NPR: On The Air, But Not In The Open
195 CommentsBy Ed Silverman // May 6th, 2008 // 3:42 pm
The latest saga of an undisclosed connection between experts and pharma comes to us courtesy of Slate. This is how a new piece begins: “A few weeks ago, devoted listeners of National Public Radio were treated to an episode of the award-winning radio series The Infinite Mind called “Prozac Nation: Revisited.”
The segment featured four experts discussing the controversial link between antidepressants and suicide. In their considered opinions, all four said that worries about the drugs have been overblown, Slate writes. The radio show, which was broadcast nationwide and paid for in part by the John D. and Catherine T. MacArthur Foundation, was hosted by Fred Goodwin, a former director of the National Institute of Mental Health.
But Slate writes that he never revealed to listeners that all four experts, including himself, have financial ties to drugmakers that sell antidepressants. Also unmentioned: “unrestricted” grants the show has received from drugmakers, including Lilly, which sells Prozac and Cymbalta. The mag goes on to write that it remains unclear how much funding was provided or when the show last received any funding, since neither Goodwin nor the show’s producers responded to repeated requests for interviews. We have left our own message for Bob Lichtenstein, whose company produces the show.
What are the connections? Goodwin is on the board of directors of Center for Medicine in the Public Interest, an industry-funded group that receives a majority of its funding from drugmakers. CMPI prez Peter Pitts was one of Goodwin’s three guests for “Prozac Nation.” Slate asked him to identify the companies that fund his group, but he told the mag, “I don’t want to go into that.”
However, Slate writes that CMPI took in more than $1.4 million in 2006 and, according to its tax forms, spent $210,000 to influence the media through a large conference, a blog the group maintains, op-eds published in major newspapers, and multimedia programs and podcasts. Pitts, by the way, is also senior vp for global health affairs at Manning Selvage & Lee, which reps Lilly, Pfizer, Glaxo and others, although Slate writes that, on the show, Pitts was identified only by his title as “a former FDA official.” Pitts tells Slate that he doesn’t know why his ties to industry weren’t revealed on the show.
The second guest on “Prozac Nation,” Andrew Leuchter, is a professor of psychiatry at UCLA who has received research money from drugmakers, including Lilly, Pfizer, and Novartis. The third guest, Nada Stotland, president-elect of the American Psychiatric Association, has served on the speakers’ bureaus of Glaxo and Pfizer. Their ties weren’t revealed to listeners. Instead, each was introduced as a prominent academic.
Slate did learn one thing - the mag reports that Lichtenstein Creative Media was dissolved by the state of Massachusetts on March 28 for failing to file annual reports since its establishment in 2004.
Lisa Van S
Peter Pitts, Have you no shame!!… Does anyone have the DSMIV diagnosis for habitual Lieing.
Dan
There are several doctors, mainly, who take a different stance on meds and the pharma industry. Where are they when interviewed by mass media? There are at least a dozen, and they are authors who have researched such topics.
NPR has just simply attempted to narrow the minds of its receivers. Don’t be one of them.
University Update - UCLA - NPR: On The Air, But Not In The Open
[...] State University NPR: On The Air, But Not In The Open » This Summary is from an article posted at Pharmalot » News, Comment and Conversation on Tuesday, [...]
Justice in Michigan
Mon dieu. Peter Pitts is to “former FDA official” what Robespierre is to “former French guy.”
Not false. Just a little … minimalist.
Peter Pitts
I think it’s important to point out that I spoke with one of the “journalists” who wrote the story in Slate for quite some time on the actual issue of the media’s coverage of the SSRI debate. None of that made the article. I think it’s also worth noting that at least on the the authors has, er, issues with accuracy. Google both names and check out the article in the New York Times. A robust debate on the SSRI issue is very important. Trying to stifle debate by personal attacks just shows a lack of intellectual rigor — and cowardice.
Peter Pitts
I think it’s important to point out that I spoke with one of the “journalists” who wrote the story in Slate for quite some time on the actual issue of the media’s coverage of the SSRI debate. None of that made the article. I think it’s also worth noting that at least one the the authors has, er, issues with accuracy. Google both names and check out the article in the New York Times. A robust debate on the SSRI issue is very important. Trying to stifle debate by personal attacks just shows a lack of intellectual rigor — and cowardice.
Ed Silverman
Hi Peter,
Can you be more specific?
Thanks,
ed
pg
Personal Attacks - a Few Examples?
http://drugwonks.com/blog/kooksrus
http://drugwonks.com/blog/david-graham-public-health-enemy
http://drugwonks.com/blog/dr-stupak-on-ssris-and-suicide
http://drugwonks.com/blog/fearmongering-on-ssris-as-a-pr-tool
Lisa Van S
Peter,
A robust debate on the SSRI issue is very important. Trying to stifle debate by personal attacks just shows a”lack of Intellectual Rigor,… and cowardice”.
Wow look who is calling the kettle black. How about the personal attack you and your fellow colleagues at FDA lodged upon a dead child. You had no problem with attacking a dead child who no longer had a voice, a child who no longer lives to defend himself. That was “Cowardice”,.. maybe you should practice what you preach!!
Im guessing you never took the time to read this letter that was addressed to you inn February 2004.
http://baumhedlundlaw.com/media/ssri/paxil/fdahearing/tierneyletter.htm
Lisa Van S
Ed,
Peter doesnt know how to be more sspecific,.. clearly his comments to slate lacked substance,… or maybe even truth.
pg
Lisa, have you got another link to it?
Lisa Van S
pg,
I dont,.. please google Jennifer Tierney fda. I dont know why the link isnt working
pg
Lisa, thanks for the search keywords hat tip which brought up a slightly different link to the letter you referred to in your comment to Peter Pitts above.
Now I understand better just what you were getting at and noticed in the third paragraph of the letter how “conclusions” were considered “biased” if they were for presenting the case for risks, but ‘unbiased’ if they were in agreement of how SSRIs were safe and effective for children - which meant no chance of a robust debate I guess.
The link: http://www.baumhedlundlaw.com/media/ssri/paxil/FDAHearing/TierneyLetter.htm
Peter Pitts
I challenge the authors of the article to give Ed a copy of my taped interview. And I give Ed my permission to use it.
Lisa Van S
Peter,
We are all ears,…
Your former position at FDA has Educated you quite well. You know darn well, that, the authors have no intention of sharing their work product with another reporter!! It was a nice try anyway. You could always put out a written rebutal,. But again the safety of antidepressants in children was never a concern of yours, its just another child hanging themselves,.. right!
Peter Pitts
They taped it. Let them share it.
Lisa Van S
Peter,
How Juvenile!!…
Eskimo
Mr. Pitts, looking at all those posts on drugwonks.com, I couldn’t tell who was making the personal attacks, the “kooks” and the “document stealers” or the site’s authors who label them that way.
pg
That 3rd paragraph re Peter P apparently believing that only people who say that SSRIs are “safe” and “beneficial” to children - but anyone who brings up the other side, the risks, are “biased” in a way reminds me of this old drugwonks piece of work
“February 01, 2006
Freedom of Speech? Sure. But Only If You Agree With Me
By Peter Pitts”
which at the moment is at http://web.archive.org/web/20060202140553/http://drugwonks.com
Peter Pitts
The New York Times
January 17, 2005
Dispute Puts a Medical Journal Under Fire
By BARRY MEIER
Last year was an especially bad one for the pharmaceutical industry, which experienced controversies over how drug studies are disclosed and the implosion of the painkiller Vioxx. Now, as a result of the recent publication of an article about the antidepressant Prozac, it appears that the staid, usually methodical world of medical journals could suffer its own black eye.
On New Year’s Day, the British medical journal BMJ published a news article suggesting that “missing” documents from a decade-old lawsuit indicated that Eli Lilly & Company, the maker of Prozac, had minimized data about the drug’s risks of causing suicidal or violent behavior.
Within days, the article was cited in hundreds of television and newspaper reports. An outraged Washington lawmaker demanded to know if Lilly had hidden the information from the Food and Drug Administration. While company officials refuted the article’s assertions, it was still repeatedly cited. And last Thursday, Lilly spent about $800,000 to run full-page advertisements in 15 major publications to dispute the article.
The incident may prove to be a messy one for the BMJ, which is based in London and owned by the British Medical Association, a professional group. Much of the journal, formerly known as the British Medical Journal, is devoted to research reports about medical issues that are reviewed by experts. But the BMJ, like some other medical journals, also has a separate news section that prints articles like the recent one about Prozac. As it turns out, some of the Eli Lilly documents, which the BMJ said it received from an anonymous source, have been circulating for years. And, Lilly officials said, the BMJ and its reporter declined to provide the company with copies of the documents at issue prior to the article’s publication.
The American freelance reporter who wrote the article, Jeanne Lenzer, declined to be interviewed, referring all questions to the BMJ. Officials there did not respond to written questions, but a spokeswoman, Emma Dickinson, said in an e-mail message on Friday that the publication “takes this issue very seriously” and will address Lilly’s concerns after reviewing them.
The BMJ, which is considered a leading medical journal, may have little choice. While Lilly has not taken legal action, its lawyers have notified the publication that the company considers the article to be “inaccurate and defamatory,” asserting that the records were not missing and that all their relevant data had been previously submitted to the F.D.A. Also, Lilly issued an analysis last week of the 52 pages of records that the BMJ had received, which the company said supported its claims. Lilly said it got the documents from a congressman who received them from the BMJ.
“You put something out on the newswire with the imprimatur of a medical journal and people think it is fact,” said Dr. Alan Brier, the chief medical officer of Eli Lilly, which is based in Indianapolis.
The article’s appearance follows the recent controversy over whether drug makers adequately disclosed the risks that antidepressants like Prozac posed to pediatric patients. And its comes as a South Carolina teenager faces trial for murder as an adult on charges that he killed his grandparents when he was 12. The teenager, Christopher Pittman, has acknowledged the crime, but his lawyers have based his defense on the argument that he became violent after taking the drug Zoloft, an antidepressant similar to Prozac.
It was in a little-noticed article written by Ms. Lenzer in the Dec. 11 issue of the BMJ about the Pittman case that she first mentioned that the publication had received “a set of documents that mysteriously went missing from a U.S. mass murder case ten years ago.”
That article did not go into specifics. But in her article on Jan. 1, Ms. Lenzer wrote that the documents in question were connected to a Prozac-related lawsuit that grew out of a shooting rampage in 1989 by a Kentucky man, Joseph Wesbecker, that left nine people dead, including Mr. Wesbecker.
Lawyers representing the victims sued Lilly, asserting that Mr. Wesbecker’s killing spree was caused by Prozac, a drug he had been prescribed just before the crimes. During the 1994 trial of the case, Lilly pointed to Mr. Wesbecker’s long history of severe psychological problems and said that Prozac was safe.
To combat those assertions, plaintiffs’ lawyers introduced hundreds of Lilly documents. They argued that the records showed that Lilly had fully disclosed to the F.D.A. in the late 1980’s the potential of Prozac to produce suicidal thinking or acts of violence, including all the reviews by drug regulators in Germany of the issue at that time. Lilly disputed that.
The jury found in favor of Lilly. But a legal controversy over the trial later erupted when it was revealed that plaintiff lawyers and Lilly lawyers had reached an undisclosed financial deal just before the case went to the jury to effectively settle by agreeing not to appeal the verdict.
A Lilly spokesman, Phil Belt, said that Ms. Lenzer, who lives in Kingston, N.Y., first contacted the company on Dec. 13, a few days after her article about the Pittman case appeared.
Mr. Belt said Ms. Lenzer asked where a published report about the data in a specific 1988 internal Lilly report had appeared. At that time, she also requested an interview with the company’s chief executive, Sidney Taurel, to discuss what she described as “missing” Lilly documents, Mr. Belt said.
Mr. Belt said the company told Ms. Lenzer that Lilly needed to see the records at issue before it proceeded. He added that Ms. Lenzer later told Lilly that she could not do so, saying that the source of the documents was anonymous.
As the Christmas and New Year’s season approached, Mr. Belt said that Ms. Lenzer told Lilly officials that they could pick up the issue after the holidays.
At some point in December, however, Ms. Lenzer or her editors apparently sent the documents it had received to Congressman Maurice Hinchey, Democrat of New York, and to the F.D.A. And a few days before New Year’s, the BMJ distributed Ms. Lenzer’s article to other news organizations with the provision they could not write about it until its publication date on Jan. 1 - a practice known as an “embargo.”
That article carried the headline, “FDA to Review ‘Missing’ Drug Company Documents,” which caught the attention of other news organizations. Mr. Belt said that when Lilly became aware of the embargoed news release, it tried to reach editors at BMJ but was unsuccessful. Both Ms. Lenzer and the BMJ did not respond to written questions about the publication’s interactions with Lilly, including why the documents were not shown to the drug maker.
The only Lilly document specifically mentioned in the BMJ article was a 1988 report that stated that 38 percent of depressed patients taking Prozac during clinical trials experienced side effects like agitation, insomnia and nervousness, a rate twice that of those taking a placebo.
Such side effects, which are sometimes referred to as “activation,” reflect the fact that some depressed patients who take Prozac and drugs like it often experience a surge of physical energy well ahead of psychological recovery. Some experts have long expressed concerns that such reactions can be so severe in a few patients that they may ultimately act on suicidal or violent impulses.
For procedural reasons, the 1988 Lilly memo itself was not introduced as evidence in the Wesbecker case, said Nancy Zettler, one of the two plaintiffs’ lawyers involved. But Ms. Zettler said that one of her expert witnesses, Dr. Peter Breggin, testified extensively about its contents at that trial.
Ms. Zettler said that she was so perplexed by the BMJ article that she contacted Ms. Lenzer after it appeared. “Her original article made it seem like we had deep-sixed some of this stuff and I was curious,” she said.
Both Ms. Zettler and Paul Smith, the other plaintiffs’ lawyer in the Wesbecker case, said that Ms. Lenzer did not contact them prior to the article to talk about the records or ask for others from that case.
Another plaintiffs’ lawyer who has used Lilly documents in other lawsuits, Arnold Vickery, also said he did not discuss the records with Ms. Lenzer prior to her report. Mr. Vickery and another lawyer are representing Christopher Pittman.
Dr. Breggin has written articles arguing against the use of Prozac and other drugs and has mentioned the 1988 Lilly memo in his writings; he is scheduled to be an expert witness in the Pittman case.
Several pages sent to the BMJ were not produced by Lilly but are photocopies of slides produced by an F.D.A. official who presented them at a 1991 public hearing that reviewed the possible suicide risks of Prozac. After its review, that agency panel decided not to issue any additional warnings.
Ms. Zettler said she still thinks the issue of what Lilly told the F.D.A. in the mid-1980’s about Prozac’s potential risks is unsettled. But after more than 15 years of the drug’s use, numerous lawsuits and public reviews, it may also be largely moot.
As a result of the recent controversy about the potential suicide risks posed by antidepressants to children and teenagers, the F.D.A. last week sent out final new labeling language about those dangers to all makers of such drugs, including Lilly.
A spokeswoman for the agency, which is still reviewing the records sent to BMJ, said that it had not yet found anything new in them. Ms. Dickinson, the publication’s spokeswoman, said that it was reviewing Lilly’s rebuttal to its article.
pg
Peter P, are you saying that the early 2005 news piece you posted above more or less summarises the topic of the tape as in you comment “They taped it, let them share it” ?
Justice in Michigan
I’m also lost. Is some or all of the below not true?
“Goodwin is on the board of directors of Center for Medicine in the Public Interest, an industry-funded group that receives a majority of its funding from drugmakers. CMPI prez Peter Pitts was one of Goodwin’s three guests for “Prozac Nation.” Slate asked him to identify the companies that fund his group, but he told the mag, “I don’t want to go into that.”
However, Slate writes that CMPI took in more than $1.4 million in 2006 and, according to its tax forms, spent $210,000 to influence the media through a large conference, a blog the group maintains, op-eds published in major newspapers, and multimedia programs and podcasts. Pitts, by the way, is also senior vp for global health affairs at Manning Selvage & Lee, which reps Lilly, Pfizer, Glaxo and others, although Slate writes that, on the show, Pitts was identified only by his title as “a former FDA official.” Pitts tells Slate that he doesn’t know why his ties to industry weren’t revealed on the show.”
pg
Regarding Peter P’s post with article of 17th Jan 2005 - it didn’t finish there and this is an extract from 10 days later:
Eli Lilly Prozac Documents: What do They Reveal?
“Thu, 27 Jan 2005
A report in the BMJ (formerly the British Medical Journal) that relied on internal Eli Lilly documents to challenge Lilly’s claims about the safety of Prozac has stirred a prickly hornet’s nest. [1] The documents show, among other things, that a 1988 review of clinical trials found that 38% of patients taking Prozac compared to 19% of patients on placebo experienced “activation,” which is linked by the FDA in current labeling to violent and suicidal behavior. [2] [PZ-477] .
Lilly took out a full page advertisement (”An open letter to patients and doctors” signed by Lilly CEO, Sidney Taurel) in 15 newspapers nationwide stating: “it was simply wrong to suggest that information on Prozac was missing, or that important research data on the benefits and possible side effects of the drug were not available to doctors and regulators.” [3] The BMJ has just issued a correction and an apology to Eli Lilly for suggesting that documents went “missing” stating: “all the documents supplied to the BMJ were either Eli Lilly documents or were in the hands of Eli Lilly [and] had in fact been disclosed during the suit.” [4]
The Associated Press reports that BMJ editor, Kamran Abbasi, said the apology was limited to the issue of whether the documents were missing from the court case. “Whether or not Eli Lilly made all of the information available to the FDA at the appropriate times is a question for the FDA to answer…. we await their response.” Morry Smulevitz, a spokesman for Lilly, said the company also awaited the FDA’s finding. [5]
Inasmuch as the documents’ authenticity is not in dispute, and the information about the hazardous drug effects contained in the documents (stamped “confidential) is of vital importance to public health - we will focus on their content rather than be diverted by who said what to whom. The documents reveal that as early as 1984 - years before the FDA approved the drug - Lilly knew or should have known that Prozac frequently induced severe adverse side effects, including “activation” and suicidality [6]:
“…frequency of side effects was very high (partly more than 90%) and side effects resulted nearly in each study in drop outs. The frequency of side effects depended on the dose, the age, and the duration of treatment… the clinical significance of side effects is not only the frequency of their occurrence but also their severity.…”
Its a bit long to post it all, a lot there and these has been a lot more since.
pg
Peter P, it seems you chose to leave out the “correction” at the end of the article you posted which link is at:
http://www.nytimes.com/2005/01/17/business/media/17journal.html?_r=1&pagewanted=2&oref=slogin
The CORRECTION, at the end of the article (page 2) is:
“Correction: January 19, 2005, Wednesday:
An article in Business Day on Monday about the fallout over a medical journal report on a 1994 Prozac-related lawsuit involving Eli Lilly & Company omitted a word in describing the plaintiffs’ position, reversing the meaning. The sentence should have read, “They argued that the records showed that Lilly had NOT fully disclosed to the F.D.A. in the late 1980’s the potential of Prozac to produce suicidal thinking or acts of violence.”
