listen to you anymore, there’s really not much to say other than that  I’d like to suggest Shiner over Zoloft. It has way fewer side effects. And the warning label on beer actually tells women that they shouldn’t drink it while pregnant, unlike the crap that your friends over at PSI like to write online about antidepressants.

===

So this is me declaring my selective independence from Texas Red Dirt. I promise from now on that I will still listen to select other Texas Red Dirt bands who don’t go around supporting awful programs and websites that deal in deadly misinformation.

See what I mean by cured?

Filed under: antidepressants, Congress, Melanie Stokes, mothers act, PPD, Pregnancy, suicide, , , , , , , , , ,

Tracking the American Epidemic of Mental Illness – Part II by Evelyn Pringle

Tracking the American Epidemic of Mental Illness – Part II

Tax dollars are being used to fuel the American epidemic of mental illness by promoting the preemptive drugging of persons supposedly at risk of developing mental disorders, to the great benefit of the pharmaceutical industry.

In March 2010, the US Department of Health & Human Services Substance Abuse & Mental Health Service Administration Center for Mental Health Services announced $16.5 million in funding for “Mental Health Transformation Grants,” one of SAMHSA’s services grant programs.

“In order to complement but not duplicate the efforts of other CMHS programs, FY 2010 funding for MHTG will focus on services for adults with or at-risk for serious mental illnesses,” the agency noted.

Applications were required to implement evidence-based or best practices that would create or expand capacity to address one or more of five Strategic Initiatives, including: “Prevent mental illness through outreach, screening, and early interventions for adults with early signs of mental illness or who are at risk, and promote wellness through holistic treatment approaches.”

An evidence-based practice, or EBP, refers to approaches to prevention or treatment that are validated by some form of documented research evidence.  As an example of a practice that could be implemented, SAMHSA listed under “Prevention and Wellness: Early Intervention,” the  “Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP),” along with a link to its website http://www.changemymind.org/.

EDIPPP is a national program replicating the “Portland Identification and Early Referral,” or “PIER,” a treatment research program at the Main Medical Center, in Portland, Maine.

On a webpage for PIER on the Center’s Website, under “Project Overview,” it states: “The goals are to improve outcomes and prevent the onset of the psychotic phase of illnesses like Bipolar Disorder, Major Depression, and Schizophrenia.

“This is the first program in the United States to identify the entire population of at risk young persons and offer them treatment,” PIER said in a September 26, 2005 press release.

EDIPPP was funded through a $14.4 million million grant for the “National Demonstration of Early Detection, Intervention and Prevention of Psychosis in Adolescents and Young Adults,” from the Robert Wood Johnson Foundation, and is “designed to prevent psychosis in teens and young adults,” according to an April 10, 2007, announcement on RWJF’s launch of the program.

“The national program is expanding PIER’s success during the past seven years in identifying and treating young people experiencing subtle and early symptoms that herald the onset of serious mental illness,” a November 2007 report in Behavioral Healthcare, by Dr James Maier, a research psychiatrist with PIER, notes.

EDIPPP works with people between the ages of 12 and 25, with an average age of persons entering the program between 15 and 16.

“Widespread dissemination of this early intervention model throughout the United States offers tremendous hope and optimism for combating some of the most devastating and costly illnesses that can afflict young people and their families,” Maier claims.

The RWJF grant set up additional EDIPPP sites in Sacramento, California; Salem, Oregon; Ypsilanti, Michigan; and Glen Oaks, New York. A site in Albuquerque, New Mexico was added in 2008.

RWJF also funds a booklet for professionals, on how to prevent mental illness with early detection titled, “Recognizing and Helping Young People at Risk for Psychosis: A Professional’s Guide,” which can be downloaded free off the internet.

From the start, PIER has always been primarily funded by RWJF, according to its website.  However, on October 13, 2003, Mental Health Weekly reported that the program had received a $3.9 million grant from the National Institute of Mental Health, and a parallel $2 million grant from the Center for Mental Health Services intended for a related program in early identification of non-psychotic disabilities.

