Evelyn Pringle May 29, 2007
Federal lawmakers are stepping up the pace to put a stop to the pharmaceutical industry's customer recruitment schemes used to boost the sale of psychiatric drugs by tugging at heartstrings in promoting mental health screening programs as suicide prevention tools.
On May 18, 2007, US House of Representative Ron Paul (R-Texas), a physician by calling, introduced a federal legislative bill HR 2387 that would block federal funding for any mandatory mental health screening programs. At last count, 12 other members of the House were listed as co-sponsors of the bill.
First of all, contrary to the lie that the industry is trying to sell the pubic, there is no epidemic of child suicides. There are roughly 50 million school-age children in this country, and according to the June 16, 2006, Washington Post, there were only 1,737 suicides by children and adolescents in 2003, the last year for which national statistics are available.
In addition, experts have said over and over that screenings do not work. A March 28, 2002 paper, "Suicide in the United States," by Jane Pearson, PhD, chairman of the National Institute of Mental Health Suicide Research Consortium at the time, states: "[W]hen researchers have tried to predict suicide using as many known risk factors as possible, they are still unable to predict who will and who will not commit this act."
In the paper, she also verifies a real danger that screening critics are concerned about, in stating that, "a prevention program for high-school aged youth found that participants were more likely to consider suicide a solution to a problem after the program than prior to the program."
According to Dr Nathaniel Lehrman, former clinical director of Kingsboro Psychiatric Center, in Brooklyn NY, in the paper, The Dangers of Mental Health Screening, "No matter how we define mental illness in children or adults, it cannot be found by simple screening."
"Nobody can, by merely looking at someone else, or even on the basis of a pen and pencil questionnaire," he says, "differentiate the transient emotional disturbances we all have from those which last longer."
Dr Lehrman also says screenings won't prevent suicide because those who are contemplating it usually won't tell. "Only when gross insanity exists can "mental illness" be recognized on inspection - and then we need neither experts nor screening," he states.
"There are as many causes of depression as there are people suffering from it," he explains
"Troubled people can indeed benefit from good mental health care," he advises, "But good treatment requires addressing voluntarily a patient's unique individual problems."
"For this, screenings are unnecessary," he adds.
The drugs marketed with the screening programs are the new generation of selective serotonin reuptake inhibitor antidepressants (SSRIs), including Zoloft, Prozac, Paxil, Celexa, Lexapro and Luvox, which were falsely promoted as more effective than the older class of drugs in treating depression while the increased risk of suicide by patients taking the drugs was concealed.
The other drugs are the new class of atypical antipsychotics with brand names of Zyprexa, Risperdal, Clozaril, Abilify, Seroquel and Geodon. It should be noted that the atypicals were FDA approved for the limited use of treating adults with schizophrenia and manic episodes of bipolar disorder, also known as manic-depression, the most serious of all mental illnesses.
These new drugs obviously do not work. A June 2005 study lead by researchers from Harvard Medical School, funded mostly by the National Institute of Mental Health, found that although there has been a dramatic rise in the treatment of mental disorders over the past decade, there had been no corresponding drop in the rate of suicidal thought and behaviors in adults.
The study pointed out that there had been a huge increase in the use of antidepressants during the 10-year period studied, but the rate of suicidal ideation, gestures and attempts has not changed at all.
Dr Barry Duncan, author of "What's Right With You," also says, "rates of depression have not changed for thirty years," and, "suicide rates, despite the millions taking antidepressants, have not reduced."
Dr Duncan points out that more than 150 million prescriptions worth $14 billion were written for antidepressants in 2003 alone.
However, evidence continues to mount that shows SSRIs are linked to suicide. 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."
This latest study echoes a report by records researcher Ken Kramer that found most child suicides in Florida were by children who are already on psychotropic drugs. Mr Kramer analyzed every autopsy and toxicology report on every child suicide in the state of Florida from 2000 to 2004.
"The majority," Mr Kramer says, "had already received psychiatric drug treatment even with the FDA warnings that say these drugs can cause mania, suicide, psychosis, worsening depression and even homicidal thoughts."
A recent March 2007 report by the Government Accountability Office on Pediatric Drug Research states: "About two-thirds of drugs that are prescribed for children have not been studied and labeled for pediatric use, placing children at risk of being exposed to ineffective treatment or incorrect dosing."
Off-label refers to prescribing drugs to treat conditions other than those approved by the FDA and listed on the label. It can include prescribing drugs to unapproved populations, such as children or the elderly, or in higher doses than specified on the label.
It is illegal for a drug maker to promote off-label uses, but doctors are allowed to prescribe a drug for any use they choose. However, almost without exception, the lawsuits now pending against psychotropic drug makers accuse the companies of influencing doctors to prescribe the medications for off-label uses.
Critics say this profit-driven drugging of patients recruited with screening programs has got to stop, because a whole generation of Americans are becoming disabled right before our eyes, and lawmakers should realize that the government is going to have to pay to care for these disabled people for life and not just their medical care, but for their very existence.