That correction may well defend ‘your’ argument re that date - or not, I haven’t taken it all in, but whichever it works it would be good to see the ‘whole’ thing, along with the link so that we can all check, don’t you think?
Jane
http://drugwonks.com/blog/slime-alot_slime_a_little__then_ignore_the_real_issue/ Someone is mad Ed!
Lisa Van S
Jane,
Peter Chooses not to defend himself,… Why?.. Guilty conscience maybe?…
He knows that antidepressants induce Homicidal/Suicidal thinking and gestures in the Pediatric population,..He’s just not man enough to admit it,..
Peter J. Pitts
“BMJ 2005;330:211 (29 January), doi:10.1136/bmj.330.7485.211-a
Correction and apology, Lenzer, BMJ 330 (7481) 7
Correction and apology
Eli Lilly: Correction and apology
An article by Jeanne Lenzer in our 1 January issue (BMJ 2005;330:7) reported that the US Food and Drug Administration was to review confidential Eli Lilly documents that had been sent to the BMJ by an anonymous source.
The article stated that these documents had gone “missing” during a 1994 product liability suit filed against Eli Lilly.
That statement has been the subject of a detailed investigation conducted by the BMJ following a complaint by Eli Lilly. That investigation has revealed that all of the documents supplied to the BMJ that were either Eli Lilly documents or were in the hands of Eli Lilly had in fact been disclosed during the suit.
At the end of the trial, all the documents were preserved by Court Order or were disclosed by Eli Lilly to the plaintiffs’ lawyers in related Prozac claims.
The BMJ did not intend to suggest that Eli Lilly caused these documents to go missing. As a result of the investigation, it is clear that these documents did not go missing. The BMJ accepts that Eli Lilly acted properly in relation to the disclosure of these documents in these claims. The BMJ is happy to set the record straight and to apologise to Eli Lilly for this statement, which we now retract, but which we published in good faith.
The same article described Dr Peter Breggin as “the medical witness for the Wesbecker case.” He was, in fact, the expert witness for the plaintiffs.”
pg
http://bmj.bmjjournals.com/cgi/eletters/330/7485/211-a#95276
“Arguments about which group of lawyers or experts saw or did not see the files in question are nothing more than distractions from the more important question. Of much more importance to physicians is: Why did Eli Lilly not share this data with the general medical community?“
pg
Points 14 and 17 regarding a Lilly ‘defender’ in the FDA HERE might help answer the question directly above.
pg
http://www.fda.gov/bbs/topics/NEWS/2003/NEW00892.html
April 21, 2003
“We’re fortunate to have Peter [Pitts] on our team,” said Dr. McClellan. “He’s a seasoned, innovative, and strategic communicator. Effective communication is essential in fulfilling FDA’s mission of protecting and promoting the public health.”
A LETTER was sent to Peter Pitts in 2004 but I can’t find a reply as yet.
The only ’seasoned, innovative and strategic’ references to the author of the polite and well informed letter so far appear to be by way of personal attacks such as
http://drugwonks.com/blog/what-s-really-depressing/
“…Where will Healy, David Graham and the rest go to wash the blood off their hands? And will the FDA do the right thing and stop handing black boxes out to protect themselves from Senator Grassley and the press?”
pg
On ‘blaming’ suicide rate on the use of antipsychotics as purported in http://drugwonks.com/blog/what-s-really-depressing - if that is correct then it could be based on evidence:
MAY 2008 pub. On the rise of antipsychotic use in children
“…CONCLUSIONS. The overall prevalence of antipsychotics almost doubled [in the UK] between 1992 and 2005; however, the rate of increase was much lower than the reported figures in the United States. The prescribing of atypical antipsychotic drugs has increased despite the lack of conclusive evidence showing their superiority over older conventional antipsychotics. Additional investigation is required to evaluate their efficacy and safety in children and adolescents.”
On suicidality and the antipsychotic Zyprexa:
“…What’s more, the rate of completed suicides linked to Zyprexa is higher than any other drug in its class, according to clinical trial data supplied to the US Food and Drug Administration (FDA) by Eli Lilly itself. The data revealed that out of 2500 patients taking Zyprexa, there were 12 completed suicides as compared with none with patients on placebo.
What isn’t known is the number, from clinical trial data, of suicides not completed. While no one would dispute that an unsuccessful suicide is a merciful preservation of a human life, the context of someone driven to suicide and making the attempt is equally serious.
Beatriz E. Ebel vs. Eli Lilly & Company cites the latter as over-promoting Zyprexa, achieving tremendous success in so doing. Zyprexa accounts for a third of Eli Lilly’s revenue, and is easily the top-selling drug in its class.
However, such success often comes in a vacuum, and in this case it is alleged that Eli Lilly suppressed the most damming side effects relating to suicide. To this end Dr. David Healy, professor of Psychiatry at the University of North Wales, claims in a statement that Eli Lilly “suppressed data on suicidal acts on Zyprexa from these trials. The data are not available in the scientific literature, nor from FOI [Freedom of Information Act] requests to the FDA, nor from enquiries to the company.“
Lisa Van S
pg,
gotta, love ya…
Lisa Van S
pg,
Here in the U.S., the antipsychotics Seroquel and Abilify carry an FDA Black Box Warning of suicide/violence in the Pediatric Population.
pg
“Can we say Conflicts of Interest?”
(http://drugwonks.com/blog/what-s-really-depressing again)
Can we? Until drugwonks / ‘Center for Medicine in the Public Interest’ (mostly funded by drugmakers) starts to achieve its purported objective and work in the interests of the public where medicine is concerned, I think we can safely say YES.
pg
Hi Lisa, thanks for both comments. We crossed comments I think as I was putting the last comment on CMPI (above) together. I have to go offline now and will probably get back to take a look tomorrow. Hope you have a good day :)
Jane
drugwonks changed their article - it orginally was titled “Slime-alot, Slime a lttile then ignore the real issues” and threatened to sue Ed.
Hadamar Lager
Goodwin, what a charmer. Scroll down to “The Second Violence Inititative”:
http://www.breggin.com/racistfedpol.html
The Infinite Mind
The Infinite Mind responds to “Stealth Marketers.”
http://fray.slate.com/discuss/forums/thread/1237086.aspx?ArticleID=2190775
From Bill Lichtenstein
Senior Executive Producer, The Infinite Mind
In their May 6 Slate article, Jeanne Lenzer and Shannon Brownlee use The Infinite Mind’s recent program “Prozac Nation: Revisited” to frame an argument that pharmaceutical companies are planting “stealth marketers” inside seemingly objective media outlets to manipulate public opinion. The article suggests that as public radio producers we have allowed our guests on our national weekly program to hide financial links with pharmaceutical companies for the purpose of promoting the use of dangerous prescription drugs.
Ironically, “Prozac Nation: Revisited” was intended to examine the way the media has handled links between violent behavior, suicide and antidepressants. Our interest in the story began with press reports about Steven Kazmierczak, whose shooting rampage at Northern Illinois University left six dead and 16 wounded. We wanted to know: Why did the major news media uniformly target Steven’s withdrawal from an antidepressant as explanation for his violent act? Why did the media ignore any number of other factors, such as his gun collection, his work as a prison guard, or his troubled childhood? We were interested in exploring the reflexive public reaction that ends up making the medication the culprit, and so simplifies a disturbing violent act while stigmatizing the already vulnerable people who take or consider taking prescription medication for depression.
And at the core of the program, we asked the question we always ask, the question that has guided the past 10 years of The Infinite Mind: Where is the best science on this particular issue? In this case, does the science find links between antidepressant medications and out-of-control behavior?
To help us, we turned to recognized experts in the field. Framing the discussion, we began with Dr. Andrew Leuchter, director of UCLA’s Laboratory of Behavior and Pharmacology, who himself has conducted much of the important research in this area.
Next, we spoke with Dr. Nada Stotland, current president of the American Psychiatric Association and an expert in medical ethics. Dr. Stotland, another distinguished research scientist and clinician, spoke about the gap between public perception and the research about violence, suicide and psycho pharmaceutical medications.
Finally, we talked to Peter Pitts, a former associate commissioner for the Food and Drug Administration who was involved in the FDA’s 2004 “black box” labeling of antidepressants as carrying a risk of suicidal thoughts and behavior, and who was at the time the “go-to” guy for the FDA on that issue.
What we didn’t know, because he didn’t disclose it to us, was that Pitts is currently working for a public relations firm whose clients include major pharmaceutical companies. If we had known, and (full mea culpa here) we should have, we would have disclosed that connection. Pitts apparently didn’t disclose it elsewhere, either - he’s appeared on NPR’s Talk of the Nation as well as PBS’ News Hour with Jim Lehrer, without either of those programs mentioning the PR company ties.
In any case, to suggest that distinguished researchers such as Drs. Stotland and Leuchter are shills for the drug industry is bad journalism. Pharmaceutical companies fund the lion’s share of research being conducted today. There are strict ethical codes and laws governing the use of such funds. Journalists covering this industry know that, and routinely disclose only those ties that are likely to raise serious questions about a researcher’s neutrality. It would be patently ridiculous, for example, to presume that Dr. Stotland, speaking for all American psychiatrists as president of the APA, would somehow distort the truth because of some past connection to an industry speakers’ bureau.
It is important to state that we stand by the program and its editorial content. There is, as our guests observed, no credible evidence that the use of antidepressants contributes to the sort of violence that erupted at NIU. There is, on the other hand, a study by the Centers for Disease Control and Prevention suggesting that more young people may be dying in part because of the chilling effect of the FDA “black box” warning. While some will take issue with these studies, we believe they are important, that they deepen the public dialog, and that they’ve gotten lost in superficial media coverage of a complex issue.
So finally, let’s tackle the other question raised in the Slate article: Is it acceptable for a public radio program about the human mind to take grants from the pharmaceutical industry?
Back in 1994, I came face to face with that question. Preparing to produce a program about people living with schizophrenia, I met with Delano Lewis, who was at the time president of National Public Radio. I told Lewis that I had offers of unrestricted educational grants from several pharmaceutical companies who were interested in helping lift some of the stigma about this misunderstood and feared disease, but that I wasn’t sure whether it would be proper to accept the grants.
The conversation that we had helped set the ground rules that have governed our underwriting ever since. Lewis began by observing that in many cases, especially on difficult and unpopular subjects, it would be hard to find support from organizations without some kind of substantial interest in the subject matter. The important thing, he said, was to assure listeners and stations that there was an absolute firewall between funding sources and editorial decision-making.
With this in mind, 14 years ago, we created a system with the following rules: We would take no more than 15 percent of our total budget from any one industry sector. We would not take substantial amounts from any one company. Corporate support would have to come in the form of unrestricted “no strings attached” educational grants. Corporate funding would be mixed with support from other sources (in the case of The Infinite Mind, that’s been sources like the MacArthur Foundation, the National Institutes of Health and the National Science Foundation.) We would list underwriters on the air. Under no circumstance would producers ever have editorial discussions with any funder; and it’s probably important to note that in the case of the pharmaceutical industry, such conversations would be a violation of federal law as well as a violation of our own ethics as journalists. And, we would require employees to sign a code of conduct that requires disclosure of any potential conflict of interest and makes failure to disclose a fireable offense.
By the way, our 1994 program on schizophrenia, with substantial and disclosed support from the pharmaceutical industry, won a Peabody Award and was credited with changing the way Americans look at people with serious mental illness. Over the past 18 years, following these rules, our programming on the human mind has been honored with more than 60 awards for journalistic excellence and offering insight into issues that society would often prefer to ignore.
In the interest of full disclosure, I also should note for the record that Lenzer, who co-authored the Slate article, called me a few days after the “Prozac Nation: Revisited” program aired to pitch a program that she wanted us to do for The Infinite Mind, called “Journalists on Prozac,” which would feature her and her writing partner Shannon Brownlee. Checking into Lenzer’s credentials, I found a troubling article in The New York Times taking her to task for a British Medical Journal article that suggested that Eli Lilly and Company, which makes Prozac, had concealed documents about the link between anti-depressants, suicide and violence. The BMJ subsequently retracted the article, with full apologies, and the whole matter was widely covered in the news media.
After we told Jeanne Lenzer that we would not be proceeding with a program featuring her, she and Brownlee wrote the article for Slate.
pg
“Our interest in the story began with press reports about Steven Kazmierczak, whose shooting rampage at Northern Illinois University left six dead and 16 wounded. We wanted to know: Why did the major news media uniformly target Steven’s withdrawal from an antidepressant as explanation for his violent act?”
Really? Where did you find “major news media that uniformly targetted Steven’s withdrawal from antidepressants as an explantion for his violent act”?
If you google Steven Kazmierczak, I don’t think you’ll find the ‘majority’ of the media mentioned it at all. The ‘majority’ of the media seem very comfortable with not mentioning any involvement with anything to do with pharmaceutical companies - in any case where prescription drugs are involved.
In just about ANY homicide/suicide, it takes a lot of searching amongst news media to find ANY mention of drug involvement.
The “majority” of news media… do as they’re told.
pg
They ‘do as they’re told’ just like the majority of front groups such as that described by the “Infinite Mind” with its “substantial and disclosed support from the pharmaceutical industry”.
Seasoned, innovative and strategic moves all round, and thats drug makers, FDA and front groups - and there’s no loyalty amongst thieves (or pharma fronts) when drugs are at stake.
pg
Those ’seasoned, innovative and strategic moves’ are precisely now drug makers and their ‘key opinion leaders’ and ‘funded front groups’ make their money all round - isn’t that so Peter Pitts of Drug Wonks, certain members of the FDA and Infinite Mind?
pg
http://drugwonks.com/blog/slime-alot_slime_a_little__then_ignore_the_real_issue
“…We are aware that our critics don’t have the intellectual bandwidth or the maturity to actually engage on the issues or respectfully disagree or debate…”
Woah Mr Pitts. What a shame you sold YOUR intellectual bandwidth (and your integrity) out to the pharmaceutical industry.
HorusCat
“Activation” is not synonymous with homicidal/suicidal/violent behavior. Attempts to conflate the latter with the former are egregiously misleading.
pg
What rubbish Horus. Completed suicides in clinical trials
(see further up: The data revealed that out of 2500 patients taking Zyprexa, there were 12 completed suicides as compared with none with patients on placebo)
are NOT attempts to mislead. The ‘misleading’ is done by people like Pitts who clearly attack those who bring these issues to attention.
Will you next be saying that these files on a different risk are attempts to mislead?
http://www.furiousseasons.com/zyprexadocs.html
pg
I’ll rephrase that. The documents ARE attempts to mislead, attempts by Eli Lilly to mislead physicians and ultimately their patients, but the exposure of those documents are not.
HorusCat
You haven’t rebutted my point. Activation is not the equivalent of violent behavior. Psychiatrists define activation very broadly, including negatively-connotated terms such as restlessness, insomnia and anxiety AND positively-connotated words such as energized, brightened up, brought out of lethargy. For a sluggish, couch-bound depressive, activation can be a good thing. For an already hypomanic bipolar, it is a bad thing.
Suicide is suicide; to argue that every individual “activated” by a medication is suicidal is horse-hockey and dilutes your argument.
HorusCat
pg,
Full disclosure: your blurb about Zyprexa and suicide was found on a trial lawyer’s website.
Akathisia is ALSO not activation. Akathisia is a much more strictly defined term, denoting physical restlessness to the point of being almost non-stop. An activated person will say he feels restless and anxious. An akathetic person literally will be unable to remain seated. There is a gradient in between, of course, and a careful physician asks many questions and observes a patient closely.
pg
Horus, you are TRYING to dilute or shift the argument. If you read the links above perhaps you could follow what is being said.
Or are you intentionally defending conflicts of interest and corruption?
pg
Personally, I wouldn’t in any want to be seen to be in Peter Pitts corner. Goodnight.
pg
should read: I wouldn’t in any way want to be seen to be in Peter Pitts corner…
Do you defend corruption Horus?
pg
Horus, lawyers have some purpose here, they get to SEE the evidence often.
I think you’ll find that the other links are NOT to lawyer sites.
pg
And yes, I do give the links - there was no ‘non disclosure’ on my part - the link you chose to criticise clearly lead you to a lawyers site!
Once again Horus - are you defending corruption?
HorusCat
pg,
You do intend to mislead–knowing that most won’t follow your links, you present your information as though it were an article in a reputable newspaper, not an enticement to contact an attorney “published” on a trial lawyers’ website.
Here are the data from the trials, in clear contradistinction to your “facts” and “links.” BTW, this comes from the plaintiffs’ attorneys in the Alaska case–where lawyers get to SEE the evidence:
Completed Suicides – HGAJ
for Olanzapine subjects: 9/2500 = 0.4%
for Placebo subjects: 1/236 = 0.4%
for Haldol subjects: 1/810 = 0.1%
Suicide: Olanzapine 12 (of 3139 subjects)
Information about suicide attempts is presented only for the HGAJ trial (page 47):
Suicide attempts - HGAJ
Olanzapine 3.4%
Placebo 4.0 %
These results were not found to be statistically significant.
1) suicide / suicide attempts:
Olanzapine does not appear to be any more or less effective than placebo in terms of completed suicide. Olanzapine may be associated with a higher rate of suicide than older neuroleptics.
So, where do your trial lawyers get their information? If the Alaska plaintiffs’ attorneys couldn’t posit a causative relationship between olanzapine and suicide, how are you doing so? The trial lawyers’ site you link clearly lies. There were obviously completed suicides in the placebo arms of the trials.