In Portland, young people typically are referred to PIER by high school guidance counselors, pediatricians, or other clinicians who attended presentations about PIER’s work, visited the PIER Website (http://www.preventmentalillness.org), and are familiar with the early warning symptoms that suggest the onset of a psychotic illness, according to the report in Behavioral Healthcare.

Mental Illness According to PIER

In a fact sheet posted to “Dispel the Myths,” the PIER website claims that, “Mental disorders are as easy to diagnose as asthma, diabetes, and cancer.”

“Treatments are effective 60%-80% of the time, success rates that meet or exceed success rates for cutting edge treatment for heart disease,” the sheet states.

“In many cases, PIER does use medications,” the Websites says. “We believe that some of the newer medications effectively improve thinking and combat early symptoms.”

“Research suggests these medications may have a protective effect against changes in the brain that cause mental illness,” it reports.

Under costs, it reads: “For now, services provided by PIER staff are supported by grants. However, if certain medications, medical tests, or neurological assessments are ordered, there will be a charge.”

The PIER program was founded in 2000, by Dr William McFarlane, and after 10 years in operation, on May 28, 2010, the ChangeMyMind website listed only two “case studies and impact stories that illustrate the effectiveness of the Early Detection and Intervention for the Prevention of Psychosis Program.”

Medicated for Life

Virtually every person entering the PIER program is prescribed antipsychotics, such as Risperdal or Invega, marketed by Johnson & Johnson, the parent company of the Robert Wood Johnson Foundation. These prescriptions are off-label because antipsychotics are not FDA approved to “prevent” mental illness in any age group.

An August 2008 article, by Charles Schmidt in Discover Magazine, highlighted the PIER program with a byline that stated: “A new mix of therapy and medication may stave off psychosis among teens at risk.”

Schmidt discussed the case of Camila (not her real name), who entered the program in September 2001, when she was 14. “Camila and her family stuck with PIER for the four-year treatment program, which ended formally in 2005, and still keep in touch with counselors there,” he reports.

However, “Camila’s health still hinges on antipsychotic medication,” Schmidt says. “In the summer of 2007 she went off the drugs for a spell and her strange feelings returned.”

He notes that her reliance on antipsychotics raises issues. “On the one hand, it shows that the threat of psychosis hasn’t really been removed, it’s just been held in check.”

“What we hope is that the benefits of treatment will be lifelong,” McFarlane says in the article. “We don’t have any empirical evidence to support that yet, but what we’ve seen is that young people who still haven’t converted to psychosis after about three years of our treatment don’t seem to be at much risk.”

While he suggests that over time, some patients may be able to go off medications, McFarlane acknowledges that PIER hasn’t developed a plan for managing that process, Schmidt reports.

“As to when or if they can go off medication, that’s hard to say,” he told Schmidt. “I think many of our patients don’t feel a need to stop; they certainly don’t feel oppressed by it. At a certain point it becomes a personal choice.”

A fortune can be made from these life-long antipsychotic customers. In April 2010, the price for one box of Invega, at a middle dose, was $1,373 at DrugStore.com. Risperdal went for $788 per 90 pills. The cost was $1,395 for 100 tablets of Abilify.  Seroquel cost $997 per 100.  One-hundred capsules of Geodon sold for $918 and Zyprexa cost $1,523 for a hundred 10mg pills.

In 2003, McFarlane told Mental Health Weekly that with about 3% of the population at risk for a serious mental illness, Greater Portland could expect about 75 young people to develop a disorder each year.

RWJF Front Group

The founder of RWJF, Robert Wood Johnson, was chairman of Johnson & Johnson for over 30 years, from 1932 to 1963, as a member of the drug maker’s founding family. Throughout the years, the majority of the Foundation’s money has come from investments in J&J stock. RWJF’s board of trustees has always been stacked with the drug company’s executives. For instance, current and past trustees have held positions at J&J such as President, CEO, Vice President, Chairman of the Board, and Treasurer, and have served along side another family heir on the board, Robert Wood Johnson IV.