Linda Hurcombe, author of "Losing a Child: Explorations in Grief," admits that her concerns about mental health screening programs arise from a personal tragedy. She is a US citizen living in the UK where prescription drug advertising is illegal, but her daughter fell victim to drug advertising while she was visiting the US.
"A few years ago my undepressed teenage daughter saw an antidepressant ad on American television," Linda explains, "and on her return to our rural home she went to her doctor and asked for the drug."
"It took her about eight minutes to persuade the doctor," Linda says, "followed by 63 days of descent into chaos which ended in her suicide by hanging."
"As far as patient advocacy is concerned," she notes, "it is alluring to an increasingly health-aware public to demand more knowledge."
"But what sort of 'knowledge' is likely from a gaggle of marketing moguls?" she points out.
"We must give the marketing men and women their due," Linda says, "as they medicalize the human condition from the cradle to the grave."
"Disturbing examples," she points out, "include toddlers taking mint-flavoured Prozac for bipolar disorder, antsy kids being calmed with methamphetamines, people diagnosed with 'intermittent explosive disorder' [read 'anger'], being medicated instead of addressing the causes of the stress in their lives."
Linda has a new book, "Depression: healing emotional distress," coming out soon.
Even with the limited approved uses for atyicals, last year drug makers sold more than $15 billion in antipsychotic drugs, according to data compiled by Bloomberg. Lilly's Zyprexa generated $4.4 billion in sales last year, and Johnson & Johnson's Risperdal had sales of $4.2 billion. Sales of Abilify climbed 41 percent to $1.3 billion.
Some of the known adverse events associated with these drugs include rapid weight gain and high blood sugar levels which are risk factors for diabetes, and disfiguring tics, dystonia which produces involuntary, often painful muscle contractions, heart attacks and sudden death in elderly patients.
Sales figures are so high because the makers of atypicals have doctors prescribing the drugs for all kinds of unapproved uses. On May 10, 2007, the New York Times reported that when Anya Bailey developed an eating disorder at 12 years old, her mother took her to a psychiatrist at the University of Minnesota who prescribed Risperdal.
Risperdal is not approved for treating eating disorders or any disorder in 12 year olds.
Anya gained weight, the Times noted, but within 2 years, she developed a crippling knot in her back the result of a nerve condition called dystonia, and now receives regular injections of Botox to unclench her back muscles and she often wakes up crying in pain.
The Times reported that the mother was surprised to learn that her daughter received a drug for a treatment not approved by the FDA, but was more surprised to learn that the psychiatrist who supervised Anya's care received more than $7,000 from 2003 to 2004 from Risperdal maker Johnson & Johnson, in return for giving lectures about one of the company's drugs.
These new drugs are being fed to so many people in all age groups for uses not approved by the FDA that experts say its often impossible to determine whether a symptom is caused by a mental disorder or a side effect from a drug.
Dr Elliot Valenstein, PhD, author of "Blaming the Brain", says, "It is now difficult to find mental patients who have not had a history of drug treatment, and as a result many of the brain abnormalities found in these patients are probably iatrogenic, that is, produced by the treatment rather than being the cause of the disorder."
"It is well established," he advises, "that the drugs used to treat a mental disorder, for example, may induce long-lasting biochemical and even structural changes, which in the past were claimed to be the cause of the disorder, but may actually be an effect of the treatment."
Dr Lehrman warns that the screening programs will "harm thousands of Americans by giving them stigmatizing diagnoses which can follow them for the rest of their lives, and then drugging them."
In some cases, patients, including children as young as 2, are being given SSRIs, atypicals and ADHD medications all at the same time in drug cocktails that would make any patient act crazy. And when the weird behaviors start, the dosages of the drugs are increased and often another medication is added to the mix to treat the "new strange behaviors" which are actually side effects from the drug cocktail.
The serious side effects associated with these drugs are only now being revealed to the public and health care providers because the drug companies concealed studies that showed the adverse events had occurred in their own clinical trials years ago.
Also, the drug makers are starting to pay dearly for a decade of illegal marketing practices and the concealment of the adverse effects of the drugs.
For instance, to date, Eli Lilly has spent more than $1 billion to settle out of court with about 26,000 Zyprexa victims, with still more litigants waiting in the wings. Zyprexa has been linked to serious side effects, including diabetes, hyperglycemia and pancreatitis.
The company is also facing lawsuits by 10 states and 4 class actions, filed on behalf of shareholders, charging Lilly with fraud in promoting the off-label sale of Zyprexa while concealing its side effects.
Zoloft maker Pfizer's March 2007 SEC filing states in part, "A number of individual lawsuits have been filed against us in various federal and state courts alleging personal injury, including suicide and suicide attempt in certain cases, as a result of the purported ingesting of Zoloft."
Pfizer will no doubt be facing more lawsuits in the near future because Zoloft has now been linked to life-threatening birth defects in babies born to mothers who took the drug during pregnancy.