There’s corruption for you, pg. Trial attorneys exploiting patients’ pain to fill their coffers. The law firms get rich while any successful plaintiff gets nearly zip, zero, zilch, nada. Are you an attorney, pg? How can you sleep with yourself? Are you defending corruption? Are you defending people who would scare the severely mentally ill and their caregivers away from useful medications…thus actually leading to MORE suicide, since untreated schizophrenics are often successful suicides.
Lilly does not claim that olanzapine is suicide-preventive. Only Clozarel can make that claim among the antipsychotics. But you are patently mistaken in asserting that the use of olanzapine is associated with suicide and suicidal behavior.
I am no fan of Zyprexa and would vigorously admonish anyone in my family against using it when there are alternatives. However, I paid $250 for a complete list of the adverse events reported post-marketing with Zyprexa in 2002. I read every single page, and there were scores of pages. Suicide was not a signal.
Once again, pg, my suspicions about your motivation point me to the Scientology cabal…
pg
Horus, are you - as you appear to be- posting in defense of corruption? The issues are actually clear, the corruption involved is also perfectly clear. The FDA have the data on the suicidal acts (or haven’t you read it through?).
Unlike you and Peter Pitts, I leave LINKS so that YOU and others can follow them to read article around the extract I leave and can so confirm that I have not altered an extract.
For instance, further above again I didn’t even leave an extract, I simply referred to “points 14 and 17″ in a link.
Surely anyone with any intelligence (or perhaps integrity) would realize that you NEED to go the links to see what I referred to rather than trying to discredit anyone who does leave a link.
Obviously this is not the case with you, so for your assistance I’ll leave copy over the whole lot, rather than just point to 14 and 17 which is regards to Prozac I believe and does indeed come from the lawyer’s site who recorded the documentation. The point numbers do not copy over, but you’ll be able to find the number and which lawyer recorded these by finding the post referring to points 14 and 17 somewhere above:
“Below is the time-line presented to the jury in the Forsyth v. Eli Lilly Trial. It was presented during closing arguments by the plaintiffs. It lists Lilly’s internal documents. The plaintiffs allege that it shows that Lilly knew about Prozac-induced suicidality and violence (even before Prozac was approved for marketing in the United States) and that this was withheld from the public.
Aug. 1978 - Team Meeting Minutes - “There have been a fairly large number of reports of adverse reactions . . . Another depressed patient developed psychosis . . . Akathisia and restlessness were reported in some patients.” Exhibit 30 (2nd page, end of 2nd paragraph)
May 1984 - BGA Comments - “During the treatment with the preparation (Prozac) 16 suicide attempts were made, 2 of these with success. As patients with a risk of suicide were excluded from the studies, it is probable that this high proportion can be attributed to an action of the preparation (Prozac) . . .” Exhibit 42 (page 3, 6th paragraph)
Jan. 1985 - Lilly receives reasons why the BGA will reject Lilly registration, one of which was because of “SUICIDAL RISK.” With instructions for “IMMEDIATE FOLLOW-UP ON ALL KEY OPINION LEADERS ON THE BGA COMMISSION FOR SELECTED VISITATION NEXT WEEK.” Exhibit 53
March 29, 1985 - “Benefit/Risk Considerations” - “The incidence rate (suicide) under fluoxetine (Prozac) therefore purely mathematically is 5.6 times higher than under the other active medication imipramine.” . . . “The benefits vs. risks considerations for fluoxetine (Prozac) currently does not fall clearly in favor of the benefits. Therefore, it is of the greatest importance that it be determined whether there is a particular subgroup of patients who respond better to fluoxetine (Prozac) than to imipramine, so that the higher incidence of suicide attempts may be tolerable.” Exhibit 58 (pages 18 & 22)
June 1986 - Draft of Proposed PRECAUTIONS and ADVERSE REACTIONS Sections of the Prozac Package Insert - “Mania and psychosis may be precipitated in susceptible patients by antidepressant therapy.” Exhibit 5 (1st page) (never included in actual inserts)
Aug. 1989 - Additional Feedback Regarding the Fluoxetine (Prozac) Review by the Commission A (Germany) - “3. The counterindication because of acute suicidality should become a warning whereby the physicians should be advised that in the absence of sedation, the risk of higher suicidality should be taken into account.” Exhibit 88
Nov. 17, 1989 - Letter to sales representatives on article about Prozac-induced akathisia authored by Dr. Lipinski and others. “In the article the authors voice their suspicion that ‘the triad of symptoms’ (anxiety, nervousness, and insomnia) reflects the syndrome of akathisia, ‘which, in their view is apparently related to fluoxetine (Prozac) therapy.” But the sales people are warned: “Use of this information in product discussions may violate federal law.” Exhibit 91 (1st page, 2nd paragraph and 2nd page, last sentence)
Jan. 1990 - PROZAC and SELF-DIRECTED VIOLENCE - “We have just received a pre-print of an article (not a letter to ed.) Which we understand is to appear in the February 1990 AMERICAN JOURNAL OF PSYCHIATRY suggesting that Prozac can induce severe, intense, obsessional suicidal ideation.” . . .” Exhibit 94
Jan. 30, 1990 - Letter to sales representatives giving the sales people a “heads-up” on the forthcoming Teicher article regarding Prozac and Suicide and instructing them as follows: “Because these issues (suicide) are not part of our current marketing plan, you should not initiate discussions on these articles. … “Again, because these issues are not part of our current marketing plan, discussions should not be initiated by you.” Exhibit 15 (bottom of second page)
Feb 1990 - Teicher article published “Emergence of Intense Suicidal Preoccupation During Fluoxetine (PROZAC) Treatment” - “The purpose of this report is to suggest the surprising possibility that fluoxetine (Prozac) may induce suicidal ideation in some patients.” . . . “In our experience, this side effect has occurred in 3.5% of patients receiving fluoxetine (Prozac) . . .” Exhibit 95
February 7, 1990 - Leigh Thompson Memo - “Anything that happens in the UK (England) can threaten this drug (Prozac) in the US and worldwide. We are now expending enormous efforts fending off attacks because of (1) relationship to murder and (2) inducing suicidal ideation.” Exhibit 97
February 7, 1990 - Leigh Thompson Memo - “I am concerned about reports I get re UK attitude toward Prozac safety. Leber (FDA) suggested a few minute ago we using CSM database to compare Prozac aggression and suicidal ideation with other antidepressants in UK. Although he is a fan of Prozac and believes a lot of this is garbage, he is clearly a political creature and will have to respond to pressures. I hope Patrick realizes that Lilly can go down the tubes if we lose Prozac and just one event in the UK can cost us that.” Exhibit 98
June 1990 - Letter to Lilly by concerned doctor - “I am writing to inform Eli Lilly Company that a disturbing number of suicides or suicide attempts associated with Prozac has come to my attention over the last several months.” I am concerned that the association with Prozac may be more than coincidental.” . . . “There appears to be growing concern that Prozac may somehow trigger a suicidal preoccupation in a small subset of patients and that their families should be warned of this potential risk. It is certainly possible that some of the cases reported are “coincidence” in that the depressed person may have attempted suicide independently of Prozac. However, some of these cases appear to be in patients taking Prozac for reasons other than depression.” Exhibit 102 (2nd page)
July 18, 1990 - Memo regarding call from Paul Leber at the FDA. “Paul Leber called yesterday; I contacted him at 6:15 am this morning and half-hour conversation, very, very pleasant . . .” “The call was about suicide.” . . . “He asked that we FAX nothing to him unless he has agreed before hand.” “Paul (Leber) is taking a position in talking with outside folks today that Lilly and FDA working together on the suicide issue and following closely the postmarketing events, but that there are no denominators and the best that can be done is to put a ‘cap’ on the number of events.” Exhibit 104 (top of 1st page and bottom of 2nd page)
August 3, 1990 - Letter to sales representatives regarding reports of suicidal ideation/behavior possibly associated with PROZAC therapy. “This information is not intended to replace our current promotional strategy but is being provided to enable you to respond to physicians when appropriate. You should not initiate discussion on these issues nor use this letter in detailing. However, if asked to comment on these issues by a health care professional, you should: 1. Reassure the health care professional that no casual relationship has been established between suicidal ideation and PROZAC therapy.” Exhibit 17 (bottom of 1st page and top of 2nd page)
August 31, 1990 - “Dear Doctor” letter assuring them that there is no “causal relationship between Prozac and suicidality (ideation or acts).” Exhibit 22
September 12, 1990 - Lilly memo between Max Talbot and Leigh Thompson- Talbot says “One possible strategy if FDA presses for an additional labeling change vis-a-vis suicide is a class-wide (i.e. ALL antidepressants) cautionary note; however we should take this position only as a last resort.” Thompson replies: “that report MUST move swiftly through approval and to Dr. Leber’s (FDA) hands - - he is our defender.” Exhibit 109
September 14, 1990 - Lilly memo between John Heiligenstein (Lilly) and Leigh Thompson - Heiligenstein says: “We feel caution should be exercised in a statement that “suicidality and hostile acts in patients taking Prozac reflect the patient’s disorder and not a causal relationship to Prozac - - - - Postmarketing reports are increasingly fuzzy and we have assigned ‘Yes, reasonably related’ on several reports.”. . . “You may want to note that trials were not intended to address issue of suicidality.” Exhibit 110
September 25, 1990 - Minutes of Lilly Meeting with FDA - discuss doing an in-hospital rechallenge of patients who met predefined criteria for suicidal acts and ideation and agrees to “analyze international data relating to suicide.” Exhibit 112
October 2, 1990 - Memo to Lilly employee Leigh Thompson to Lilly employee Robert Zerbe regarding an upcoming Prozac symposium in which the issue of suicidality is discussed. “Then the question is what to do with the ‘big’ numbers on suicidality. If the report numbers are shown next to those for nausea, they seem small.” Exhibit 113 (2nd page.)
November 7, 1990 - Leigh Thompson memo - “I’d suggest that priorities are: (1) protect Prozac” . . . Exhibit 116
November 13, 1990 - Memo from Claude Bouchy (Lilly Germany) to Leigh Thompson Re: Adverse Drug Event Reporting - Suicide Fluoxetine - In response to Lilly’s request that he (Bouchy) change the event “suicidal ideation” to “depression,” Bouchy writes: “Hans (another Lilly employee in Germany) has medical problems with these directions and I have great concerns about it. I do not think I could explain to the BGA, a judge, to a reporter or even to my family why we would do this especially on the sensitive issue of suicide and suicidal ideation.” Exhibit 117
November 14, 1990 - Second memo from Claude Bouchy (Lilly Germany) to Leigh Thompson Re: Adverse Drug Event Reporting - Suicide Fluoxetine in which he states: “I personally wonder whether we are really helping the credibility of an excellent ADE system by calling overdose what a physician reports as suicide attempt and by calling depression what a physician is reporting as suicide ideation.” Exhibit 118
April 15, 1991 - Memo to Leigh Thompson called “Upcoming TV appearance” Section I. “MESSAGE GOALS - Whatever questions you are asked or direction the interview take, the three points we want to establish are: 2. ‘It’s in the disease, not the drug.’; Section III ‘If pressed, or as a postscript to the above, then make the point that absolutely no evidence indicates that PROZAC as a cause of such behavior (violence and suicide).’, and ‘Prozac defense . . . There is simply no medical or scientific merit to the argument.” Exhibit 123
April 23, 1991 - Leigh Thompson Memo re 20/20 Show in which he admits that on the issue of suicidality “I did NOT share the European data AT ALL.” and “She attacked on us hiding data by dividing up reports by many COSTART terms. She had numbers for suicide, overdose, intentional overdose, unintentional overdose and said they came to 1200 (or 1400) total suicides - - so we went around on OD not necessarily being suicide and COSTART, etc.” Exhibit 124 (bottom of 1st page and 4th paragraph of 2nd page)
May 15, 1991 - FDA Meeting to Discuss Fluoxetine Rechallenge Protocol - “we agreed to have the rechallenge protocol ready to go by September 1, 1991 Exhibit 125
August 1991 - Dr. David Healy’s Article “Antidepressant Induced Suicidal Ideation” - “These two cases suggest that the emergence of suicidal ideation on antidepressants cannot always be attributed to a lifting of psychomotor retardation but rather that the ideas may in some instances be produced by antidepressants.” Exhibit 126
October 29, 1991 - Lilly prepared draft for Dr. Beasley entitled “Suggested Reply Points to Oswald, Healy & Creaney” in which he acknowledges that item 3 of the HAMD is an insensitive measure of suicidality and states:”There was no specific rating scale for akathisia included in the trial designs for the studies reported, so the only source of data would be adverse event reports. Akathisia is a subjective phenomenon and hence would rely on patients volunteering information.” Exhibit 130 (2nd page)
December 1991 - Dr. Rothschild’s Article “Re-exposure to Fluoxetine After Serious Suicide Attempts by Three Patients: The Role of Akathisia” - “This is the first report, to our knowledge, of patients restarted on fluoxetine (Prozac) after a previous suicide attempt during fluoxetine treatment.” . . .”When re-exposed to fluoxetine, the patients again developed akathisia and suicidal ideation. The suicidal feelings abated when the akathisia was treated by the discontinuation of the fluoxetine (Prozac) or the addition of propranolol.” Exhibit 131 (Cross-examination)
January 23, 1992 - Lilly memo regarding upcoming meeting with Taiwanese doctors (Drs. Lu and Ko) to discuss the report on their study results entitled “suicidal attempts and fluoxetine (Prozac) treatment.” Exhibit 133
April 8, 1992 - Weinstein (Lilly employee) Report - “Mission Accomplished. Professor Lu will not present or publish his fluoxetine (Prozac) vs. maprotiline suicidality data.” Exhibit 144
March 3, 1993 - Forsyth’s deaths
1994 - Dr. David Healy’s Article “The Fluoxetine and Suicide Controversy” - Dr. Healy concludes: “In the opinion of this author, the volume of case reports and other studies is sufficient to demonstrate that antidepressants and antipsychotics may induce suicidal ideation in certain individuals under certain conditions.” Exhibit 153
1995 - Dr. Jick’s Study “Antidepressants and Suicide” - “The results indicate that only fluoxetine (Prozac) has a rate that seems to be substantially higher than that of the other antidepressants.” Exhibit 155
June 1998 - Dr. Roger Lane’s article “SSRI-Induced Extrapyramidal Side-Effects and Akathisia; Implications for Treatment” appears in the Journal of Psychopharmacology. “SSRI-induced akathisia is a relatively rare but is frequently unrecognized when it does occur.” . . . “The precise definition of akathisia is a matter of controversy, as is the relative importance of the objective and subjective aspects of the disorder. Is akathisia a movement disorder or an intense and uncomfortable mental state . . .” “It may be less of a question of patients experiencing fluoxetine (Prozac)-induced suicidal ideation, than patients feeling that ‘death is a welcome result’ when the acutely discomforting symptoms of akathisia are experienced on top of already distressing disorders.”
I hope that helps you Horus to understand what exactly it is that you appear to be defending.
Goodnight.
pg
Horus, your mention of “scientology” is ridiculous. I don’t even KNOW one personally! But what it does do, is show you use ridiculous strategies to discredit others. There are decent people all over the world (though you may not be aware of it) of all beliefs and faiths that do not appreciate corruption, particularly when it affects the lives of others. Scientologists are but one small part of those people and I am NOT a scientologist. Shame on you for using that very old tactic! I thought at least you were brighter than that.
Insider
Found a nice photo of Peter Pitts!
pg
Insider. Lovely photo :-)
pg
Zyprexa. ‘…in all of these scientific publications you aren’t able to find the fact that this is the drug with the highest suicide rate in clinical trial history…’
From an article October 2005, Columbia.
http://www.ahrp.org/COI/HealyColumbia1005/index.php
“…So this all leads us to this next point, which is data on completed suicides and suicidal acts in the trials of antipsychotics sent in to FDA for registration purposes. Now remember, people like me and like all of you in this audience I think if asked to review the evidence on Risperdal compared with the older drugs would have come to the same conclusion that we should be using Risperdal first. But if you remember FDA didn’t come to that conclusion. The difference is that the published articles aren’t showing the same thing as FDA has been seeing. What the FDA has been seeing, which isn’t in any of the published articles, are figures of this sort here which are the completed suicides and suicidal acts on Risperdal and Zyprexa (28). ”
28 links to a slide of trial suicide rates at http://www.ahrp.org/COI/HealyColumbia1005/Slide28.jpg
“If you look at the Zyprexa suicide figures, these come from 2500 people who were in 5 clinical trials. You repeatedly hear that one of the problems we’ve all got is that the pharmaceutical companies hide trials. Well far from hiding these trials, these 5 clinical trials have given rise, when I checked last, to 234 different publications, of which 41 are major publications. These trials haven’t been hidden. There are 8 articles or abstracts per trial. But in all of these scientific publications you aren’t able to find the fact that this is the drug with the highest suicide rate in clinical trial history. You aren’t able to find either from any of the articles that have been published or from the FDAs reviews of the drug how many people went on to suicidal acts. And, given that these figures suggest Zyprexa has the highest suicide rate in clinical trial history, you would have to think from the fact even FDA aren’t prepared to show what the figure of suicidal acts is that it may be rather high…”
pg
Note from the slide (in comment above) that completed suicides are 12 in 2500 participants, not 9 in 2500 as posted by Horus.
pg
Horus said: “Are you defending people who would scare the severely mentally ill and their caregivers away from useful medications…thus actually leading to MORE suicide, since untreated schizophrenics are often successful suicides.”
Actually that does not appear to be so.
Comparison of Suicide Rates in Treated Schizophrenia Patients Found 20-Fold Increase
“Wednesday, 01 March 2006
An analysis published in the current issue of the British J of Psychiatry (BJP) of the suicide rate among schizophrenia patients treated at the same hospital in North Wales (UK) before psychotropic drugs and patients treated (in and out of hospital) with neuroleptics and /or atypical antipsychotics, found a 20-fold increase in the suicide rate since use of psychotropic drugs…”
“…In an invited accompanying commentary, Dr. Trevor Turner, Consultant Psychiatrist and Clinical Director, Department of Psychiatry, of a university hospital in London, writes: “If their figures are carefully boiled down, they show that in the course of 5 years the historical cohort had 1 suicide in 594 individuals, whereas the present-day cohort had 7 suicides in 133 individuals.” Thus, patients treated with the latest antipsychotic drugs had a 20-fold increased risk of suicide compared to those treated without drugs in Victorian times.