RWJF is listed in a Medicaid fraud lawsuit, filed against J&J by whistleblower, Allen Jones, a former federal fraud investigator, and joined by the Texas attorney general, as providing funding for illegal marketing schemes to increase the off-label sales of Risperdal, including funding the development of the “Texas Medication Algorithm Project (TMAP),” which required doctors to prescribe the newest, most expensive antipsychotics, antidepressants, anticonvulsants, and ADHD drugs to patients covered by public programs, like Medicaid and Medicare, who were diagnosed with mental disorders, and a nearly identical set of child drugging guidelines known as the “Texas Children’s Medication Algorithm Project (CMAP).”

In addition to Risperdal and Invega, J&J also markets the ADHD drug Concerta, and Topamax, an anticonvulsant.

A May 11, 2005, report by RWJF on the results of the funding of TMAP grants totaling $2,389,581 to the University of Texas Southwestern Medical Center at Dallas and a grant of $353,747 to the Texas Department of Mental Health and Mental Retardation, describes the supposed “Problem,” that led to the creation of the TMAP drugging guidelines as:

“In the 1980′s and 1990′s, as pharmaceutical companies began producing new and more efficacious medications to treat people with serious mental disorders such as depression, bipolar disorder, and schizophrenia, the question arose of how to choose the most appropriate treatment options. Concerns about wide variation in prescribing practices by physicians and complaints from consumer advocates about the negative consequences of this variation spurred the creation of evidence-based guidelines and medication treatment algorithms.”

The “Contacts” for the grants listed in the report, were Dr A John Rush,  for the University, and Dr Steven Shon for the state of Texas.  Shon was fired in October 2006, after the Texas attorney general determined that J&J had improperly influenced him to make Risperdal a preferred drug on TMAP.  In 2008, Rush was added to a list of psychiatric academics who failed to disclose all the payments they received from drug companies, by Senator Charles Grassley, as part of an investigation conducted on behalf of the US Senate Finance Committee, which oversees Medicaid and Medicare spending.

As a main component of the off-label marketing schemes, the lawsuits against the antipsychotic makers allege that the drug companies “seeded” the medical literature with reports and papers purporting to be written by “experts” when they were actually ghostwritten with the names of experts attached after the fact.

In its report on the TMAP grant results, RWJF boasts that: “More than 50 articles on the Texas Medication Algorithm Project have appeared in the Journal of Clinical Psychiatry, Psychiatry Research, Managed Care, Health Services Research, Journal of the American Academy of Child and Adolescent Psychiatry and other peer-reviewed journals.”

“Over the next two years, Project Directors Rush and Shon and their colleagues plan to publish additional articles on other areas of interest,” the report said.

On August 18, 2008, a Dallas Morning News headline read: “Conflict of interest fears halt children’s mental health project,” in reference to the Children’s Medication Algorithm Project. “A state mental health plan naming the preferred psychiatric drugs for children has been quietly put on hold over fears drug companies may have given researchers consulting contracts, speakers fees or other perks to help get their products on the list,” the News wrote.

To date, four of the five atypical makers have settled fraud charges involving the illegal off-label marketing of antipsychotics, including for use with children. Eli Lilly paid $1.4 billion for Zyprexa, Bristol-Myers Squibb’s fine was $515 million for Abilify, Pfizer paid $301 for Geodon, and AstraZeneca just forked out $520 million for Seroquel.

But the fines are merely chocked up to the cost of doing business. For instance, although AstraZeneca paid a whopping $520 million fine, Seroquel had sales of $4.9 billion in 2009, with more than half coming from the US. Overall, antipsychotics were the top-earning class of drugs in the US, in both 2008 and 2009, with sales of $14.6 billion in 2009, according to IMS Health.

J&J is the only atypical maker that has not settled the off-label marketing charges against it – yet. However, two units of J&J “will pay more than $81 million to resolve criminal and civil claims over illegal promotion of the epilepsy drug Topamax,” according to Bloomberg news on April 29, 2010.

Also, over the past 2 months, J&J’s McNeil division has recalled over 40 varieties of child and baby medications after the FDA found massive safety and manufacturing violations at a plant in Fort Washington, Pennsylvania, including formulations of Tylenol, Motrin, Zyrtec and Benadryl. The FDA also found problems with “strength, quality and purity.”

