The Bitter Pill

The Official Blog of UNITE – uniteforlife.org

Free Travel for Military Personnel with Prescribing Power

Evelyn Pringle June 2009

From 1998 through 2007, there were 8,700 trips by Department of Defense personnel paid for by the healthcare industry, with a price tag of more than $10 million, according to a new report titled, “Pentagon Travel,” by the Center for Public Integrity.

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

The sponsors 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 June 9, 2009 summary of the study on its website 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 summary 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.

“They pay for them because it works,” says Thomas Murray, president of the Hastings Center, a nonpartisan bioethics research institute, in the summary. “Trust me, their marketing departments are paying very close attention to cost benefit analysis for these kinds of gifts.”

Shahram Ahari worked as a sales representative 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, he explained, is to make friends with doctors and pharmacists to get them talking about the drugs or devices, and then reward them with additional perks for prescribing the drugs.

“The return on dividends is phenomenal,” Ahari said 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.

Filed under: 2009, anticonvulsants, antipsychotics, GAO, military, SSRIs, suicide, veterans

Suicide Prevention Drug Pushing Racket – Part II

Evelyn Pringle August 21, 2009

A recent study in the April 2009, Pharmacoepidemiology and Drug Safety journal found no change in the suicide rate in teens as a result of the regulatory ban in the UK on the use of SSRI antidepressants with children under 18, which did result in a drastic reduction in SSRI use among kids.

“Anti-depressant use in under 18 year olds halved after the warnings,” Pulse Today reported on April 24, 2009.

The research team from the University of Bristol concluded that “there was no evidence of an overall effect on suicides of regulatory action to restrict prescribing of SSRIs to young people.”

Lead researcher, Dr Benedict Wheeler, told Pulse: “We found no clear evidence of a beneficial effect on population suicide rates. However, and equally importantly, we did not find evidence of an adverse effect on suicide rates either.”

“This is important, because many mental health workers and researchers have been concerned that reduced antidepressant prescribing to children might inadvertently lead to an increase in suicides,” he said.

Athough “the rate of suicide among 15 to 19 year olds fluctuated to varying degrees in the 22 countries analysed between 1990 and 2006, there was ‘no consistent change’ in the rate of suicide after the restrictions came into place in 2003,” Pulse reported.

A year and a half ago, Medscape reported that a study found the drop in SSRI prescribing in the UK did not lead to a spike in youth suicides on February 21, 2008. The study, also led by Dr Wheeler, was published online February 14, 2008, in the BJM. The researchers set out to evaluate the impact of changing patterns of antidepressant use on suicide or self-harm in young people in the UK, following 2003 regulatory action.

“These data for England do not indicate that reductions in antidepressant use have led to an increase in suicidal behavior,” the group wrote.

“The findings are important, in that reduced access to antidepressants in young people in the United Kingdom following regulatory intervention appears not to have had an adverse impact on suicide deaths or hospital admissions for deliberate self-harm,” Dr Wheeler told Medscape.

Continuing adherence to regulatory guidance on prescribing antidepressants to young people is supported by this evidence, he added.

In a related time trend study also published online February 14, 2008 in the BMJ, Lucy Biddle, PhD, and colleagues at the University of Bristol reported that the rate of death by suicide in young men in England and Wales was the lowest it had been in 30 years.

To investigate overall suicide trends, the researchers reviewed data from 1968 to 2005 for men and women aged 15 to 34, and found suicide rates in young men aged 15 to 24 and 25 to 34, peaked in 1990 and 1998, respectively, and then showed a steady decline. In 2005, suicide rates for men in these age groups were the lowest they had been since the mid-1970s.

The researchers reported that suicide rates in young women were also at the lowest level they had been in many years and they did not find any temporal correlation between the changes in antidepressant prescribing rates and changes in suicide rates.

On February 15, 2008, a researcher in both studies, Professor David Gunnell, noted in a BBC News report that concerns about the dangers of reducing antidepressant use in children, who might therefore be at an increased risk of committing suicide, had been raised by US research.