These startling findings are certain to stir much controversy because they challenge a key mental health treatment goal — suicide prevention — which is also offered as the prime justification for mental screening in U.S. schools. These findings also challenge the widely cited 10% lifetime risk of suicide among schizophrenia patients…”
pg
Having difficulty with the link at the moment, but cached works:
http://216.239.59.104/search?q=cache:2ZidMnvN0NQJ:www.ahrp.org/cms/content/view/88/28/+antipsychotics+rise+in+suicide+rates&hl=en&ct=clnk&cd=4&gl=uk
pg
“Increased Risk of Suicide From Psychotropic Drugs
Clinical Psychiatry News online reports (below) that an independent analysis of the suicide rate in psychotropic drug trials– for drugs approved by the FDA between 1985-2000– found that the NEW DRUGS did NOT REDUCE the risk of suicide–they INCREASED the risk…”
http://www.namiscc.org/Research/2002/AntipsychoticSuicideRisk.htm
At a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health, Dr. Arif Khan raised serious concerns about the apparent link to suicide of the new psychotropic drugs: “‘We have to ask if medication is the only way’ to approach the prevention of suicide?” Dr. Kahn analyzed the data on suicide rates for more than 71,604 patients who were treated in clinical trials. He noted that despite the fact that in most clinical trials patients who are actively suicidal are excluded–the suicide rates in those trials are exceedingly high:
752 per 100,000 persons for those treated with atypical antipsychotics–risperidone, olanzapine, and quetiapine;
718 per 100,000 persons for those treated with all the selective serotonin reuptake inhibitors;
425 suicides for those treated for “social anxiety disorder” with nefazodone, mirtazapine, and bupropion;
136 suicides for those treated for panic disroder–with benzodiazepine alprazolam;
105 suicides for those treated for obesessive-compulsive disorder with anticonvulsant valproate.
[The suicide rate of persons in the population at large is 11 per 100,000 per year.]
pg
In conclusion, Peter Pitts’ attacks, such as the one on the late Loren Mosher for instance, appear to be finance driven and as misleading as personal attacks can get. No wonder the FDA are under criticism as to their ability to protect the public when they hire such morally dishonest individuals.
http://drugwonks.com/blog/kooksrus
“This kookery is being pushed by a group called the Alliance for Human Research Protection which was formed by Loren Mosher who believed that schizophrenia and other mental illnesses could be treated without any medication.”
It would seem from the evidence available, that Loren Mosher - and others who come under the ’strategic’ scrutiny of people like Peter Pitts - are working for the public interest, ie, working to save lives.
CMPI. Its a front group funded mostly by drug makers. It would be most aptly stand for ‘Center for Medicines in my Personal/pharmaceutical Interest’.
HorusCat
pg,
1. Dr. Healey presents no footnotes for his data. Where do they come from?
2. Dr. Healey’s analogy of the loaded gun is flawed. He implies that the placebo cohort has a completely unloaded gun. In fact, the placebo “gun” also contains bullets. The point of a statistical analysis is to determine which gun contains more bullets and if the difference is statistically significant. From there, the medical community must decide if the statistical difference is CLINICALLY significant. If the suicide rate is 0.4% and it is doubled to 0.8%, a physician would probably conclude that the difference is NOT clinically significant, but Dr. Healey would claim that a drug “doubled” the suicide rate.
3. Comparing the suicide rate of a cohort from the 1800s to a cohort from today is disingenuous. Social conditions and taboos have changed greatly. Other factors aren’t taken into consideration: family support, community support, hospitalization likelihood, etc. With the advent of the psychotropics came also the “patients’ rights” groups who argued vehemently for “least restrictive” conditions–meaning patients who had previously been hospitalized for lengthy periods of time (and therefore, far less likely to commit suicide) were set free in the community–often with little or no support. A schizophrenic homeless person getting a psychotropic in the 1990s is far more likely to commit suicide than a schizophrenic hospitalized person receiving no treatment (but probably spending a lot of time in restraints) in the 1890s.
4. The antipsychotics, except for clozapine, are not marketed for suicide prevention. Physicians don’t use them for that purpose. They use them to try to give the patients some semblance of a normal life and keep them out of the hospital. Every community mental health center that I have seen also offers–even requires–an array of ancillary services with social workers, nurses, group activities, clubhouses, ACT teams and therapists. All of this is designed to give the patient as much support as possible in the “least restrictive” environment.
5. Comparing the suicide rate of a schizophrenic or depressed/anxious population with the baseline suicide rate of a mixed population is an inappropriate comparison. Dr. Khan points out that suicide rates were higher in the placebo arms.
6. Citing volunteer studies of non-anxious persons receiving serotonergic drugs to inform our clinical use of serotonergic drugs needs to be interpreted under two caveats: a) volunteers receiving sertraline received a higher dose than what is typically used in the clinically anxious patient; b) serotonin is known to cause initial anxiety, resulting in anxiolytic activity after this initial anxiogenesis. Thus, patients would have to be monitored in the acute stage of treatment for anxiogenesis, with anxiolytic activity expected to follow after a longer course of treatment.
7. Dr. Healey’s citation of the CATIE trial is a red herring. The endpoint of that trial was suspect to clinicians. Patient adherence to medication regimes is not a clinical endpoint. Compliance is known to be the biggest hurdle clinicians face (in any population, not just the mentally ill). Psychiatrists have never thought the atypicals are more effective than the typicals (except for clozapine). They use the atypicals for reasons of tolerability (no drooling, more energy, no mental “fog”, so far, no tardive dyskinesia), not efficacy. Any doctor who has seen a $1 million verdict in a tardive dyskinesia trial is not likely to prefer the typicals over the atypicals, and the CATIE trial was not long enough to show any difference in TD rates.
My points are all mixed up up there, but I didn’t feel like going through and re-ordering and re-numbering.
Getting on the SSRIs is taking me off the subject–my initial observation was about olanzapine and suicide. Dr. Healey presents no citations to buttress his assertions about olanzapine.
As usual, your “data” come from those who agree with your position. You cannot produce original histories of patients or raw data from trials, only the interpretations of those who may have an axe to grind, such as Dr. Healey and organizations specifically formed to advocate against the use of psychotropic drugs. I am not necessarily saying his data are false–I just want to see sources and original documents, not his powerpoint presentation.
Once again, in contrast to Dr. Healey’s unsupported “evidence,” one need only look at the post-marketing experience with Zyprexa. If there were indeed a suicide signal, the competitors to this medication would have found it and trumpeted it. Believe me, selling against olanzapine used to be the most difficult challenge I faced. If patients had been commiting suicide willy-nilly, we would have been all over it. Like I pointed out, in my desperation I ordered the post-marketing AE reports on olanzapine. If suicide had been in there, I would have noticed. Instead, we had to point out that physicians were commiting slow homicide with metabolic risks.
Our treatment approach to the chronically mentally ill (schizophrenics)leaves much to be desired. They are a population with few advocates, treated by a specialty with a low reimbursement rate, misunderstood by the population at large (get those homeless people off the street!), with available resources getting scarcer all the time. As basic research progresses, it becomes clear that schizophrenia arises from multiple loci in the brain, with many neurotransmitters involved. It is a progressive disease, with medication success being far less likely as a patient moves through the disease state and organic function is lost forever. No clinician, researcher or pharmaceutical company believes that the current medication paradigm we have is even close to optimal. But the logical conclusion of what you assert seems to me to be that we should warehouse our chronically mentally ill, MAYBE using thorazine or haldol to sedate them, restraining them physically when they become agitated, and keeping them out of sight and out of mind.
pg
Cheers Horus, over to you and those blinding $ signs that somehow manage to cover your eyes as you present ‘information’.
HorusCat
Believing that schizophrenia, an provably organic disorder with a progressive course leading to brain atrophy and ventricular enlargement, should be lumped together with anxiety and depression (although pathogenic changes also occur with chronic mood disorders)and treated with “counseling” or “proper nutrition” is just idiotic.
HorusCat
pg,
Have you spent time in a community mental health center? I have. I have spent hours. These are people abandoned by the community, often abandoned by their families, struggling to live meaningful lives with some dignity and joy, fighting against a disease that robs them of emotion and motivation. The clinicians and others who serve them are, for the most part, truly caring and empathic people who have taken on a job most of us would shun. The pharmaceutical companies–made up of individuals who know first-hand the ravages of schizophrenia–seek medication options for these patients not just for profit, but for the satisfaction of doing something important and meaningful.
pg
Carry on Horus!
Once again:
“Increased Risk of Suicide From Psychotropic Drugs
Clinical Psychiatry News online reports (below) that an independent analysis of the suicide rate in psychotropic drug trials– for drugs approved by the FDA between 1985-2000– found that the NEW DRUGS did NOT REDUCE the risk of suicide–they INCREASED the risk…”
http://www.namiscc.org/Research/2002/AntipsychoticSuicideRisk.htm
At a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health, Dr. Arif Khan raised serious concerns about the apparent link to suicide of the new psychotropic drugs: “‘We have to ask if medication is the only way’ to approach the prevention of suicide?” Dr. Kahn analyzed the data on suicide rates for more than 71,604 patients who were treated in clinical trials. He noted that despite the fact that in most clinical trials patients who are actively suicidal are excluded–the suicide rates in those trials are exceedingly high:
752 per 100,000 persons for those treated with atypical antipsychotics–risperidone, olanzapine, and quetiapine;
718 per 100,000 persons for those treated with all the selective serotonin reuptake inhibitors;
425 suicides for those treated for “social anxiety disorder” with nefazodone, mirtazapine, and bupropion;
136 suicides for those treated for panic disroder–with benzodiazepine alprazolam;
105 suicides for those treated for obesessive-compulsive disorder with anticonvulsant valproate.
[The suicide rate of persons in the population at large is 11 per 100,000 per year.]
pg
Bye Horus. Do please keep going. It shows us all where you’re at.
HorusCat
pg,
Respond to my requests for actual raw data; don’t engage in ad hominem attacks. What are your credentials? How much time have you spent with those suffering from schizophrenia? How many times have you stopped outside the doors of a CMHC to chat with the smokers (who tell you that you are “lookin’ good today, sugar”)? How often have you been in state hospitals? How frequently do you visit the in-patient units or the psychiatric emergency rooms in urban hospitals? What resources do you provide the staff of the CMHCs to improve the lives of the chronically mentally ill? How many times has a physician told you that a patient who couldn’t leave his apartment has gone shopping with his ACT team (and the meager disability check provided by the state)?
You harangue and argue and hurl insults, but you provide no insight as to what you are doing to help those you would “protect.”
pg
Sorry Horus, you’re the pharma ‘expert’. I’m not. YOU do some REAL research for a change.
pg
Bye. Why not ‘email’ Peter Pitts, I’m sure he’ll help, you are clearly on the same side lol.
HorusCat
pg,
You also don’t respond to requests for more information. I asked for evidence or data from a source with no axe to grind. Instead, you refer me back to a website sponsored by a group that shares your biases.
I point out that the atypicals aren’t used for suicide prevention. You come back to suicide. I point out that comparing suicide rates from a mentally ill population to the at-large suicide of a relatively healthy population is like comparing malamutes to chihuahuas and you come back with the exact same citation.
You don’t advance the discussion; you merely repeat yourself, thinking that if you say the same thing over and over, it becomes more convincing.
I would hazard the guess that anyone who reads what I have to say versus what you have to say would fine more illumination and curiosity in my words than in yours, as others have pointed out in other discussions on this site. I am not getting rich from what I do. I don’t even sell an antipsychotic anymore. I am upfront about my motivation in doing my job–it is a source of income AND a source of intellectual and emotional satisfaction.
Share you motivation and activities, pg. Typing behind your curtain, you seem to me to be the Wizard of Oz.
HorusCat
pg,
Why this inability to actually converse? When I ask real questions and share my experience, you just insult me. You have no credibility when you do that. If you want to persuade me to see things your way, do more than just tell me to email Peter Pitts. Tell me what you have found that works better. Share your experience and insight into this population of people. I hear no compassion and empathy for the mentally ill in your words; I only hear venom and bitterness against the pharmaceutical industry.
pg
Before signing out, I need to add to this earlier comment - the additions will be in upper case:
“In conclusion, Peter Pitts’ attacks AND HORUS’ DEFENSE OF PETER PITTS, such as the one on the late Loren Mosher for instance, appear to be finance driven and as misleading as personal attacks can get. No wonder the FDA are under criticism as to their ability to protect the public when they hire such morally dishonest individuals.
http://drugwonks.com/blog/kooksrus
“This kookery is being pushed by a group called the Alliance for Human Research Protection which was formed by Loren Mosher who believed that schizophrenia and other mental illnesses could be treated without any medication.”
It would seem from the evidence available, that Loren Mosher - and others who come under the ’strategic’ scrutiny of people like Peter Pitts AND PHARMA REPS LIKE HORUS - are working for the public interest, ie, working to save lives.
CMPI. Its a front group funded mostly by drug makers. It would most aptly stand for ‘Center for Medicines in my Personal (PHARMACEUTICALLY FUNDED)Interest’.
Have a good weekend Horus! Don’t give up, its in your interest to keep it going. I don’t get paid ANYTHING for my effort by the way. In case you missed the point, as you do most things, I’m NOT a scientologist (or a lawyer, or anything else you’d like to smear me with either) as you tried to imply in an earlier post in that ‘pharmaceutically funded’ kind of way.
HorusCat
YOU do some REAL research for a change….
I would say spending 8 hours a day in community mental health centers, talking to inpatient docs, walking the halls of the state mental hospitals and actually talking to the chronically mentally ill and those who serve them qualifies as REAL research. You, on the other hand, apparently have nothing to offer but personal attacks.
pg
WIZARD OF OZ??
Get real Horus. I’m someone commenting in an attempt to help save … lots…of lives and, unlike you, I have no financial interest. I’m going offline. Do your best for damage limitation - your money depends on that.
HorusCat
pg,
Once again, you fail to engage, you just attack. I have not defended Peter Pitts. I have argued that the antipsychotics are helpful in the attempt to improve the lives of the chronically mentally ill. You have failed to refute my arguments. ??? I don’t know if you are a lawyer or a scientologist or the man in the moon; I just know that you seem unable to do anything but attack me.
pg,
Why don’t you engage me on a real and authentic level? You say that I shouldn’t stereotype you as a scientologist or lawyer, yet you engage in just such depersonalization. Your bitterness prevents you from acting like a human being. I just find that baffling.
pg
LOL, why should I engage someone with $$$ blinds on. Sorry Horus, I’ve put the facts, you don’t like them. Deal with it. I’m not playing your game ok? Tarraaa.
pg
In conclusion, Peter Pitts’ attacks, such as the one on the late Loren Mosher for instance, appear to be finance driven and as misleading as personal attacks can get. No wonder the FDA are under criticism as to their ability to protect the public when they hire such morally dishonest individuals.
http://drugwonks.com/blog/kooksrus
“This kookery is being pushed by a group called the Alliance for Human Research Protection which was formed by Loren Mosher who believed that schizophrenia and other mental illnesses could be treated without any medication.”
It would seem from the evidence available, that Loren Mosher - and others who come under the ’strategic’ scrutiny of people like Peter Pitts - are the ones working for the public interest, ie, working to save lives.
CMPI. Its a front group funded mostly by drug makers. It would … most aptly stand for ‘Center for Medicines in my Personal(pharmaceutically funded) Interest’.
pg
Drugwonks: “Center for Medicines in my Personal (pharmaceutically funded) Interest’
I hope this comes out with the intials in bold.
pg
On ‘biases’ and pharmaceutically funded definitions.
“Lisa, thanks for the search keywords hat tip which brought up a slightly different link to the letter you referred to in your comment to Peter Pitts above.
Now I understand better just what you were getting at and noticed in the third paragraph of the letter how “conclusions” were considered “biased” if they were for presenting the case for risks, but ‘unbiased’ if they were in agreement of how SSRIs were safe and effective for children - which meant no chance of a robust debate I guess.
The link: http://www.baumhedlundlaw.com/media/ssri/paxil/FDAHearing/TierneyLetter.htm “
Nathan
It’s nice to see the mainstream media be more rational about this suicide issue. I just saw an NBC news article a few days ago that was very balanced in its view. Clearly there are issues to investigate, but it’s nothing to panic about and nothing to think that the pharma industry is somehow “covering up” data. Here’s the link. Bravo NPR and bravo NBC.
http://www.msnbc.msn.com/id/24262690/
HorusCat
pg,
You present no “facts,” you just reiterate the s.o.s. Loren Mosher has been effectively countered by years of research on the most basic levels. You won’t “play games” with me because you CAN’T engage me on an intellectual level. All of your arguments and “data” are solipsistic. A says B, and B says A, so A must be true, because B is true because A says it is. Whew. Truly a powerhouse argument. Because you can’t actually debate a point, you throw around the $$ sign argument. Wow. That’s really a powerful, intellectually-honest, insightful response (end sarcasm). Tell you what–let’s go to pubmed and search “genetics and schizophrenia.” Link to the article and let’s discuss the pros and cons.
Oh, I read the excerpt about one of Mosher’s 16 year old patient’s urinating on herself and suckling at a Soteria House worker’s breast. Nice. Just what I want for my schizophrenic daughter.
pg
Interesting, Nathan.
You’ve just given us a very good example as to how the major news media work to perpetuate what drug makers want us to believe.
“The Infinite Mind” comment way up the board alleged:
“…We wanted to know: Why did the major news media uniformly target Steven’s withdrawal from an antidepressant as explanation for his violent act? Why did the media ignore any number of other factors, such as his gun collection, his work as a prison guard, or his troubled childhood?…”
AS IF the ‘major news media’ would take the risk of fighting against the pharmaceutical influence. Lol.
pg
HORUS: I am NOT playing your pharmaceutical game in which you have a financial interest. OK?
pg
Lets recap from further up the comments:
“Comparison of Suicide Rates in Treated Schizophrenia Patients Found 20-Fold Increase
“Wednesday, 01 March 2006
An analysis published in the current issue of the British J of Psychiatry (BJP) of the suicide rate among schizophrenia patients treated at the same hospital in North Wales (UK) before psychotropic drugs and patients treated (in and out of hospital) with neuroleptics and /or atypical antipsychotics, found a 20-fold increase in the suicide rate since use of psychotropic drugs…”
“…In an invited accompanying commentary, Dr. Trevor Turner, Consultant Psychiatrist and Clinical Director, Department of Psychiatry, of a university hospital in London, writes: “If their figures are carefully boiled down, they show that in the course of 5 years the historical cohort had 1 suicide in 594 individuals, whereas the present-day cohort had 7 suicides in 133 individuals.” Thus, patients treated with the latest antipsychotic drugs had a 20-fold increased risk of suicide compared to those treated without drugs in Victorian times.