The FDA’s inspection report notes that J&J received about 46 consumer complaints “regarding foreign materials, black or dark specks [in their drugs] from June 2009 to April 2010.” J&J had knowledge of problems since May 2009, which means it was allowing children and infants to ingest potentially poisonous drugs for a year before the product recall took place.

Time Magazine as Promoter

On June 22, 2009, the RWJF website posted a link to download the full text of an article in Time Magazine, by John Cloud titled, “Staying Sane May Be Easier Than You Think,” who reported: “The most exciting research in mental health today involves not how to treat mental illness but how to prevent it in the first place.”

“In fact,” Cloud said, “many mental illnesses — even those like schizophrenia that have demonstrable genetic origins — can be stopped or at least contained before they start.”

“This isn’t wishful thinking but hard science,” he claimed.

The article discussed a report by the National Academics, “an organization of experts who investigate science for the Federal Government,” nearly two years in the making, “on how to prevent mental, emotional and behavioral disorders.” A quick check found one of the sponsors of the National Academies to be RWJF.

“The report concludes that pre-empting such disorders requires two kinds of interventions,” Cloud said, “first, because genes play so important a role in mental illness, we need to ensure that close relatives (particularly children) of those with mental disorders have access to rigorous screening programs.”

“Second,” he noted, “we must offer treatment to people who have already shown symptoms of illness (say, a tendency to brood and see the world without optimism) but don’t meet the diagnostic criteria for a full-scale mental illness (in this case, depression).”

“Some prevention programs even prescribe psychiatric medications, including antipsychotics and antidepressants, to people who aren’t technically psychotic or depressed,” Time reported.

“This is a big concern,” Joseph Rogers, founder of the Philadelphia-based National Mental Health Consumers’ Self-Help Clearinghouse told Cloud. “Because, gee, if you miss, you can really do more harm with some of these drugs than good.”

“But those who contributed to the National Academies report say preventing the suffering of people with mental illness is worth the risk of some false positives, partly because of the enormous cost of treating mental illness after it’s struck,” Cloud reported.

The article profiled PIER and McFarlane, who was described as “one of the world’s top authorities on preventing mental illness.”

According to Time, the “National Institute of Mental Health is funding a trial of McFarlane’s work, and while he is still writing up his data for publication, his anecdotal results are promising: most of the kids are so far avoiding a first psychotic episode.”

Preemptive Drugging Unsupported

In a 2008 paper titled, Atypical Antipsychotic Agents For the Schizophrenia Prodrome: Not a Clear First Choice,” published in the “International Journal of Risk & Safety in Medicine,” Dr Stefan Kruszewski, a psychiatrist, and Dr Richard  Paczynski, a neurologist, both from Harrisburg, Pennsylvania, explain that, “Pharmacologic intervention at the earliest stages of suspected psychotic illness is an intuitively appealing concept and a logical extension of the current approach to many other diseases of the central nervous system.”

“However,” they report, “a critical analysis of the results of structured clinical investigations which have explored the use of ATAPs for new-onset psychotic symptoms raises safety concerns and does not support pre-medication in this setting as a preventive strategy.”

“Over the past several years,” the paper states, “a voice has emerged in the international psychiatric community recommending early prescription of the atypical antipsychotic agents (ATAPs) for adolescents and young adults who appear to show signs consistent with a schizophrenia prodrome. Early use is predicated on the possibility that ATAPs may prevent progression to full-blown psychotic illness in this high-risk population. “

“This trend has been encouraged despite a paucity of data which clearly support the effectiveness of these agents for this indication, and despite evidence of adverse side effects including,” the authors note.

These circumstances prompted their literature review, “focusing on the five published studies that have explicitly addressed the preventative efficacy of the most widely prescribed ATAPs in structured (i.e., non-anecdotal) clinical settings.”

In the summary and conclusion section of the paper, the authors report that the results from the available controlled trials reviewed are in line with several of the conclusions of the naturalistic study by Cornblatt et al. “That is, early prescription of ATAPs to adolescents and young adults seeking medical attention for prodromal psychotic symptoms is associated with high rates of medication non-adherence.”