“There’s been a greater fall in antidepressant prescribing in the UK but we have seen none of the potentially alarming upturn in suicides,” he said.

In the Medscape report, Dr Wheeler pointed out that his findings differed from those of Robert Gibbons and colleagues, who reported in the September 2007, “American Journal of Psychiatry,” that mortality rates for suicides in 5- to 19-year-olds in the US increased in 2004, following regulatory action.

In a Newsweek article titled “Trouble in a ‘Black Box'”, Gibbons went so far as to say: “I think the FDA has made a very serious mistake. It should lift its black-box warning because all it’s doing is killing kids.”

“You may induce two suicides by treatment, but by stopping treatment you’re going to lose dozens to hundreds of kids. You’re losing more than you’re saving. That’s the calculus,” said Dr Robert Valuck, of the University of Colorado Heath Sciences Center, in the Newsweek article.

In the Medscape report, Dr Wheeler noted that “critiques” of the Gibbons study in “Letters to the Editor” in the Journal, suggested that the US situation might not actually differ that much from the study findings in UK.

In fact, in one such letter, the respected British Columbia researcher, Jon Jureidini, said the Gibbons study “incorrectly analyzed the relationship between U.S. selective serotonin reuptake inhibitor (SSRI) prescription rates and suicide rates among children.”

The Gibbons study claimed there was a correlation between a 22% decrease in SSRI prescriptions and a 14% increase in youth suicide rates between 2003 and 2004, after warnings were issued by the FDA.

“As it turns out,” Dr Jureidini wrote, “preliminary figures are now available from the Centers for Disease Control (CDC), which show that fewer people under age 25 committed suicide in 2005 (when prescribing did decrease) than in 2004.”

“In the year in which suicide rates rose sharply,” he said, “there was no significant drop in SSRI prescribing.”

When broken down into separate age groups, government statistics for 2005, show the number of suicides was lower for all young people in the US, on the website of the National Center for Injury and Prevention and Control.

For children aged 5 to 14, there were only 270 in 2005, compared to 285 suicides in 2004. In the age group of 15 to 24, the number of suicides dropped to 4,139 in 2005, from 4,316 in 2004.

The statistics show that overall, when children are combined in the age group of one through eighteen, suicides fell from 1,471 in 2004, down to 1,408 in 2005. In 2006, the latest year posted, there were only 1,296 suicides in this age group.

On July 24, 2008, Pharmalot’s Ed Silverman reported on data from the Agency for Healthcare Research and Quality that showed antidepressant prescriptions rose in 2005. “The increase amounted to roughly 10 percent, and that occurred in a year in which new and controversial Black Box warnings were added to the labeling,” he wrote.

A survey of doctor and hospital visits in 2005, by the CDC, found the most commonly prescribed drugs were antidepressants, with 48% of the prescriptions written by primary care physicians.

Yet, as recently as January 30, 2009, in a Medscape Continuing Medical Education seminar, sponsored by Lexapro and Celexa maker, Forest Labs, Robert Gibbons was still saying: “we have seen in 2004 and 2005, the years for which CDC [Centers for Disease Control] has available data on youth suicide rates, the largest increases in youth suicide rates in history since they initially were monitored,” in citing his own discredited study.

“There have been significant decreases in the prescriptions overall of antidepressants to children and adolescents,” Gibbons said “And that has spilled over to the young adult and middle-aged adult range as well.”

The disclosure section for the seminar shows Gibbons has served as an expert witness for Zoloft maker, Pfizer, and Wyeth Pharmaceuticals, maker of the antidepressants, Effexor and Pristiq.

Gibbons is a Professor of Biostatistics and Psychiatry and Director of the Center for Health Statistics at the University of Illinois at Chicago College of Medicine, according to his bio on the Department of Psychiatry’s webpage.

In 2007, the American Foundation for Suicide Prevention, and Paxil maker, GlaxoSmithKline, donated between $10,000 and $24,000, to UIC College of Medicine, according to the Spring 2008 “UIC Medicine,” newsletter. Zoloft peddler, Pfizer, donated between $50,000 and $99,000.