These startling findings are certain to stir much controversy because they challenge a key mental health treatment goal — suicide prevention — which is also offered as the prime justification for mental screening in U.S. schools. These findings also challenge the widely cited 10% lifetime risk of suicide among schizophrenia patients…”
pg
More recapping. ZYPREXA - highest suicide rates in all clinical trials.
From an article October 2005, Columbia.
http://www.ahrp.org/COI/HealyColumbia1005/index.php
“Zyprexa. ‘…in all of these scientific publications you aren’t able to find the fact that this is the drug with the highest suicide rate in clinical trial history…’
“…So this all leads us to this next point, which is data on completed suicides and suicidal acts in the trials of antipsychotics sent in to FDA for registration purposes. Now remember, people like me and like all of you in this audience I think if asked to review the evidence on Risperdal compared with the older drugs would have come to the same conclusion that we should be using Risperdal first. But if you remember FDA didn’t come to that conclusion. The difference is that the published articles aren’t showing the same thing as FDA has been seeing. What the FDA has been seeing, which isn’t in any of the published articles, are figures of this sort here which are the completed suicides and suicidal acts on Risperdal and Zyprexa (28). ”
28 links to a slide of trial suicide rates at http://www.ahrp.org/COI/HealyColumbia1005/Slide28.jpg
“If you look at the Zyprexa suicide figures, these come from 2500 people who were in 5 clinical trials. You repeatedly hear that one of the problems we’ve all got is that the pharmaceutical companies hide trials. Well far from hiding these trials, these 5 clinical trials have given rise, when I checked last, to 234 different publications, of which 41 are major publications. These trials haven’t been hidden. There are 8 articles or abstracts per trial. But in all of these scientific publications you aren’t able to find the fact that this is the drug with the highest suicide rate in clinical trial history. You aren’t able to find either from any of the articles that have been published or from the FDAs reviews of the drug how many people went on to suicidal acts. And, given that these figures suggest Zyprexa has the highest suicide rate in clinical trial history, you would have to think from the fact even FDA aren’t prepared to show what the figure of suicidal acts is that it may be rather high…”
pg
“Bravo NPR and bravo NBC.
http://www.msnbc.msn.com/id/24262690/ ”
Odd that the major media do their best to NOT cover the risks.
You can’t get much more ‘major’ in media than msnbc now can you!
Justice in Michigan
Maybe not the main issue, but I am still genuinely confused about some of this controversy. In NPR’s response, up the thread, they write:
“What we didn’t know, because he didn’t disclose it to us, was that Pitts is currently working for a public relations firm whose clients include major pharmaceutical companies. If we had known, and (full mea culpa here) we should have, we would have disclosed that connection. Pitts apparently didn’t disclose it elsewhere, either - he’s appeared on NPR’s Talk of the Nation as well as PBS’ News Hour with Jim Lehrer, without either of those programs mentioning the PR company ties.”
Is the accuracy of this statement being challenged?
Thanks for clarification.
pg
No Justice - its hasn’t been challenged :-) I hope that clears it up. This might help too:
http://www.sourcewatch.org/index.php?title=Peter_Pitts
Apologies to all for the boring repeated comments here. They’re necessary at the moment, but just consider the decades of repeated confirmation of safety of drugs from masses of key opinion leaders and (ex) FDA guys on how safe the drugs are.
HorusCat
pg,
Repeating arguments which I have refuted doesn’t make them true. Comparing Victorian era medical outcomes to current medical outcomes is beyond ridiculous. Again, you cite a trial lawyer’s website without providing the raw data–whereas I provided raw data directly from the plaintiffs’ lawyers in a Zyprexa case. You’re beginning to look moronic.
You say you won’t argue with someone who has “$$$” in front of their eyes. Well, I obviously CANNOT argue with someone who evidently cannot respond to requests for facts with actual FACTS and who can only respond to rational, logical argument with the equivalent of a two-year-old’s raspberry. “I’m not going to talk to you because you’re BAD (as I define it).” That’s your answer? I am sure you will persuade many with that approach.
You have to resort to that sort of ad hominem attack because you in fact do NOT have any of the experiences I have had; you do NOT have raw data to back up your assertions, and you do NOT have the majority of the basic and clinical research community on your side when it comes to the anti-psychotics. You won’t argue with me because you can’t. The personal insults could be more variegated though; the money one is getting a little old. How about, “HC, you’re ugly and your mother dresses you funny!” Now that would be a departure from the tired financial slurs.
pg
Peter Pitts on Manning Selvage & Lee site:
http://www.mslpr.com/practices/healthcare-pr/capabilities/?searchterm=peter%20pitts
“…Global Health Affairs & Health Policy
Our Global Health Affairs unit is led by former FDA Associate Commissioner Peter Pitts. With a team of top-level experts in MS&L’s US and EU offices, MS&L helps clients understand and influence government thinking on key health policy issues. Our services include:
Monitoring emerging health issues to protect clients, particularly legislative and regulatory activities
Developing communications strategies to support or thwart issues, including outreach to key agenda-setters, coalition-building, e-fluencer campaigns and media outreach
Addressing reimbursement challenges
Preparing for competition from generics in key countries or regions…”
pg
Horus, I put the facts there and I suggest that if wish to refute them, you contact the author - an expert historian and psychopharmacologist, former consultant to the pharmaceutical industry - to discuss your own ‘expert’ opinion!
OK?
HorusCat
pg,
C’mon pg baby, cough it up. Everyone else on this site is transparent. We know a lot about Justice, Nathan, Matt Helm, Matthew, Lisa Van S, Jack2, FPME and me. You present yourself as some sort of truth-seeker, but I suspect you have ties to anti-medication New Age type organizations. Not that there is anything wrong with that, but it would certainly show that you are not some objective, omniscient arbiter of truth and fairness in the medical-scientific community. Basically, pg, what are your credentials other than you know how to google?
pg
Peter Pitts, defending ‘Clients’ and attacking science:
http://discovermagazine.com/2007/oct/sciences-worst-enemy-private-funding/article_view?b_start:int=1&-C=
“…Nevertheless, Nissen found himself under attack, often by people with explicit financial ties to the drug industry. His challengers have included Valentin Fuster, who wrote a critique of Nissen’s work in Nature Clinical Practice Cardiovascular Medicine. Fuster receives Glaxo funding and serves as the chairman of Glaxo’s Research and Education Foundation. Peter Pitts wrote a stinging attack on Nissen in The Washington Times; he is a senior vice president at the PR firm Manning Selvage & Lee, which represents Big Pharma, including Glaxo. Douglas Arbesfeld, a senior communications consultant at the FDA, disparaged Nissen in a biting e-mail to the media. He formerly worked as a spokesman for Johnson & Johnson…”
HorusCat
pg,
The point is you don’t, in fact, put out facts. You put out the views and suspect data of those with whom you agree. Then you say, “Contact them.” Well, you are acting as their spokesperson by quoting them. You are citing “articles” from a lawyer’s website. You are citing “facts” from Healey that have no citation for raw data. You are like a sniper taking potshots from a tree who is outraged when the targets call in air cover and nails you.
I can see why I appear to be the only on the site who will engage you. You get kind of boring.
pg
Horus, you’re descending into the desperately ridiculously attempts to discredit now LOL.
HorusCat
pg,
The point is you don’t, in fact, put out facts. You put out the views and suspect data of those with whom you agree. Then you say, “Contact them.” Well, you are acting as their spokesperson by quoting them. You are citing “articles” from a lawyer’s website. You are citing “facts” from Healey that have no citation for raw data. You are like a sniper taking potshots from a tree who is outraged when the targets call in air cover and nail you.
I can see why I appear to be the only on the site who will engage you. You get kind of boring, actually. I get more creative and sometimes fact-based debate from my 10 year old.
pg
I guess you belong to the Peter Pitts Pharmaceutically Phunded Phan Club!
HorusCat
pg,
In order to discredit you, one would have to find you credible to begin with. In your unwillingness or inability to actually RESPOND to my questions rather than REGURGITATE what you have said before, you discredit yourself.
In your refusal to reveal yourself, you are hypocritical in blasting Peter Pitts for not revealing himself. In your endless castigation of my supposedly only financial motives and your refusal to discuss your own motives, you are again, hypocritical and disingenuous.
Like I said, you are the Wizard of Oz….show us the man behind the curtain.
pg
I’m really glad you find me boring Horus, perhaps with that view of yours in mind you could stop putting all your efforts today into trying REALLY HARD to discredit everything I’ve posted? LOL.
HorusCat
pg,
Whether I am a fan of Pitts or not is a non-sequitur. You can’t produce counter-arguments to what I say, so you resort to “guilt by association” tactics. But, like I point out, you refuse to reveal your own associations, lest the same “tarred by the same brush” approach be used on you.
HorusCat
pg,
I’ve already discredited everything you posted about atypicals. When you produce the raw data from the FDA about suicide and olanzapine, as I have done, or when you buy the AERS data from the FDA and prove post-marketing higher incidence of suicide with olanzapine, you will regain credibility. You’re a legend in your own mind, but only there.
pg
Horus, you’re clearly a good pharma rep as all you give is pharmaceutical rhetoric. I’m nobody important in the legal or pharmaceutical field and if I said who I am you’d be no wise than I am as to who ‘Horus Cat’ is, but I appreciate your rather in depth and lengthy interest in such a ‘boring’ poster lol. As it happens, I’m likewise bored with your attempts to get attention away from the facts and so, from now on, will not be wasting energy in answering you at all. Goodbye.
Now back to Peter Pitts and to one of my favorite websites:
http://pharmagiles.blogspot.com/2007/06/stick-and-stones.html?showComment=1185046680000
delighted
pg,
Keep it coming. HC looks more desperate with each post!
Lisa Van S
Hey HorusCat,
You are one hellofa character,.. you know darn well that industry isnt going to share raw data. PlEEEEZ!
Lisa Van S
The Infinite Mind,
Clearly,.. you have repeated an Industry,.. spoon fed comment, in regards to decrease of antidepressants, has increased suicide. If you have a copy of CDC’s completed 2005 suicide report,..please share. If you dont then maybe you,. sir,.. should consider a retraction of your above statement. Hmmmm,… Industry folks dont want that cat out of the bag!!!
Im curiuos as to how you chose your experts,.. were they spoon fed to you,.. why not have Dr. Healy, or Dr. Glenmullen? Id love to see a real debate amongst experts.
And Sir,.. if you truly cared about the truth,… you would demand Industry to turn over the raw data.
http://www.ssristories.com
HorusCat
Lisa Van S,
I provided raw data from one of the olanzapine trials on a post above-came from the plaintiffs’ counsel in the Alaska trial. pg just didn’t like it, so she ignored it. No difference between placebo and olanzapine suicide rates (and both less than 1%). You can’t say “X” happens and then not provide facts, but only unsupported assertions from those who happen to agree with you (from trial lawyers’ websites and a powerpoint presentation with no citations and homemade slides).
AERS data–post-marketing reports–are available to anyone who is willing to pay for them. No one is stopping you from requesting them and reading through them for a suicide signal.
And repeating over and over the fact that suicide rates in schizophrenics are different today than they were 120 years ago doesn’t prove anything.
If you want a make an argument, provide something concrete from which to advance. You can’t say something is true just because someone else says it is and expect to be taken seriously. Galileo had mathematics to back up his assertion that the earth revolves around the sun. pg doesn’t provide any DATA, only assertions. Those are fine to start with, but back them up or quit arguing.
Lisa Van S
HorusCat,.. OK
“AERS Data-postmarketing reports are available to anyonyone who is willing to pay for them. No one is stopping you from requesting them and reading through them for a suicidal signal.”
It be done,.. see here: 2004-2006 AERS,.. name your poison!
http://www.psychdrugdangers.com
AA
HC,
If doctors don’t take it seriously when patients report med side effects, how can we trust the data that doesn’t show a link between suicides and meds? Recently, there was a report that was definitely true with Statins. I can find the link if you want.
I don’t have a study to prove this but based on talking to many people in similar situations, when you have a mental health diagnosis, everything is attributed to your “illness”. If patients aren’t being taken seriously about complaints for non psych meds like statins, I don’t think I am being outrageous based on my experiences and others in similar situations that patients who take psych meds are being blown off about their complaints.
HC, an example is that 4 years ago, I complained about a med side effect to my psychiatrist that was blown off. Fortunately, it wasn’t suicidal ideation but it wasn’t minor either. It was only when I told him that another heathcare professional said my complaint was valid did he acknowledge that I was right. That greatly angered me.
Obviously, you can’t go back and talk to dead people. But in looking back at the history of people who sadly complete suicide on these meds, there are many signs that the med was bad news for them. The doctor either completely overlooked these signs or blew off the person’s complaints.
I just think until doctors take complaints about med side effects from patients seriously, we are never going to know the true story about these meds. I don’t mean to sound cynical but the chance of that happening is about as great as my becoming President of the US.
AA
Melody
AA–
Not off topic, but transcending medical specialties, I have seen in the diabetic community that ‘adverse events,’ or merely patient complaints are conveniently manipulated by medical professionals. Such reports ultimately are handled by ‘blaming the patient or blaming the disease.’ Medications used to treat the disease, or the regimen prescribed by the doctor to use the medicines, are blameless? So it seems. An empirical formula that suffices for one specialty spreads, viral-like.
HC above suggests that AE reports are available to all. S/he fails to acknowledge that the AE reporting system in the U.S. is dysfunctional at best. What kind of helpful information can be garnered when reporting of AE’s is voluntary, cumbersome, and fragmented?
HorusCat
Melody and AA,
I have ordered AERS data. For a process that is “voluntary, cumbersome and fragmented,” there sure were a lot of incidents reported. I myself have made AE reports to the company making a med and the FDA. It’s not hard. You can do it on line now.
AA, the fact that your psychiatrist did not take your complaint of a side effect seriously is not pharma’s fault. We talk about side effects of our meds with doctors all the time–in psychiatry, it is probably the primary topic of conversation with our physicians. From GI distress and nausea with the SSRIs to somnolence and dysmenorrhea with the antipsychotics, I have never heard anyone from pharma or medicine claim that the disease state produces the side effect. I do know that physicians have patients who complain about EVERYTHING with EVERY medication. Nothing ever works and they have every side effect known to man. I imagine that in some instances, it can be difficult to determine what is real and what is not. I had a psychiatrist who female patient called to claim of prostate enlargement (obvoiusly not a very bright patient)–she’d been reading the package insert. When you have patients like that, at what point do you tune them out? If you feel like your physician isn’t listening, what is stopping you from 1) changing physicians or 2) calling the company yourself?
At any rate, the suicide data to which I referred was from trials, so “voluntary” reporting wouldn’t be an issue, anyway.
Beyond that, to suggest that a psychiatrist would fail to take a suicide seriously is defamatory. Every psychiatrist I know takes suicide seriously–from the merest mention of it to planning to the act itself. They have to, legally, at the very least. The best thing to do if you want to commit suicide is to say nothing to anyone–in my state, at least, if you mention it and the physician judges you to be at all serious, you can be put on a 72-hour hold.
No sane doctor whose patient kills himself will be untouched by that act. My further point from what pg says above is that she implies that suicide is rampant among those taking antipsychotics. The truth is, it isn’t. I have spent 8 years in CMHCs and RARELY had a physician whose patient committed suicide. If olanzapine patients were dropping like flies (of something other than cardiovascular disease and nonketotic acidosis), someone would notice.
Another point I am trying to make is that to claim there are data out there and then refuse to provide them is disingenuous. The links she provided lead to no data, merely lawyers’ websites and homemade slides by a person with a known bias. The only data I WAS able to find show no suicide signal. Therefore, I have to conclude that until further proof is given, there is no suicide signal with olanzapine.
I would not be surprised if suicide rates have increased in the past 40 years for the chronically mentally ill. This is co-incident with the advent of the antipsychotics, but that does not indicate a causal relationship. Probably much more integral to the suicide risk of a schizophrenic person is opportunity–in the 1960s, a chronically mentally ill patient was kept closely supervised and often physically restrained in a state hospital. A suicidal patient then had motive, but no means or opportunity. Then the “patients’ rights” movement came along and patients were released by the thousands into the “least restrictive” setting possible–for many, the underpasses of bridges and subway grates in urban areas. Of course suicide rates are going to go up–patients now have all three components necessary to complete the act: means, motive and opportunity.
None of the typicals or atypicals have data showing suicide reduction, so David Healey’s argument that they don’t reduce suicide is a non-sequitur. That’s not what they’re used for.
HorusCat
Melody and AA,
I would also say that you can’t say on the one hand that you are entitled to fully informed consent–give me all the information and let me make a decision, but then act helpless and expect your physician to do all the work. If a medication doesn’t feel right, call the office and insist on being seen ASAP. If you think you’ve got a loser doc, go elsewhere. If you have a side effect, call the company. If you see a rep for your drug, tell him.
I see on this site often a weird duality of thinking: those involved in medicine in any capacity are indifferent, uncaring, corrupt and patronizing, but at the same time, they are god-like, all-knowing, all-responsible and rightfully paternalistic. The truth is that we are all just individuals involved in the process, and we all have responsibilities for ourselves and each other.
HorusCat
Lisa Van S
Went to the FDA site and found the original NDA for olanzapine. Had all sorts of raw adverse events data, including suicide and case reports. It wasn’t hard to find or read. You can do that with most any drug you want.
AA
HC,
I treated you with total respect and you inferred things in my post that weren’t even there. I expect the same courtesy.
I didn’t say that physicians don’t take complaints of suicide seriously. What I said was they blow off complaints that may be signs of potential problems. A patient may not outright say I am suicidal but will say they are feeling weird or something similar. It gets blown off as part of their mental illness.
I didn’t say that drug companies are responsible for the behavior of physicians. My question to you which you didn’t answer is if physicians blow of complaints about side effects, when they are listed in the major drug books, how can we expect the statistics for any side effect to be accurate?