“Additionally,” they say, “the introduction of ATAPs was not associated with reduction in the rate of conversion to formal psychosis beyond that explainable by chance and/or the introduction of bias secondary to baseline imbalances, inadequate blinding or even differential psychosocial supports.”

“We suggest caution in making any assumptions that justify changes in prescription-writing behavior when it involves patients who are at high risk for developing long-term psychotic illnesses but have never demonstrated sustained psychosis (psychotic illness by DSM-IV criteria),” Kruszewski and Paczynski advise.

“This would include but is not limited to persons with suspected schizophrenia prodrome,” they add.

“Even in the hands of experienced investigators using detailed screening protocols in controlled settings, only one-quarter to one-third of high-risk patients converted to full-blown psychosis,” they report.

“Consequently,” they warn, “if early use of ATAPs continues as a quasi-standard of care for new-onset psychotic symptoms, a large majority of these often young individuals will be exposed unnecessarily to poorly defined but likely substantial risks, including but not limited to obesity, hyperlipidemia, metabolic syndrome, increased rates of type II diabetes mellitus and extrapyramidal syndromes, both acute and chronic.”

“Considerations of safety must come first when the preventative efficacy of these agents remains so poorly defined,” they conclude.

(Part III of this series will highlight the Psychiatric Industrial Complex as the driving force behind the American Epidemic of Mental Illness)

Evelyn Pringle

(This series is sponsored by the International Center for the Study of Psychiatry and Psychology http://icspponline.org/index.html)

Filed under: pharmacology

Tracking the American Epidemic of Mental Illness – Part I by Evelyn Pringle

Tracking the American Epidemic of Mental Illness – Part I

by Evelyn Pringle

Over a twenty year span, starting when Prozac came on the market in 1987, the number of people on government disability due to mental illness went from 1.25 million to more than 4 million today. There has been a 35-fold increase in the number of children disabled by mental illness who receive federal disability payments, rising from 16,200 in 1987, to 561,569 in 2007.

These statistics come from a new book titled, “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness, in America,” by award winning journalist, Robert Whitaker, who also authored “Mad in America.”

For the book, Whitaker reviewed 50 years of outcomes in the medical literature, for adults with schizophrenia, anxiety, depression, and bipolar illness, and the childhood disorders of ADHD, depression and juvenile bipolar disorder, to see whether medications had altered the long-term course of the disorders and whether drugs could bring on new or more severe psychiatric symptoms.

His intent was to assess whether this paradigm of care increased the risk that a person would become chronically ill, or ill with disabling symptoms, he reports in his “Mad in America” blog, on the Psychology Today website.

“Although we, as a society, believe that psychiatric medications have “revolutionized” the treatment of mental illness, the disability numbers suggest a very different possibility,” he wrote in the April 28, 2010, Huffington Post.

On April 29, 2010, Alternet published an interview with Whitaker by Dr Bruce Levine, with the headline question of, “Are Prozac and Other Psychiatric Drugs Causing the Astonishing Rise of Mental Illness in America?”

The “literature is remarkably consistent in the story it tells,” Whitaker told Levine. “Although psychiatric medications may be effective over the short term, they increase the likelihood that a person will become chronically ill over the long term.”

“In addition, the scientific literature shows that many patients treated for a milder problem will worsen in response to a drug– say have a manic episode after taking an antidepressant — and that can lead to a new and more severe diagnosis like bipolar disorder,” he said. “That is a well-documented iatrogenic pathway that is helping to fuel the increase in the disability numbers.”

During the interview, Whitaker discusses his research on the increase of juvenile bipolar disorder in the US, as an example of how prescribing psychiatric drugs to children can actually cause mental illness.

“When you research the rise of juvenile bipolar illness in this country, you see that it appears in lockstep with the prescribing of stimulants for ADHD and antidepressants for depression,” he reports.

“Prior to the use of those medications, you find that researchers reported that manic-depressive illness, which is what bipolar illness was called at the time, virtually never occurred in prepubertal children,” he explains.

“But once psychiatrists started putting “hyperactive” children on Ritalin, they started to see prepubertal children with manic symptoms,” he reports.