A co-author on the Gibbons study was Dr John Mann, a former president of the AFSP, and a professor of psychiatry at Columbia University.

Columbia University’s 2007 Annual Report shows donations of between $100,000 and $499,000 from the AFSP, GlaxoSmithKline, Pfizer Incorporated and Pfizer International. The Pfizer Foundation gave $1 million or more.

The report also shows gifts of between $50,000 to $99,999 from Wyeth, the GlaxoSmithKline Foundation, Eli Lilly and Company, and the Eli Lilly Foundation.
Mann has served as a paid expert witness for antidepressant makers Pfizer and Glaxo. He testified in the only Paxil suicide-homicide case ever to make it to a jury.

During his testimony, Houston attorney, Andy Vickery, brought out the fact that Mann had received more than $30 million in research funding from drug companies over the previous decade.

Mann admitted during cross-examination that he had written in three articles that there was possibly a small, subpopulation of patients vulnerable to suicide or violence under the drug, Vickery told Lawyers Weekly.

On June 6, 2001, the jury ruled against the drug maker and found that Paxil “can cause some people to become homicidal and/or suicidal,” and awarded the plaintiffs over $6 million.

In nearly all the studies and papers published over the years that claim SSRIs work with children and do not cause suicide, the same academic quacks appear as investigators and co-authors. The list of names includes, but is not limited to, Joseph Biederman, David Brent, Jeffrey Bridge, David Dunner, Graham Emslie, Daniel Geller, Robert Gibbons, Frederick Goodwin, Martin Keller, Andrew Leon, Anne Libby, John Mann, John March, Charles Nemeroff, John Rush, Neal Ryan, David Shaffer, Karen Wagner and Robert Valuck.

Many of the same names also appear on the ever-growing list of so-called “Key Opinion Leaders,” who have been exposed in an investigation by the US Senate Finance Committee, under the leadership of Senator Charles Grassley, as not disclosing Big Pharma money, which thus far includes, Harvard’s Biederman, Thomas Spencer and Timothy Wilens; Nemeroff and Zachary Stowe from Emory; Melissa DelBello at the University of Cincinnati; Stanford University’s Alan Schatzberg, president of the American Psychiatric Association; Keller at Brown University; Wagner and Rush from the University of Texas; and Goodwin, the former host of a radio show called “Infinite Minds.”

Graham Emslie’s earnings from antidepressant makers were highlighted in the media last year due to his role in the “Texas Children’s Medication Algorithm Project.” Emslie was chairman of the panel that issued guidelines in 1998, instructing doctors to prescribe SSRIs off-label to children for depression.

On August 18, 2008, the Dallas Morning News ran the headline: “Conflict of interest fears halt children’s mental health project.”

“A state mental health plan naming the preferred psychiatric drugs for children has been quietly put on hold over fears drug companies may have given researchers consulting contracts, speakers fees or other perks to help get their products on the list,” the News reported.

Emslie “has made at least $130,000 in drug company speakers fees and consulting contracts since 2002,” the paper noted, citing University disclosure forms. Co-authors on guidelines of the “Texas Children’s Medication Algorithm Project,” include Karen Wagner, John Rush and Neil Ryan.

The SEC filings for Cypress Bioscience provide a good source for estimating the amount of money these “KOLs” are pulling in per year, from each separate company.
Keller and Nemeroff have served on the board of directors, the scientific advisory board, and as consultants for Cypress. Under their 2004 consulting agreements, the firm was required to pay $50,000 per year for services rendered up to and including “two days per fiscal quarter.” In addition, Cypress could request additional services at a rate of $5,000 per day.

Nemeroff was paid $19,000 for additional services in 2003, and Keller made an extra $18,000. For serving on the scientific advisory board, Nemeroff was paid $19,000 and Keller earned $18,000, in 2003. As members of the board of directors in 2002, they each received $24,000.