I can’t remember where I saw this statistic but it is estimated that the drug side effects reported to the FDA medwatch program are only 1 to 10% of what really occurs.
As far as personal responsibility, you are totally barking up the wrong tree. Just like you can’t always give details, I can’t either. But one example is I went against the advice of my psychiatrist about staying on a med. I felt it was bad news and that is one of the best decisions I ever made.
AA
Justice in Michigan
HC wrote, “None of the typicals or atypicals have data showing suicide reduction.”
Not sure whether clozapine would count as an “atpyical” in the narrow sense, but it has FDA approval to say suicide rates are _lower_ with it than others. NNT in primary study against Zyprexa was 13.
This is and isn’t relevant, but way up the thread HC asked pg whether he/she had spent much time with people who are schizophrenic. I have. I am a clinical psychologist, and, as it happens, my sister was schizophrenic.
The past tense is because she did commit suicide while on clozapine. No instance is simple, and this one has nothing to do with whyI got involved with pharma issues. But it does have to do with seeing a lot of psychotic people, including someone very close, having a wide range of experiences with different anti-psychotics.
My sister herself felt the benefits outweighed the risks, but I don’t think she would say that now. Yes, I understand about populations and individuals. Nevertheless, if the standard of benefit risk is say, penicillin vs. acute pneumonia, the anti-psychotics are very far from “miracle” status in my view.
HorusCat
AA,
I am sorry; I really meant no disrespect. I would hope that no psychiatrist would blow off a patient who says a medication makes them feel weird. Honestly, I have had docs tell me my medication makes people feel that way–so they obviously see it as a side effect and not “the patient.” I hope that you see that as a sign of a problem physician, not physicians as a whole. What helps the doc (in order to help the rep who can report it) is if you can give details about what feeling weird means. Dizzy? Sleepy? Groggy? Drunk? Loopy? Like your head is stuffed full of cotton? Cognitively impaired? Irritable? Things like that, so that a rep (or a doc who chooses to report) has concrete things to tell medical affairs. Weird means different things to every patient, obviously. A pattern can only develop if we have more specific descriptors.
Again, I am sorry if I appeared disrespectful. I meant to convey that in my experience, a good psychiatrist doesn’t attribute a patient’s report of experience on a medication as a problem with the patient and not the medication.
Justice,
Several times above I noted that clozapine does have the indication for suicide reduction. I am sorry about your sister. Clozapine is still not a miracle drug, although it is the closest thing out of all the antipsychotics. The side effects are so grossly debilitative, though, (and agranulocytosis of course can be fatal), that it is the last resort.
I also said several times that these drugs are not wonder drugs. The etiology of schizophrenia is very complex, with multiple neurotransmitters involved, as well as changes in brain structure. There will probably never be a miracle drug for schizophrenia. I hope we get better and better drugs, as well as treating people sooner, since as the disease progresses, the drugs get less effective.
Jane
“Again, I am sorry if I appeared disrespectful. I meant to convey that in my experience, a good psychiatrist doesn’t attribute a patient’s report of experience on a medication as a problem with the patient and not the medication”.
All Psychiatrist, good, bad, indifferent, are treating the suicidal effects of psychotropics with more medications. So yes they are attributing the side effects to the patients.
Justice in Michigan
HC - Sorry I missed your earlier references to clozapine and also “wonder drugs.”
pg
So there are problems giving antipsychotics to those who they are ’supposed’ to treat.
Now they are given to CHILDREN.
So just WHAT is the excuse for doing so?
And yes, the experience over decades is that psychiatrists dismiss effects of drugs and blame the ’schizophrenic’ disorder.
What will they blame when children, NOT schizophrenics, suffer those side effects?
pg
My guess is pharma reps etc will be blaming CHILDREN’s “mental disorders” for the side effects of the antipsychotics on CHILDREN.
Just like they’ve been blaming the side effects on the “disease” of ADULTS that are classed as schizophrenics?
The disease in reality is that of the mentality of the psychopaths who are happy to drug anyone for the sake of profits.
pg
Holding conversations with those psychopaths are a total wast of effort.
HorusCat
Lisa,
Your link proves my point. 119 reports of suicide linked to a drug that has been taken by millions and millions of people. You have failed to prove a cause-and-effect relationship.
pg,
Don’t throw in the children as a red herring. I have said nothing about children; your posts about olanzapine were not about children.
Are you saying that schizophrenics are only suicidal when they are on antipsychotics? Are you implying that schizophrenia is not organic in nature? Are you saying the 16-year-old girl living in Loren Mosher’s wonderland urinating on herself and SUCKING at her caregiver’s breast was a better form of treatment? Wow.
HorusCat
Lisa,
I have an Adobe copy of the NDA for olanzapine for the original indication, but I am not good enough with the computer to figure out how to excerpt from it. I got it from the FDA website, and it includes all of the raw data, including suicide case reports. Only by careful selecting certain data and ignoring others can one come up with anything close to what David Healey claims in his talk from Columbia University, which is probably why he does not provide slides of the original documents or citations. Similarly, the attorneys trolling for Zyprexa patients have to fudge the data in order to make their claims about Zyprexa and suicide–as I pointed out numerous times, even the plaintiffs’ attorneys in the Alaska trial (who used the NDA documents I referred to above) could not produce anything to support what David Healey says.
Basically, your argument seems to be that psychotropic drugs of any kind shouldn’t be used, or that patients are only suicidal because they take psychotropic drugs. That doesn’t make sense to me. And it seems patently obvious that the manifestations of mental illness include the things that you seem to ascribe only to medication: hostility, paranoia, suicidality, depression, lack of affect, etc. The scales used to assess schizophrenic patients, including those who are unmedicated, encompass hostility, agitation, paranoia, depression, anxiety and suicidality, to name only a few things. That is why clinical trials are done, to see if the majority of patients treated with an antipsychotic show reductions in those scales. To automatically say that a patient who fails to respond to a medication and remains hostile, aggressive, paranoiac, agitated, anxious, avolitional, apathetic or depressed is only that way BECAUSE of the medication is nonsensical.
Lisa Van S
HorusCat,
Cute Analasys!… Quite busy right now,.. have much bigger fish to fry.
By the way,.. when you achieve the status of a Dr. David Healy, let me know,… and then maybe I can stomach taking your opinions as Science!!!!!!
Have you forgotten,… Youre just a drug rep!!!
Atlex
Lisa,
Nice job…when you can’t refute something, issue a personal attack on HC. I, too, question Dr. Healy’s status and data. You’ve cited ridiculous figures (generated by Dr. Healy according to you) regarding anti-psychotic use in children in foster care in New Jersey. I asked you for the data and you’ve never been able to supply it.
I’ve said all along that there is very likely overuse of anti-psychotics in children–particularly young children. However, you have suggested that Dr. Healy has data showing that ~97% of children in foster care in NJ are on anti-psychotics. I’ve done my best to find this data in public sources and have come up empty. So, where’s the data to support this? Is Dr. Healy making it up?
Atlex
HorusCat
Atlex,
Thanks! I too notice that when I provide the data behind Dr. Healey’s presentation, I get attacked. ONLY a drug rep, so my citations to raw data don’t count. pg and Lisa are ONLY consumers, but THEIR references to unsubstantiated assertions by someone with a known axe to grind are golden. This is obviously a case of : that’s my story and I’m stickin’ to it.
Oh well, fortunately for the chronically mentally ill adults in this countrym the atypicals are here to stay. And fortunately, the use of olanzapine is going down due to its untoward metabolic side effects, not any propensity to cause suicide. Much research is being done on other neurotransmitter systems and the genetic underpinnings of schizophrenia, so we can hope that new and better therapies will emerge over the coming decade. In the meantime, we need to continue to advocate with our NAMI folks for more funding for CMHCs so that they can maintain their ancillary services such as ACT teams, group meetings, clubhouses, case worker support, etc.!
Lisa Van S
Atlex,
That was a nice try, and I suggest you go back and reread my post. You will also find a link to 2.5 million U.S. children were on antipsychotics, pg was gracious enough to provide a link. I stated the 97%, one must be on the inside looking out,.. Unfortunately, you are on the outside looking in.
Lisa Van S
HC,
If it were not for consumers,.. you would be out of a job.
HorusCat
Lisa,
If it weren’t for drug makers, you might not exist, because you or one of your antecedents might have died from a common infection.
And Atlex is right–when I supply DATA which has nothing to do with my mental capacity or lack thereof as ONLY A DRUG REP, you issue personal attacks.
As only a drug rep, I at least know the basic science research and clinical medical research being done in the area of schizophrenia. I at least am familiar with the working hypotheses of how the disease develops and manifests itself, and I know the MOAs of the various medications used to treat schizophrenia. I know the way that schizophrenia presents itself to the outside world, and I know that it can’t be “cured” by mushy therapeutic approaches that “embrace” and “welcome” a patient’s psychosis. Apparently, you and pg don’t know even that much.
When you reduce pg’s assertions down to the bare bones, she is saying basically that since the disease process is not organic, then schizophrenics are just mentally weak…a strong person would be able to deal with the vicissitudes of life.
And both of you, rather than celebrating the fact that millions of people have been able to lead more productive, social and rewarding lives since the advent of the atypicals, would deprive all who suffer of the medications that improve their situation. You can only justify this by rationalizing that the medications are CAUSING all of the problems…an idea that flies in the face of the fact that depression, anxiety, schizophrenia, mania, suicidality and other mental illnesses have been with us since we began recording our history.
Do some individuals have idiosyncratic reactions to psychotropics (or any med for that matter?) Yes. Does that justify removing them from the market. A sane person would say no. The benefit of the many in this case does outweigh the cost to the few.
Atlex
Lisa,
The links provided by PG do not have validated data demonstrating that 97% of foster children in NJ are on anti-psychotics. Before using that reference again, please show a valid source, not some unsourced or missourced report. As I have said repeatedly, no one on this site is argueing that anti-psychotics are not over-used in children; however, some of us take issue with constant misuse of data that overstate the scope of the problem.
Atlex
pg
“Lisa Van S
Atlex,
That was a nice try, and I suggest you go back and reread my post. You will also find a link to 2.5 million U.S. children were on antipsychotics, pg was gracious enough to provide a link. I stated the 97%, one must be on the inside looking out…”
“Atlex
Lisa,
The links provided by PG do not have validated data demonstrating that 97% of foster children in NJ are on anti-psychotics…”
? (!)
pg
Peter Pitts and Robert Goldberg’s Pharma Funded Drugwonks:
http://drugwonks.com/blog/typical_misreporting_on_atypical_use_in_kids/
“Typical Misreporting on Atypical Use in Kids
May 05 2008 | Robert Goldberg
The AP’s Lyndsey Tanner fans the flames of fear by misconstruing already breathless data dredging operation by Fariz Rani and others in this mont’s Pediatirics [sic]. about the “soaring” use of atypicals in the treatment of autism and ADHD in the UK…”
http://pediatrics.aappublications.org/cgi/content/abstract/121/5/1002?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Rani&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT
“Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom
Fariz Rani, BPharma,b, Macey L. Murray, BSca,b,c, Patrick J. Byrne, FRCPsychd,e and Ian C. K. Wong, PhDa,b
a Centre for Paediatric Pharmacy Research, School of Pharmacy, University of London, London, England
b Institute of Child Health, University College London, London, England
c Task-force of European Drug Development for the Young (TEDDY)
d Department of Adolescent Psychiatry, Bethlem Royal Hospital, South London, England
e Maudsley National Health Service Trust, Beckenham, England
OBJECTIVE. The goal was to investigate the epidemiologic features of antipsychotic prescribing to children and adolescents in general practice in the United Kingdom.
METHODS. A total of 384 participating general practices from the United Kingdom General Practice Research Database were used to identify patients 0 to 18 years of age who were prescribed 1 antipsychotic medication between January 1, 1992, and December 31, 2005. Annual age-specific prevalences and incidences of antipsychotic prescribing were calculated.
RESULTS. The overall prevalence of use of all antipsychotics increased from 1992 (0.39 users per 1000 patient-years) to 2005 (0.77 users per 1000 patient-years). The prescribing prevalence for patients 7 to 12 years of age almost tripled between 1992 (0.23 users per 1000 patient-years) and 2005 (0.61 users per 1000 patient-years). Atypical antipsychotic prescribing increased 60-fold from 1994 (0.01 users per 1000 patient-years) to 2005 (0.61 users per 1000 patient-years). However, typical antipsychotic prescribing decreased significantly from 2000 (0.44 users per 1000 patient-years) to 2005 (0.18 users per 1000 patient-years). The incidences for typical and atypical antipsychotics showed trends similar to those of the respective prevalences. However, the overall incidence (number of new starters) for all antipsychotics was relatively stable between 1992 and 2005, which suggests that patients remain on treatment longer.
CONCLUSIONS. The overall prevalence of antipsychotics almost doubled between 1992 and 2005; however, the rate of increase was much lower than the reported figures in the United States. The prescribing of atypical antipsychotic drugs has increased despite the lack of conclusive evidence showing their superiority over older conventional antipsychotics. Additional investigation is required to evaluate their efficacy and safety in children and adolescents”
Atlex
PG and Lisa,
According to the census bureau, there are roughly 10M children between the ages of 7 and 12. How does the data above lead to the conclusion that 2.5M are on antipsychotics?
Again, this is a misrepresentation of data.
Atlex
Atlex
FYI…there are ~20M in the 7-12 age group. My point still stands.
pg
I believe that the 2.5 million figure of children being prescribed antipsychotics was from a study of data between 1995 and 2002, with the lead author being Dr. William Cooper of Vanderbilt Children’s Hospital.
http://www.neuropharmacology.com/antipsychotics/index.html
Its now 2008 and the use of antipsychotics in children is rising.
Rising in babies aged 2-4 too as I understand it from this November 2007 publication:
http://apha.confex.com/apha/135am/techprogram/paper_158555.htm
“Conclusions: Preschool psychotherapeutic medication use increased across ages 2-4 for stimulants, antipsychotics, and antidepressants reflecting use for psychiatric/behavioral disorders…”
pg
Cooper’s study was data of 2 to 18 year olds as far I can see from the extracts of the publication, here:
http://psychrights.org/Articles/KidAtypicalPrescribingTrends.pdf
and from the abstracts here:
http://www.ncbi.nlm.nih.gov/pubmed/16530143
and here:
http://linkinghub.elsevier.com/retrieve/pii/S1530156705000201
Atlex
PG,
Unsurprisingly, you have completely misread the study. The study cites 2.5M prescriptions for antipsychotics in <18 in the most recent year of the study. Since most of these patients end up with 2 to 6 scripts per year, your 2.5M number should at least be divided in half and perhaps trimmed down by 1/6.
Atlex
pg
Judging by the reference in the publication above, it would seem to have been a comprehensive study using a number of reliable epidemiological sources such as National Center for Health Statistics (No. 20 below) and US Bureau of the Census (No. 21 below)
(http://psychrights.org/Articles/KidAtypicalPrescribingTrends.pdf )
REFERENCES
1. Cooper WO, Hickson GB, Fuchs C, et al. New users of antipsychotic medications among children enrolled in TennCare. Arch Pediatr Adolesc Med. 2004;158:753–759.
2. Zito JM, Safer DJ, Dosreis S, et al. Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med. 2003;157: 17–25.
3. Patel NC, Crismon ML, Hoagwood K, et al. Trends in the use of typical and atypical antipsychotics in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2005;44:548 –556.
4. Campbell M, Rapoport JL, Simpson GM. Antipsychotics in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1999;38:537–545.
5. Cortese L, Pourcher-Bouchard E, Williams R. Assessment and management of antipsychotic-induced adverse events. Can J Psychiatry. 1998;43(suppl 1):15S–20S.
6. Ratzoni G, Gothelf D, Brand-Gothelf A, et al. Weight gain associated with olanzapine and risperidone in adolescent patients: a comparative prospective study. J Am Acad Child Adolesc Psychiatry. 2002;41:337–343.
7. Buse JB, Cavazzoni P, Hornbuckle K, et al. A retrospective cohort study of diabetes mellitus and antipsychotic treatment in the United States. J Clin Epidemiol. 2003;56:164 –170.
8. Gianfrancesco F, Grogg A, Mahmoud R, et al. Differential effects of antipsychotic agents on the risk of development of type 2 diabetes mellitus in patients with mood disorders. Clin Ther. 2003;25:1150–1171.
9. Wieck A, Haddad PM. Antipsychotic-induced hyperprolactinaemia in women: pathophysiology, severity and consequences. Selective literature review. Br J Psychiatry. 2003;182:199 –204.
10. Wudarsky M, Nicolson R, Hamburger SD, et al. Elevated prolactin in pediatric patients on typical and atypical antipsychotics. J Child Adolesc Psychopharmacol. 1999;9:239 –245.
11. Jordan MP. Ziprasidone-associated galactorrhea in a female teenager. J Am Acad Child Adolesc Psychiatry. 2003;42:4 –5.
12. Safer DJ. A comparison of risperidone-induced weight gain across the age span. J Clin Psychopharmacol. 2004;24:429–436.
13. Patel NC, Kistler JS, James EB, Crismon ML. A retrospective analysis of the short-term effects of olanzapine and quetiapine on weight and body mass index in children and adolescents. Pharmacotherapy.
2004;24:824–830.
14. Blair J, Scahill L, State M, Martin A. Electrocardiographic changes in children and adolescents treated with ziprasidone: a prospective study. J Am Acad Child Adolesc Psychiatry. 2005;44:73–79.
15. Findling RL, McNamara NK, Branicky LA, et al. A double-blind pilot study of risperidone in the treatment of conduct disorder. J Am Acad Child Adolesc Psychiatry. 2000;39:509 –516.
16. Gerardin P, Cohen D, Mazet P, Flament MF. Drug treatment of conduct disorder in young people. Eur Neuropsychopharmacol. 2002;12:361–370.
17. Cheng-Shannon J, McGough JJ, Pataki C, McCracken JT. Secondgeneration antipsychotic medications in children and adolescents. J Child Adolesc Psychopharmacol. 2004;14:372–394.
18. Vitiello B. Psychopharmacology for young children: clinical needs and research opportunities. Pediatrics. 2001;108:983–989.
19. Safer DJ, Zito JM, Dosreis S. Concomitant psychotropic medication for youths. Am J Psychiatry. 2003;160:438–449.
20. National Center for Health Statistics. National Health Care Survey. Available at http://www.cdc.gov/nchs/nhcs.htm
Accessed January 17, 2005.