“Same thing happened when psychiatrists started prescribing antidepressants to children and teenagers,” Whitaker says. “A significant percentage had manic or hypomanic reactions to the antidepressants. “

“Thus, we see these two iatrogenic pathways to a juvenile bipolar diagnosis documented in the medical literature,” he states.

The bipolar kids often end up on cocktails of heavy-duty drugs, including antipsychotics such as Zyprexa, Risperdal, Invega, Seroquel, Abilify and Geodon, which cause a host of physical problems and possible cognitive decline over the long term, he told Levine.

“When you add up all this information, you end up documenting a story of how the lives of hundreds of thousands of children in the United States have been destroyed in this way,” Whitaker says.

In fact, he thinks that “the number of children and teenagers that have ended up “bipolar” after being treated with a stimulant or an antidepressant is now well over one million.”

“This is a story of harm done on an unimaginable scale,” he told Levine.

Levine, an author himself of “Surviving America’s Depression Epidemic,” describes “Anatomy of an Epidemic,” as the “most important book on psychiatric treatment in a generation.”

Role of American Psychiatric Association

In 2006, the 38,000 member strong, American Psychiatric Association, received 30% of their funding, or more than $20 million, from the pharmaceutical industry.

This year’s attendees at the group’s annual meeting last month in New Orleans “had to brave 200 protestors chanting “no drugging kids for money” and “no conflicts of interest” to get into the convention hall,” according to Martha Rosenberg’s May 30, 2010 report in OpEd News.

“If there were a take home message at the APA meeting about the blizzard of ADHD, bipolar and personality disorders threatening adults and children, it was don’t wait,” Rosenberg says. “These dangerous conditions, likened to cancer and diabetes, won’t go away.”

“Thanks to genetic advancements, psychiatric disease risks can now be detected and treated before symptoms surface, said presenters, fostering early treatment paradigms that are pretty Brave New World: People being told they have a disease they can’t feel that needs immediate and lifelong treatment at hundreds of dollars a month or their health will suffer,” she reports.

“Preemptive psychiatric drugging is likely the most dangerous idea that has come along since lobotomy,” warns the prolific anti-drugging activist, Vince Boehm.

As far as drugs, there was no star of the show, Rosenberg says. “The Next Big Thing was not a new drug at all but adjunctive therapy also known as adding existing drugs to existing drugs because they don’t work right.”

“Throwing good drugs after bad, popularized with the antipsychotic Abilify,” she explains, “has only been enhanced by a study in the January JAMA that found antidepressants don’t work for mild depression at all.”

“Antipsychotics are also being “enhanced” by adding drugs to offset weight gain and lethargic side effects,” she reports.

“The pharmaco-fraudulence which has taken over psychiatry today is absolutely breathtaking,” says Dr Nathaniel Lehrman, former Clinical Director of Kingsboro Psychiatric Center, Brooklyn NY.

“There is absolutely no rationale for adding antipsychotics to antidepressants in the treatment of depression other than the hope that somehow the patient will feel better when new medication is added when the old is not enough,” he reports.

Lehrman can think of no medication “which is really specific for anything in psychiatry.”

“The effect of all these medications is largely happenstance,” he says. “If something happens to make the patient feel better while taking a particular medication, the latter will be credited.”

Catalog of Mental Disorders

In January 2010, the APA released a draft for the 5th edition of the Diagnostic and Statistical Manual, or DSM-V, also known as the Billing Bible of psychiatry, with the official definitions of normal and abnormal. Criticisms of the revisions and the task force have been non-stop.

In a March, 2010, analysis in Psychiatric Times, Lisa Cosgrove and Harold Bursztajn reported that approximately 68% of the members of the DSM5 task force had financial ties to the pharmaceutical industry, a 2% increase over the task force members of the DSM4 with such ties.

The draft criteria for “Temper Dysregulation Disorder with Dysphoria,” has specifically come under attack as “one of the most dangerous and poorly conceived suggestions for DSM5,” by Dr Allen Frances, who was chairman of the DSM-IV Task Force, in his “DSM5 in Distress” blog on the Psychology Today Website.

“Apparently, the Work Group was trying to correct excessive diagnosis of childhood bipolar disorder—but its suggestion is so poorly written that it could not possibly accomplish this goal and instead would it would create a new monster,” he advises.