A July 25, 2002, bio for Keller in the agenda for a Cypress annual meeting, shows he was also a consultant to, “Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Janssen, Merck, Inc, Organon, Otsuka Pharmacia/Upjohn, Pharmastar, Pfizer, Inc. and Wyeth-Ayerst Laboratories.”

The bio also reports that Keller served on the scientific advisory boards of, “Bristol-Myers Squibb, Cephalon, Cyberonics, Inc., Eli Lilly, Forest Laboratories, Merck, Inc, Mitsubishi, Organon, Pfizer, Sepracor, Scirex, SmithKline Beecham, Somerse, Vela Pharmaceuticals and Wyeth-Ayerst.”

Suicide Victims on Antidepressants

In the first seven months of 2008, the “Evansville Courier & Press,” reported a near record number of 23 suicides in Vanderburgh County, Indiana. On August 11, 2008, the County’s chief deputy coroner, and a member of the local suicide prevention coalition, told the Courier that in the results of a preliminary investigation “one element” stood out: “In a majority of the cases investigated, the victim was on antidepressant medication. And none of the victims were in counseling.”

A study in the August, 2006, Archives of General Psychiatry, found children aged 6 to 18, who took antidepressants in an inpatient setting, were 52% more likely to attempt suicide in the 60 days following discharge than children who were not taking the drugs.

This study analyzed data from the national Medicaid Analytic Extract Files, including information from all 50 states, and determined that children who filled prescriptions for antidepressants after an inpatient stay were over 15 times more likely to die by suicide than kids who were not taking antidepressants.

On May 25, 2007, MedPage Today reported a study that found young suicide victims were significantly more likely to have SSRIs in their bloodstream than were young homicide or accident victims.

“In an analysis of ‘unnatural’ deaths recorded by the Virginia Medical Examiner’s Office for 1987 through 2003,” MedPage wrote, “Antony Fernandez, MD, and colleagues, found that selective serotonin reuptake inhibitors or the serotonin-norepinephrine reuptake inhibitor venlafaxine appeared significantly more often in post-mortem toxicology of suicides than of accident or murder victims.”

Studies show the SSRIs were passed out like candy to children during this time period. According to FDA estimates, in 2003, eleven million antidepressant prescriptions were written for under 19-year-olds, representing a 27% increase in 3 years.

Dr Thomas Moore, with the Drug Safety Research group, conducted a study of antidepressant use with kids during the 4-period of 1998 to 2001, and found the use of SSRIs with children doubled, and in 90% of the cases the drugs were prescribed off-label for uses not approved by the FDA.

For example, among boys 6 to 12-years-old, 52% of the prescriptions were written for attention deficit or conduct disorders, and typically, Dr Moore says, in combination with an antipsychotic or a stimulant.

There is “no scientific evidence that says that combination therapy is effective in these disorders and I know of no evidence that it is safe either,” he advises.

The study found that 17% of the children were taking drugs that were ineffective in clinical trials, and 42% were taking two or more antidepressant drugs. “So, what we are seeing is when drugs are ineffective, rather than abandoning them or trying alternatives, doctors increase the dose or combine the drugs in ways, the safety of which we are not aware,” Dr Moore warns.

Wyeth’s Effexor me-too drug, Pristiq, was approved for adults with depression in May 2008. By the end of 2008, the FDA’s adverse event reporting system showed 17 death reports for which Pristiq was listed as the primary suspect, including twelve completed suicides. Another 31 reports turned up with a search for “Suicidal Ideation.”

On July 17, 2009, a press release issued by “Wichita Family Examiner.com,” announced a “Child and Adolescent Depression Study in Wichita.” The Clinical Research Institute in Wichita, Kansas, is “looking for children from 7 to 12 years of age that are suffering with depression to participate in the trial of Pristiq,” the press release states.

“Pristiq is a FDA approved antidepressant,” the announcement states, without informing parents that the drug is not FDA approved for use by children under 18.
“Participants are compensated for their time up to $750,” according to the press release.