21. US Bureau of the Census. US Census Bureau Population Estimates.
http://www.census.gov/popest/estimates.php10/5/04
22. Cochran W. Sampling Techniques. 3rd ed. New York, NY: John Wiley & Sons; 1977.
23. Casella G, Berger RL. Statistical Inference. 2nd ed. Duxbury, Calif: Duxbury Press; 2002.
24. Kendell RE, Malcolm DE, Adams W. The problem of detecting changes in the incidence of schizophrenia. Br J Psychiatry. 1993;162:212–218.
25. Morensen P. Schizophrenia and society: an epidemiological perspective. In: Mallarkey G, ed. Managing Schizophrenia. Kwai Chung, Hong Kong: Adis International Publications; 2000:1– 8.
26. Zito JM, Safer DJ, Dosreis S, et al. Trends in the prescribing of psychotropic medications to preschoolers. JAMA. 2000;283:1025–1030.
27. Snyder R, Turgay A, Aman M, et al. Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. J Am Acad Child Adolesc Psychiatry. 2002;41:1026 –1036.
28. Van BM, De TC. Risperidone in the treatment of behavioral disturbances in children and adolescents with borderline intellectual functioning: a double-blind, placebo-controlled pilot trial. J Child Adolesc Psychopharmacol. 2001;11:5–13.
29. McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. N Engl J Med. 2002; 347:314 –321.
30. Malone RP, Maislin G, Choudhury MS, et al. Risperidone treatment in children and adolescents with autism: short- and long-term safety and effectiveness. J Am Acad Child Adolesc Psychiatry. 2002;41:140 –147.
31. Masi G, Cosenza A, Mucci M, Brovedani P. Open trial of risperidone in 24 young children with pervasive developmental disorders. J Am Acad Child Adolesc Psychiatry. 2001;40:1206 –1214.
pg
Mistake it might be, Atlex, but I think I’ll stay with the opinion of the author of the study all the same:
http://www.ahrp.org/cms/content/view/112/28/
“…Cooper said some of the increases might reflect repeat prescriptions given to the same child, but he said that is unlikely and noted that his findings echo results from smaller studies.
The study appears in the March-April edition of the journal Ambulatory Pediatrics.
Heavy marketing by drug companies probably contributed to the increase in the use of anti-psychotic drugs among children, said Dr. Daniel Safer, a psychiatrist affiliated with Johns Hopkins University, who called the potential side effects a concern…”
pg
Atlex: “Unsurprisingly, you have completely misread the study. The study cites 2.5M prescriptions for antipsychotics in <18 in the most recent year of the study. Since most of these patients end up with 2 to 6 scripts per year, your 2.5M number should at least be divided in half and perhaps trimmed down by 1/6.”
I’m sticking with the lead author of the study because I believe the author is the person most likely to know what the data actually represents.
“..Cooper said some of the increases might reflect repeat prescriptions given to the same child, but he said that is unlikely…”
Atlex
PG,
The author clearly doesn’t know how pharmacy works. There is not possible way that a child (or anyone else) would get a Rx and then continue on the drug ad infinitum without a new script being written. In adults, scripts are most often written for 30 days with from 2-5 refills. Those refill numbers tend to be lower for children, particularly young children.
Atlex
pg
I guess you’re right. He’s probably just some dumb guy that has no knowledge of prescription processes or statistical data :)
https://medschool.mc.vanderbilt.edu/facultydata/php_files/show_faculty.php?id3=1852
Research Description
Dr. Cooper pursues research in the area of evaluations of health policy and their unintended effects on health outcomes for children. Dr. Cooper has achieved national recognition for his work in evaluating health outcomes for vulnerable children served by Medicaid through evaluations using computerized databases. His work has been funded by the Agency for Healthcare Research and Quality, the Food and Drug Administration, and national foundations.
Publications
Gunn, VL, Phillippi, RM, Cooper, WO. Improvement in booster seat use in Tennessee. Pediatrics, 119(1), e131-6, 2007.
Callahan, ST, Cooper, WO. Access to health care for young adults with disabling chronic conditions. Arch Pediatr Adolesc Med, 160(2), 178-82, 2006.
Callahan, ST, Hickson, GB, Cooper, WO. Health care access of Hispanic young adults in the United States. J Adolesc Health, 39(5), 627-33, 2006.
Cooper, WO, Hernandez-Diaz, S, Arbogast, PG, Dudley, JA, Dyer, S, Gideon, PS, Hall, K, Ray, WA. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med, 354(23), 2443-51, 2006.
Bowen, ME, Poehling, KA, Gunn, VL, Carroll, KN, Callahan, ST, Arbogast, PG, Cooper, WO. Does the use of oxycodone affect diagnostic accuracy in children with acute abdominal pain. Arch Pediatr Adolesc Med, 159(4), 326-8, 2005.
Callahan, ST, Cooper, WO. Uninsurance and health care access among young adults in the United States. Pediatrics, 116(1), 88-95, 2005.
Carroll, KN, Cooper, WO, Blackford, JU, Hickson, GB. Characteristics of families that complain following pediatric emergency visits. Ambul Pediatr, 5(6), 326-31, 2005.
Cooper, WO. Validity of maternal report of acute health care for children: evaluating proxy interview responses. Arch Pediatr Adolesc Med, 159(2), 193-4, 2005.
Cooper, WO, Arbogast, PG, Ding, H, Hickson, GB, Fuchs, DC, Ray, WA. Trends in prescribing of antipsychotic medications for US children. Ambul Pediatr, 6(2), 79-83, 2005.
Cooper, WO, Arbogast, PG, Hickson, GB, Daugherty, JR, Ray, WA. Gaps in enrollment from a Medicaid managed care program: effects on emergency department visits and hospitalizations for children with asthma. Med Care, 43(7), 718-25, 2005.
Gunn, VL, Hickson, GB, Cooper, WO. Factors affecting pediatricians” reporting of suspected child maltreatment. Ambul Pediatr, 5(2), 96-101, 2005.
Gunn, VL, Phillippi, RM, Cooper, WO. Racial differences in child safety restraint use in Tennessee. Inj Prev, 11(6), 340-2, 2005.
Shankar, SM, Arbogast, PG, Mitchel, E, Cooper, WO, Wang, WC, Griffin, MR. Medical care utilization and mortality in sickle cell disease: A population-based study. Am J Hematol, 80(4), 262-70, 2005.
Butler, K, Cooper, WO. Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization. Pediatr Emerg Care, 20(11), 730-5, 2004.
Callahan, S Todd, Cooper, William O. Gender and uninsurance among young adults in the United States. Pediatrics, 113(2), 291-7, 2004.
Cooper, WO, Hickson, GB, Fuchs, C, Arbogast, PG, Ray, WA. New users of antipsychotic medications among children enrolled in TennCare. Arch Pediatr Adolesc Med, 158(8), 753-9, 2004.
Cooper, William O, Hickson, Gerald B, Ray, Wayne A. Prescriptions for contraindicated category X drugs in pregnancy among women enrolled in TennCare. Paediatr Perinat Epidemiol, 18(2), 106-11, 2004.
Valet, Robert S, Kutny, Diane F, Hickson, Gerald B, Cooper, William O. Family reports of care denials for children enrolled in TennCare. Pediatrics, 114(1), e37-42, 2004.
Cooper, William O, Boyce, Thomas G, Wright, Peter F, Griffin, Marie R. Do childhood vaccines have non-specific effects on mortality. Bull World Health Organ, 81(11), 821-6, 2003.
Cooper, William O, Lutenbacher, Melanie, Faccia, Kate, Hepworth, Joseph T. Planning of youth violence-prevention programs: development of a guiding measure. Public Health Nurs, 20(6), 432-9, 2003.
Porter, Christopher C, Poehling, Katherine A, Hamilton, Rodney, Frangoul, Haydar, Cooper, William O. Influenza immunization practices among pediatric oncologists.. J Pediatr Hematol Oncol, 25(2), 134-8, 2003.
Sox, CM, Cooper, WO, Koepsell, TD, DiGiuseppe, DL, Christakis, DA. Provision of pneumococcal prophylaxis for publicly insured children with sickle cell disease. JAMA, 290(8), 1057-61, 2003.
Cooper, W O, Kuhlthau, K. Evaluating medicaid managed care programs for children.. Ambul Pediatr, 1(2), 112-6, 2002.
Cooper, William O, Griffin, Marie R, Arbogast, Patrick, Hickson, Gerald B, Gautam, Shiva, Ray, Wayne A. Very early exposure to erythromycin and infantile hypertrophic pyloric stenosis.. Arch Pediatr Adolesc Med, 156(7), 647-50, 2002.
Cooper, William O, Ray, Wayne A, Griffin, Marie R. Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis.. Obstet Gynecol, 100(1), 101-6, 2002.
Cooper, William O, Staffa, Judy A, Renfrew, J William, Graham, David J, Ray, Wayne A. Oral corticosteroid use among children in TennCare.. Ambul Pediatr, 2(5), 375-81, 2002.
Lutenbacher, Melanie, Cooper, William O, Faccia, Kathleen. Planning youth violence prevention efforts: decision-making across community sectors.. J Adolesc Health, 30(5), 346-54, 2002.
Cooper, W O, Hickson, G B. Corticosteroid prescription filling for children covered by Medicaid following an emergency department visit or a hospitalization for asthma.. Arch Pediatr Adolesc Med, 155(10), 1111-5, 2001.
Cooper, W O, Lutenbacher, M, Faccia, K. Components of effective youth violence prevention programs for 7- to 14-year-olds.. Arch Pediatr Adolesc Med, 154(11), 1134-9, 2000.
Tamura, Y, Welch, D C, Zic, J A, Cooper, W O, Stein, S M, Hummell, D S. Scurvy presenting as painful gait with bruising in a young boy.. Arch Pediatr Adolesc Med, 154(7), 732-5, 2000.
Cooper, W O, Hickson, G B, Gray, C L, Ray, W A. Changes in continuity of enrollment among high-risk children following implementation of TennCare.. Arch Pediatr Adolesc Med, 153(11), 1145-9, 1999.
Cooper, W O, Hickson, G B, Mitchel, E F, Edwards, K M, Thapa, P B, Ray, W A. Early childhood mortality from community-acquired infections.. Am J Epidemiol, 150(5), 517-27, 1999.
Cooper, W O, Hickson, G B, Mitchel, E F, Ray, W A. Comparison of perinatal outcomes among TennCare managed care organizations.. Pediatrics, 104(3 Pt 1), 525-9, 1999.
Cooper, W O, Daniels, S R, Loggie, J M. Prevalence and correlates of blood pressure elevation in children with Guillain-Barré syndrome.. Clin Pediatr (Phila), 37(10), 621-4, 1998.
Hickson, G B, Cooper, W O, Campbell, P W, Altemeier, W A. Effects of pediatrician characteristics on management decisions in simulated cases involving apparent life-threatening events.. Arch Pediatr Adolesc Med, 152(4), 383-7, 1998.
Cooper, W O, Federspiel, C F, Griffin, M R, Hickson, G B. New use of anticonvulsant medications among children enrolled in the Tennessee Medicaid Program.. Arch Pediatr Adolesc Med, 151(12), 1242-6, 1997.
Cooper, W O, Kotagal, U R, Atherton, H D, Lippert, C A, Bragg, E, Donovan, E F, Perlstein, P H. Use of health care services by inner-city infants in an early discharge program.. Pediatrics, 98(4 Pt 1), 686-91, 1996.
Cooper, W O, Atherton, H D, Kahana, M, Kotagal, U R. Increased incidence of severe breastfeeding malnutrition and hypernatremia in a metropolitan area.. Pediatrics, 96(5 Pt 1), 957-60, 1995.
Cooper, W O, Fava, R A, Gates, C A, Cremer, M A, Townes, A S. Acceleration of onset of collagen-induced arthritis by intra-articular injection of tumour necrosis factor or transforming growth factor-beta.. Clin Exp Immunol, 89(2), 244-50, 1992.”
I’d better be going, things to do.
Atlex
Physicians are notoriously ignorant of the pharmacy process and the use of Rx data. I also suspect that they didn’t account for multiple Rxs per patient. As you have noticed (and even discussed I think), some of these children are on more than one medication, further lowering the total number of users.
Nathan
pg,
Firstoff, I don’t know the entire context of this conversation — however, it is rather funny to me that you lambaste many of the primary literature references we refer to. (when talking about SSRI efficacy, etc) Yet you seem to take this particular study as gospel truth. What is different about this article vs. the other scientific articles that you disagree with? Is it simply that this article supports your viewpoint?
Scientific papers are the medium that scientists use to converse and argue about data. As you well know, all scientific articles are not written equally. It’s easy to come up with 31 references to primary literature. It’s harder to come up with an article that comes to a conclusion that 31 different scientists will agree about. We all think differently and interpret facts and numbers a bit differently.
pg
Its STATISTICAL DATA, Nathan, not a fight for or against drugs.
The study looked at a great deal of data in order to assess how many children between 2 and 18 are given antipsychotic drugs.
The total comes to around 2.5 million given the data Dr Cooper had to hand.
It is far from funny to me that every single expert that produces any data that does not tow the industry line is lambasted all over the internet. Why is that?
ie, ‘we don’t count’ study data from any of these experts, because their credentials are ‘dubious’ etc even when those experts have themselves been consultants to the industry in the past. Now here’s Dr Cooper, who is not a psychiatrist, coming up with STATISTIAL data - numbers of children on one class of drugs.
I’ll leave you and Alex to discuss him amongst yourselves :)
Atlex
PG,
The comments by Cooper aren’t in the study, they are in the press reports, which aren’t scrutinized by the peer review process. I repeat, they data in the study does not indicate a 2.5M prevalence figure; the reference for that is a quote by Cooper from a press report.
Atlex
pg
LOL
I KNOW that Atlex, I gave the link, They are however relevant comments by the author of the study … ergo they need to be scrutised and criticised very closely by the drug industry and thank god you’re there to do that.
Ive had my shower, I’m off out. Enjoy. :)
That part of the comment again:
http://www.ahrp.org/cms/content/view/112/28/
“…Cooper said some of the increases might reflect repeat prescriptions given to the same child, but he said that is unlikely and noted that his findings echo results from smaller studies.
The study appears in the March-April edition of the journal Ambulatory Pediatrics.…”
HorusCat
Atlex,
I hate to say it, but I think pg’s closer to right on this one. From the way I understand that sampling was done (one week out of a physician’s year), repeat prescriptions probably were not a big factor, since most patients don’t return within one week. Multiple prescriptions are probably somewhat of a factor, although most patients were probably on only one or maybe two antipsychotics.
I think there are considerations other than pharma marketing. The rise in the diagnosis of “autism” and the behaviors associated with it (impulsivity, agression) isn’t due to an increase in pharma marketing. And I think the diagnosis of ODD (oppositional-defiant disorder) and other anti-social behaviors, which probably accounts for the high number of pre- and adolescent males in the results, is directly correlated to a lack of parenting and a loss of civility in our culture. Again, pharma is not responsible for this. When a child is not disciplined for the first 8 years of his life, he can become a real problem when he gets some size and strength on him. The atypicals do a good job of reining in all that anger and aggression without the expenditure of a lot of energy by a system that can’t handle the load (teachers, society).
I’m not saying using antipsychotics for this is ok, just that it probably isn’t just the wicked pharmaceutical companies out there pushing for the drugging of docile, compliant, well-behaved children.
Lisa Van S
HorusCat,.. Wow, I agree with you 100%. I do blame the Doctor’s. Why would a Physician prescribe an antipsychotic for a child under the age of two, and yes there are situations where one can blame a parent. In the case of Foster Children,..I call it chemical restraint. I have Diagnosed myself w/Oppositional Defiant Disorder, and Im sure others would agree. Would I ask for Medication?…absolutely not.
HorusCat
Lisa,
I don’t think it is just the doctors. I do believe there has been a sea change in the way we raise children–primarily with parents who stop parenting and start befriending their children and with parents who teach their kids consciously and unconsciously that they don’t have to respect other adults. I think it starts with really small things like calling adults by their first names instead of Mr. or Mrs. The brain is extremely plastic the first 5 years of life. How children are taught boundaries and civil behavior in those first five years is crucial to their behavior as adolescents and adults. The connections between neurons get reinforced with anti-social, aggressive behavior just like they get reinforced with practicing the piano or playing basketball or anything else (I have to remind my autistic son every day that’s why we practice math! Cement those synapses!). I don’t think you get an 8 year old who is knocking holes in walls and tearing doors off the hinges, attacking his parents physically and screaming obscenities in school without some tremendously poor parenting. And the problem is that by the time the child is older, changing the behavior is very difficult–even for motivated parents. Certainly, teachers can’t be expected to handle it. So it is no wonder physicians are prescribing neuroactive drugs. Chemically changing the synapses is one way to change behavior, and that is the only tool a doctor has. The parents and other trained parties must reshape neural connections with other approaches–and most aren’t motivated or educated on how to do that.
As for the under 2 year olds, you have to admit this is a very small group. And from what I have heard from my docs, most of these are profoundly MRDD patients who are harming themselves (head-banging, for instance). I have seen those children–wearing helmets and restrained in wheelchairs so that they don’t bash their brains out. It is really sad and an impossible situation for the parents.
Lisa Van S
HorusCat,… how do explain prescribing antipsychotics to babies. As far as it being a small group, that may have been correct years ago,.. The prescribing of these meds have skyrocketed.
Atlex
HC,
Here’s a quote from the study:
“The study has some important limitations…. The
surveys were based on visits rather than on individual
children. Thus, it is possible that the increased frequency
of antipsychotic prescriptions represents more prescriptions per child rather than a greater number of children receiving antipsychotic prescriptions.”
I speculate that it the increase is due both to an increased number of children receiving anti-psychotics and an in crease in the number of anti-psychotics per child. Moreover, there I don’t think that there is any assurance that the script is filled, taken or continued. That leads me to my contention that the media report of 2.5M children on anti-psychotics (as opposed to 2.5M prescriptions for antipsychotics as stated in the study), which is not in the study but was in the post-study media reports, is likely an exaggeration designed to what would be recognized as a problem without the exaggeration.