“The “diagnosis” would be very common at every age in the general population and would promote a large expansion in the use of antipsychotic medications, with all of the serious attendant risks,” he warns.

“While trying to rescue kids who are now misdiagnosed as bipolar,” Frances says, “it will undoubtedly open the door to the misdiagnosis of normal kids who happen to be temperamental or in difficult family circumstances.”

The syndrome was first called “severe mood dysregulation (SMD),” but the Childhood Disorders Work Group decided to rename it “temper dysregulation with dysphoria (TDD),” because (a) the new name is more descriptive; and (b) the name of DSM diagnoses does not typically include a denotation of severity, according to the group’s report.

In any event, the prescribing of psychiatric drug cocktails will continue no matter what they end up calling the new disorder. If TDD is a form of BD, “first-line treatment would consist of atypical antipsychotic medication and/or mood stabilizers,” the group states in the report. “On the other hand, if TDD is on a continuum with unipolar depressive disorders, anxiety disorders, and ADHD, first-line treatment would consist of serotonergic reuptake inhibitor antidepressants (SSRI’s) and stimulants.”

In a March 8, 2010 article in Skeptic Magazine, Dr John Sorboro warned that the “folks writing the new DSM-V are even considering a new classification of “prodromal” disorders, which means you may qualify for diagnosis of a mental disorder just based on the hunch of your psychiatrist. “

“Psychiatrists get paid for treating mental illness,” he says. “There is a strong motivation for them to look at things they used to attribute to chronic personality, or just life, and see them as psychiatric illness.”

“These changes have nothing to do with any real definitive science or specific tests that can effectively demonstrate who has a disorder,” Sorbora notes. “It’s little more than psychiatry repackaging people with different labels.”

“Who gets what label has a lot more to do with politics and the economics of psychiatry than it does with any true understanding of the developmental or biologic underpinnings of specific behavior let alone whether we choose to see “different” as “disordered,” he points out.

Sorboro says following the money has led many people to seriously question “the motivations of some of psychiatry’s most prolific researchers who shape how people get diagnosed, what disorder label they are given, and what drugs they are prescribed.”

He notes Senator Charles Grassley’s ongoing investigation to determine the full extent of industry fees paid to psychiatric researchers, and that “some of the biggest names in the business have been accused of misconduct.”

The “biggest names in the business,” identified by Grassley thus far, include Harvard University’s Joseph Biederman, Thomas Spencer and Timothy Wilens; Charles Nemeroff and Zachery Stowe from Emory University; Melissa DelBello at the University of Cincinnati; Alan Schatzberg, the president of the American Psychiatric Association from Stanford University; Martin Keller at Brown University; Karen Wagner and A John Rush from the University of Texas; and Fredrick Goodwin, the former host of a radio show called “Infinite Minds,” broadcast for years by National Pubic Radio.

“Among all the problematic suggestions for DSM5, the proposal for a ” Psychosis Risk Syndrome” stands out as the most ill conceived and potentially harmful,” according to Dr Frances, in his “DSM5 in Distress” blog on the Psychology Today Website.

“This is a clearly the prescription for an iatrogenic public health disaster,” he warns.

“The whole concept of early intervention rests on three fundamental pillars- being able to diagnose the right people and then providing them with a treatment that is effective and safe,” he explains. “Psychosis Risk Syndrome” fails badly on all three counts, he warns.

“The false positive rate would be alarming,” he says, “70% to 75% in the most careful studies and likely to be much higher once the diagnosis is official, in general use, and becomes a target for drug companies.”

“Hundreds of thousands of teenagers and young adults (especially, it turns out, those on Medicaid) would receive the unnecessary prescription of atypical antipsychotic drugs,” he warns.

“There is no proof that the atypical antipsychotics prevent psychotic episodes,” he says, “but they do most certainly cause large and rapid weight gains (see the recent FDA warning) and are associated with reduced life expectancy—to say nothing about their high cost, other side effects, and stigma.”