Suicides Skyrocket Among Young Men and Women in the Military

On July 23, 2009, the “Air Force Times,” reported that the US Senate has ordered “an independent study to determine whether an increase in military suicides could be the result of sending troops into combat while they are taking antidepressants or sleeping pills.”

Senator Benjamin Cardin (D-Md), who pushed for the study, said he does not know whether there is a link, but he believes prescription drug use, especially when it is not closely supervised by medical personnel, needs a closer look, the Times noted.

“One thing we should all be concerned about is that there are more and more of our soldiers who are using prescription antidepressant drugs … and we are not clear as to whether they are under appropriate medical supervision,” Cardin told the Times.

“Surveys … have shown that as many as 12 percent of those who are serving in Iraq and 17 percent of those who are serving in Afghanistan are using some form of prescribed antidepressant or sleeping pills,” he said. “That would equal 20,000 of our service members.”

“Death by suicide is at record levels in the armed services,” according to Dr Peter Breggin, one of the top experts on psychiatric drugs in the US.

“Simultaneously,” he says, “the use of antidepressant drugs is also at record levels.”

“The army confirms that since 2002 the number of suicide attempts has increased six-fold,” he notes. “And more than 128 soldiers killed themselves last year.”

The FDA requires antidepressant makers to list the following adverse effects on the labels of their drugs: “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity … and mania.”

“We are giving our troops drugs that provide a prescription for uncontrolled, disinhibited violence, including agitation, irritability, impulsivity, hostility, and aggressiveness,” Dr Breggin points out.

“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.”

“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,” he notes.

In his latest book, “Medication Madness,” Dr Breggin describes dozens of cases in which peace-loving citizens became suicidal, violent and psychotic from taking antidepressants.

As of July 19, 2009, on the website, “SSRI Stories – Antidepressant Nightmares,” (http://www.ssristories.com), there were over 3,200 news stories, mainly criminal in nature, that have appeared in the media (newspapers, TV, scientific journals), or were part of testimony at FDA hearings on SSRIs in either 1991, 2004 or 2006, in which antidepressants are mentioned.

“Even these 3200+ documented stories only represent the tip of an iceberg since most stories do not make it into the media,” the website points out.
Drugs Drugs and More Drugs

From 1996 to 2006, prescriptions for psychiatric drugs in the US increased by 73% among adults and 50% with children, according to a study in the May/June 2009 issue of the journal “Health Affairs.”

Another study in the same issue, found spending for mental health care grew more than 30% over the same 10-year period, with almost all of the increase due to psychiatric drug costs.

According to the latest statistics from the Agency for Healthcare Research and Quality, the number of people treated for mental disorders increased from 19 million to 36 million between 1996 and 2006. “The overall treatment costs for mental disorders rose from $35 billion (in 2006 dollars) to nearly $58 billion, making it the costliest medical condition between 1996 and 2006,” Medical News Today reported on August 5, 2009.

The “National Survey on Drug Use and Health,” published by the Federal Substance Abuse and Mental Health Services Administration, in December, 2008, reported that in 2007, 10.9 percent of adults aged 18 or older, or an estimated 24.3 million persons, had experienced serious psychological distress in the past year, and 44.6% had received mental health services in the past year.

Of those adults who received services, 87% were given prescription medication, and 34.6% received drugs only. In contrast, only 10.7% received outpatient treatment alone with no medication.

The successful peddling of the new generation of psychiatric drugs, evidenced in the ten year period above, was accomplished through a suicide prevention racket. However, in 1996 there were 30,903 suicides in the US, and in 2006, there were 33,292, according to the National Center for Injury Prevention and Control.

Written for Natural News

Filed under: 2009, AFSP, antipsychotics, drugging children, front groups, KOL, Mann, military, Natural News, SSRIs, suicide, TMAP, veterans

Tracking the American Epidemic of Mental Illness – Part III

Evelyn Pringle June 9, 2010

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 DSM5 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.”

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

Filed under: 'ADHD', 2010, antipsychotics, APA, drugging children, DSM, front groups, http://schemas.google.com/blogger/2008/kind#post, ICSPP, military, SSRIs, veterans

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