“Imagine the human tragedies that follow the mislabeling of 70% of children as severely mentally ill, who are then exposed to extremely toxic drugs that induce diabetes, cardiovascular disease, and a host of other severe adverse effects,” warned Vera Hassner Sharav, founder and president of the Alliance for Human Research Protection, in a February 10, 2010 Infomail.

Unnecessary Drugging

“We are going to have an epidemic of young adults with yet-to-be-determined neurological problems due to the long term use of psychotropic drugs,” warns Washington DC psychiatrist Dr Joseph Tarantolo, Board Chairperson of the International Center for the Study of Psychiatry and Psychology.

An epidemic is defined as 1% of the population and there will be far more than 1% injured by these drugs, he says.

Every human being is at risk of becoming “psychotic,” he states. “It has been said that in the Nazi Germany concentration camps psychosis was 100%.”

“Once one agrees that something is universal, one is simply trying to describe the human condition, not make a medical diagnosis,” Tarantolo advises.

Dr Stefan Kruszewski, a graduate of Princeton University and Harvard Medical School, has seen many patients who experienced one or more episodes of psychosis from medications, illicit drug withdrawal, acute stress, metabolic conditions, PTSD or other psychiatric diagnoses, “who recovered and did not re-experience problems later in life.”

In his extensive clinical experience with psychotic individuals, “recovery after psychosis has been the “norm,” not the exception,” he says.

“More significantly, and somewhat contrary to the prevailing psychiatric professional view,” he notes, “the overwhelming majority of my clients in who I observed this ‘norm’ did NOT require psychiatric medicines to sustain them.”

“And, many of them who were prescribed antipsychotic medications to ‘thwart’ another psychotic episode fared somewhat worse than those who were not prescribed any combination of antipsychotics and mood stabilizers,” he adds.

Dr Thomas Edward Bratter is president and founder of the John Dewey Academy in Massachusetts, a residential, voluntary, educational-treatment school for gifted but self-destructive adolescents. This drug and medicine-free facility uses compassionate psychotherapy.

Most students arrive at the Academy with multi DSM-IV labels to justify prescribing psychotropic poisons and receiving third party payments, Bratter says, and have been “raped by the pejorative psychiatric cartel.”

He calls the “Psychosis Risk Syndrome” criminal because “such a diagnosis ignores the awesome toxic power of a negative self-fulfilling prophesy which maximizes failure by perpetrating the unproven myth of mental illness.”

“There needs to be a class action against those who would endorse this movement,” he says, and Bratter would gladly testify on behalf of children and adolescents who need to be protected from such a toxic and damaging conspiracy.

Toxicology expert, Dr Lawrence Plumlee, is president of the Chemical Sensitivities Disorders Association, and editor of, “The Environmental Physician of the American Academy of Environmental Medicine.”

The Chemical Sensitivity Disorders Association was established to provide information and support to chemically sensitive people; to disseminate information to physicians, scientists and other interested persons; and to encourage research on chemical sensitivity disorders and minimizing hazards to human health.

Plumlee is concerned about the DSM5 proposal by the Somatic Symptom Disorders Work Group, to change the name of the category “Somatic Symptom Disorders,” to “Complex Somatic Symptom Disorder.”

“The new draft DSM manual proposes that chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivity are “somatiform” disorders requiring psychiatric consultation,” he says. “It’s the same old story of Psychiatry trying to extend its diagnostic labels and drug treatments to new populations.”

This is “an effort by psychiatry to psychiatrize physical illnesses and to try to suppress the complaints of these patients by prescribing psychiatric drugs,” Plumlee says.

“But experience is showing that the psychiatric procedures and drugs are making patients worse,” he advises.

Using psychiatric diagnoses and drugs on diseases of neurotoxicity helps the chemical companies in two ways, he reports. “It fools some people into thinking that poisoned people are crazy, thus getting the poisoners (chemical companies) off the hook,” and two, “it sells more chemicals (psychiatric drugs) to treat those who really need detoxification, not more chemicals in their bodies. “

(Part II of this series with show how tax dollars are being used to fuel the American Epidemic of Mental Illness)

Evelyn Pringle

(This series is sponsored by the International Center for the Study of Psychiatry and Psychology http://icspponline.org/index.html)

Filed under: pharmacology

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