Atlex
HorusCat
Atlex,
You’re right. I didn’t read carefully enough. There is a huge difference between number of patients taking a drug and number of prescriptions filled.
Lisa,
I just explained why a “baby” (I don’t call a 2 year-old a baby) may be given antipsychotics. If you have a mentally-retarded, developmentally-delayed “infant” who is insistent upon banging his head upon the ground or the wall until he fractures his skull, then atypicals seem like a desirable solution. You don’t really have hard numbers for the level of antipsychotic prescribing in the infant and toddler set. Perhaps life where you live is different, but the only place I see toddlers (have never seen an infant) in for psychiatric care is in the specialty departments of big medical schools.
Severely MRDD children may not be on your radar screen, but like I said, I have seen these kids. It is heart-breaking, and I don’t blame the parents or the physicians for trying to find some way to make life more bearable for all involved.
pg
On antipsychotics prescribed to “very young” children in Florida:
http://psychcentral.com/blog/archives/2007/11/01/very-young-children-being-prescribed-antipsychotics-in-florida/
“…The use of antipsychotic medications with children 0-5 [years old] is of concern. The guidelines developed by the program indicate this practice is generally “not recommended” while recognizing that disruptive aggression in autism is now an FDA indicated use. Only 8% of the young children receiving antipsychotic treatment had a diagnosis of autism. ADHD was the most frequently used diagnosis for children 0-5 years on antipsychotic medication. Affective disorder is the next most frequently appearing diagnosis despite Florida’s expert panel’s assertion that the diagnosis is of questionable validity for children under 6 years old.
The situation for the 0-5 age group also offers the greatest cause for concern. While the use of antipsychotics with this age group is highly unusual according to the MDTMP guidelines, this group had the smallest percentages of antipsychotic scripts written by psychiatrists. Furthermore, the percentage of antipsychotic scripts for children 0-5 years to total antipsychotic scripts written was highest for pediatricians.
In other words, pediatricians — professionals who are supposed to have the child’s best interests in mind — are some of the worst abusers of antipsychotic prescriptions to children who probably shouldn’t even be diagnosable. (There remains a raging debate amongst professionals whether many of these serious mental disorders can be reliably and appropriately diagnosed in children younger than 5 years old by a mental health professional, much less a primary care physicians specializing in children [not mental health disorders].)…”
The’re more detail if you go to the link.
Isn’t drugging infants and toddlers with mind altering substances that can have severe neuro and physical side effects what, under any other circumstance, we’d call serious “child abuse” ?
pg
On ‘unintentional antipsychotic poisoning in childen’ where 1 tablet can cause ’severe’ symptoms.
http://www.ingentaconnect.com/content/adis/dsf/2005/00000028/00000011/art00004
“…The aim of this review was to determine the spectrum and severity of effects of unintentional antipsychotic poisoning in children. A computerised literature search of MEDLINE (1966 to February 2005) and EMBASE (1980 to February 2005) was undertaken. The Internet was searched using URL: http://www.google.com. The proceedings of the North American Congress of Clinical Toxicology (NACCT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) were hand searched. All cases of unintentional antipsychotic (all classes) poisoning in children aged 0–6 years were included. The data extracted included the age, weight, antipsychotic, dose, clinical effects, treatment and outcomes. The toxic dose was estimated as the lowest dose causing objective adverse effects.
Sixty-eight reports were identified. Few contained all of the required information. Most of the case series included multiple antipsychotics with limited information on individual drugs or all ages with limited paediatric information.
For most antipsychotics the ingestion of one tablet caused symptoms that were sometimes severe and usually lasted from 1 to 3 days. Extrapyramidal symptoms (EPS) were often delayed for up to 12–24 hours.
Chlorpromazine caused CNS depression, hypotension and miosis; EPS and cardiac effects were rare, and the toxic dose was estimated to be 15 mg/kg. Haloperidol caused drowsiness (rarely coma) and over one-half of patients had neuromuscular effects (mainly EPS), with a toxic dose estimated at 0.15 mg/kg. Thioridazine caused CNS depression and potentially cardiac effects, with a toxic dose of 1.4 mg/kg. Atypical antipsychotics caused significant CNS depression (except risperidone); EPS were less common. Toxic doses were clozapine 2.5 mg/kg, olanzapine 0.5 mg/kg and aripiprazole 3 mg/kg. EPS responded to anticholinergic drug treatment.
In summary, unintentional antipsychotic ingestion in children can cause severe effects that last 1–3 days, often with one tablet. Children potentially ingesting a toxic dose or who are symptomatic should be considered for assessment in hospital. Most cases resolve with good supportive care. Toxic doses are only estimates that are based on limited data and should be used with caution until prospective studies are undertaken…”
pg
“…In summary, unintentional antipsychotic ingestion in children can cause severe effects that last 1-3 days, often with one tablet. Children potentially ingesting a toxic dose or who are symptomatic should be considered for assessment in hospital…”
(http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=20047442 )
Does the actual act of prescribing daily antipsychotics to children change the physiology of the child or the chemical effects of the drug? Doesn’t giving young children a mind altering substance that, when taken ‘accidentally’ causes severe effects classed as ‘poisoning’, consititute child abuse?
pg
A “public health disaster of monumental proportions” ?
Michigan Children. One of the severe, often permanent, effects of psychotropic drugs is the brain damage that causes movement disorders.
http://www.northernexpress.com/editorial/features.asp?id=2465
“…TODDLERS AND DRUGS
A key report obtained by Hansen showed that in 2005, some 3,064 psychiatric drug prescriptions were issued to children, ages four and under. They ranged from antidepressants to what are called atypical antipsychotics.
A third were sedative hypnotics/anxiolytics (sleeping pills like Ambien and Lunesta and anxiety reducers), while another third were antidyskinetics (also called antiparkinsonians) typically prescribed for trembling in Parkinson’s patients and for movement disorders such as tics, tremors and restless legs syndrome in children…”
“…‘PUBLIC HEALTH DISASTER’
Hansen wonders why the number of very young Michigan children on anti-Parkinson drugs has quadrupled in the past two years. He suspects it may be due to drug-induced movement disorders caused by psychiatric drugs used for the treatment of ADHD, autism, and depression in children.
“If the increased prescribing of antidyskinetics is the direct result of an increase in the diagnosis and treatment of ‘mental disorders’ in American toddlers, then we could be witnessing a public health disaster of monumental proportions,” Hansen said…”
pg
How can can anyone tell if an infant has a mental disorder? Babies cry because they have colic, or stomach ache, or are hungry, or simply want to be picked up to be close to their mother etc. Infants and toddlers are designed to get attention by getting on their parents’ nerves by crying. Adults did that too when THEY were infants. Just HOW can anyone excuse giving an infant or toddler - both have developing brains - a powerful toxic drug that can cause permanent brain damage to ADULTS?
pg
“and I don’t blame the parents or the physicians for trying to find some way to make life more bearable for all involved.”
Bearable for whom? Adults. Busy doctors. Fraught parents. All of whom are considered seemingly to be more important that the young children who simply nolw get poisoned to make life better for adults. The same adults who were fortunate to be brought up parents who cared about them and understood their ‘moods’ and ‘childish behaviour’ and realized that this was CHILDHOOD, parents who hugged them, protected them, comforted them when they cried, told them off when they had a tantrum, encouraged them when they behaved well, guided them kindly but firmly when they behaved badly, interacted when they were bored, etc.
Pedriaticians and psychiatrists would not have made their grade had they been dosed up with the drugs they are now prescribing to children. How sick is this society?
pg
The silence on the issue of adult responsiblity to children is deafening.
pg
Videos on drug-induced movement disorders we so happily subject our children to:
Prescription drug-induced Dyskinesia
http://www.youtube.com/watch?v=5-zwe_hgOyE
Prescription drug-induced Tardive Dyskenysia
http://www.youtube.com/watch?v=R0EbgpyztCA
Prescription drug-induced Oromandibular Dystonia
http://www.youtube.com/watch?v=sCo82bv5lRM
HorusCat
pg,
You get tiresome. You take such an extreme stance that you become laughable. Instead of slamming me with posts you’ve already made and links to sources that only agree with you, why don’t you engage in a little dialogue? I’m not talking about your average toddler. I’ve had two of them, and one who is autistic. I get the difference. And mine is MILD. Banging your head against the floor hard enough to cause a subdural hematoma or a depressed skull fracture is not “normal childhood behavior.” And when that child gets old enough, he can literally kill himself with that behavior. I have seen the MRDD kids in helmets and restraints. Your naivete is mind-boggling. A child can’t be held 24/7 so that he doesn’t injure himself. Crying is normal. Literally non-stop crying and an inability to be consoled is not normal. These are parents who hug and caress and try to soothe their children. They are not monsters who go out drinking while their kids bawl in dirty diapers.
You would get a lot farther with your arguments if you conceded some territory. Instead, you sound like either the right-to-lifers who NEVER want an abortion to be legal or the abortion Nazi’s who think a baby should be abortable up until it emerges from the birth canal. Life DOES have some gray areas, pg.
HorusCat
pg,
BTW, I agree with you about the overuse. I don’t see how one can diagnose ADHD in an infant or toddler. Antipsychotics should not be used as tranquilizers (which happens mostly with the older ones–the ones that also cause the movement disorders). Pediatricians should not be prescribing antipsychotics; although, the text does not clarify whether these prescriptions are REFILLS of an original psychiatric prescription or not. That would put the onus back on the psychiatrist; the pediatrician is just refilling a scrip.
pg
Dear HC, I agree, I am tiresome. I’m also tired of what you promote and the way you don’t SEE this:
Dear Momma, Dear Doctor. Thank you for putting me on drugs that caused this:
http://www.youtube.com/watch?v=LPTSr_FK8PY&feature=related
pg
I have put links to those ‘anecdotal’ REAL human beings. I’m very sorry you just dont have the ability to understand HC.
Keep on defending them good ole’ drugs to shut them pesky kids up (!)
pg
And HC, keep on taking that Zoloft.
pg
And don’t forget HC when your children grow up the children of as drug industry front, YOU chose to give your children drugs your Momma would never have given you. YOU are responsible. Be happy.
HorusCat
pg,
You are a caricature.
HorusCat
pg,
If Saturday Night Live or the Onion tried to invent you, they wouldn’t be nearly as funny. You are impossible to parody; you make Jonathin Swift look like a piker. Have a good night.
HorusCat
oops, Jonathan.
pg
LOL HC - if only I were as amusing as your comments :)
Have a good day
truthman30
“HorusCat
pg,
Have you spent time in a community mental health center? I have. I have spent hours. These are people abandoned by the community, often abandoned by their families, struggling to live meaningful lives with some dignity and joy, fighting against a disease that robs them of emotion and motivation. The clinicians and others who serve them are, for the most part, truly caring and empathic people who have taken on a job most of us would shun. The pharmaceutical companies–made up of individuals who know first-hand the ravages of schizophrenia–seek medication options for these patients not just for profit, but for the satisfaction of doing something important and meaningful”
Are you absolutely and totally out of your deluded mind HC?..
I have been to psychiatric hospitals and community health centers and they are run by people with no empathy, no compassion and in the cases of the psychiatrists they view the patients with complete disdain and condescension…
“The pharmaceutical companies made up of individuals who know first hand the ravages of schizophrenia” .. Says HC..
Are you nuts? , the pharmaceutical companies are exploiting ALL mental Disorders…
The patients in these places are the easiest prey …
I sometimes think the Zoloft you are taking is beginning to cloud your vision and distort reality for you HC..
HorusCat
No truthman,
I just live in a different place than you do. Your experience is not my experience; what is so deluded about that? Perhaps your cynicism blinds you to the goodness that exists in the people doing this work, or maybe you need to move somewhere else.
truthman30
HorusCat
No truthman,
I just live in a different place than you do. Your experience is not my experience; what is so deluded about that? Perhaps your cynicism blinds you to the goodness that exists in the people doing this work, or maybe you need to move somewhere else.
Yeah you certainly do live in a “different place”..
La la land..
My cynicism is borne out of personal experience and what I have witnessed myself..
I have earned my cynicism about the pharmaceutical industry and the psychiatric profession..
Maybe you need to to get off the Zoloft HC?
You might see the psychiatric profession for what it is then..
A fraud and a lie..
Instead of some SSRI induced fairy tale vision..
HorusCat
truthman,
Your experience does not determine reality for the rest of the world. Your single experience, whatever it was, is more than balanced by the positive experiences of hundreds of thousands of others served by the community mental health system. Your inability to understand schizophrenia and related disorders as organic doesn’t render that reality untrue, it just makes you sound ignorant. Or are you now working with the chronically mentally ill to improve their lives in some other way? Perhaps living with one 24/7 so that he doesn’t go homeless, starve to death, hurt himself or someone else? That would be a productive thing to do, since you evidently have hard evidence that drugs are unnecessary for schizophrenia. Or do you just sit on the sidelines and criticize, while doing nothing yourself to help these people?
pg
“HorusCat
truthman,
Your experience does not determine reality for the rest of the world. Your single experience, whatever it was, is more than balanced by the positive experiences of hundreds of thousands of others served by the community mental health system. Your inability to understand schizophrenia and related disorders as organic doesn’t render that reality untrue, it just makes you sound ignorant. Or are you now working with the chronically mentally ill to improve their lives in some other way? Perhaps living with one 24/7 so that he doesn’t go homeless, starve to death, hurt himself or someone else? That would be a productive thing to do, since you evidently have hard evidence that drugs are unnecessary for schizophrenia. Or do you just sit on the sidelines and criticize, while doing nothing yourself to help these people?”
We know what you do HC - You spend your time, apparently as a working parent, promoting industry interests in working time and then promoting it here online in those hours when you are not working.
You have no idea what Truthman or anyone else does, the one thing you do know (which often seems to be why you spend so much of that valuable parenting time online, doing your very best for the industry in arguing everything said) is that they do NOT get paid to promote industry interests.
truthman30
Thanks PG..
Yup HC, Any rational individual would have to wonder why, in your spare time, you seem so intent on defending psychiatry and pharma? Could it be perhaps because your wages depends on it?…
truthman30
HC says “the positive experiences of hundreds of thousands of others served by the community mental health system” ..
That has to be the most ridiculous statement I have ever heard!!!
So where are all the happy mental health web sites then?
Where are all the happy mental health service users congregating to express their divine love and loyalty for the mental health system? ..
Where are they HC?
Where are all these happy mental health system people that you talk about?
I’ll tell you where they are..
They are in your head HC..
They don’t exist in the real world..
Get off the Zoloft..
And deal with reality..
You are obviously completely deluded..
truthman30
“Your inability to understand schizophrenia and related disorders as organic doesn’t render that reality untrue, it just makes you sound ignorant. Says HC ”
I understand schizophrenia VERY WELL HC ..
A previous work colleague of mine had the “condition” ..
I worked with her for a year, and I befriended her when most others were afraid of her and “her condition”, I picked her up and drove her to work everyday with me, I spent my lunch hour with her, I dropped her home every day, I spent all day working with her and trying to help her.. She had three breakdowns while we worked together, she was prescribed a myriad of meds and was in and out of the psych ward, of which i visited her on every occasion too..
It was the MEDS AND PSYCHIATRY which pushed her down the path of mental illness..
She was diagnosed with post natal depression ten years previously (at 18). then she was put on anti-depressants, after a few years of being poisoned with that, she had adverse reactions and was diagnosed with bi-polar, more drugs and more adverse reactions led her to her current diagnosis of schizophrenia .. From post natal depression to schizophrenia in ten years of psychiatric treatment with an assortment of dangerous drugs..
The last time I saw her, she was on Zyprexa and her tongue would dart in and out of her mouth , and her lips and face were in spasm, she looked like a ghost of herself..
I know what these sick psychiatrists are capable of , I know what these sick drug companies are capable of..
I am not deluded HC because I know what’s going on..
You don’t want to face to up to the reality of your profession..
The fact that you need Zoloft to deal with the world of drug pushing attests to this..
You need to wake up HC..
You are part of a regime which destroys lives..
And even you yourself are slowly being poisoned by the Zoloft..
As you go around pushing these meds on others..
Your reality is beyond the ridiculous…
HorusCat
Wow pg and truthman,
The level of venom in your personalities speaks volumes.
HorusCat
and pg,
You’re obviously not a parent, so fuck off.
truthman30
no venom in me HC..
Just a harsh dose of cold reality…
pg
“HorusCat
Wow pg and truthman,
The level of venom in your personalities speaks volumes.”
“HorusCat
and pg,
You’re obviously not a parent, so fuck off.”
Have a good evening, HC!
Netherlands, May 2008
http://psychservices.psychiatryonline.org/cgi/content/abstract/59/5/554
“Use of Antipsychotic Drugs Among Dutch Youths Between 1997 and 2005…
…RESULTS: From 1997 to 2005, prevalence increased from 3.0 to 6.8 per thousand. Prevalence was highest among ten-year-olds to 14-year-olds (11 per thousand), especially among boys (17 per thousand). The increased prevalence was mainly attributable to an increased use of second-generation antipsychotics and to a longer duration of use. Median duration of use doubled from .8 year in 1998–1999 to 1.6 years in 2001–2002.
CONCLUSIONS: Second-generation antipsychotic drugs were increasingly prescribed, and for longer periods of time, to younger children, probably because of new indications. This practice increases the exposure of a young population to (partly unknown) risks.“
pg
If Schizophrenia is a “provably organic disorder with a progressive course leading to brain atrophy and ventricular enlargement” as someone stated way up this thread somewhere, then
WHY is it that researchers still debate whether problems like child abuse can be the cause of schizophrenia (http://www.sciencedaily.com/releases/2006/06/060614120625.htm )?
If it isn’t organic, then what factor exists in people diagnosed as “schizophrenic” (and then ’studied’ in research) which leads to brain atrophy?
The same factor that causes Tardive Dyskenisa perhaps?
The antipsychotic “treatment”? The “treatment” now being given to toddlers and older children for behaviour that apparently constitutes a diagnosis of ADHD, and other things not even related to psychosis?
Could it be, as this blogger (http://redlifehome.blogspress.net/2008/05/06/no-clozapine-from-the-doctor-the-company-or-the-fda ) says:
“…the psychiatric establishment, underpinned by the pharmaceutical industry, has glossed over studies showing that antipsychotics cause extensive damage the most startling being permanent brain atrophy brain damage or tardive dyskinesia.” ?
pg
“…Taking on the critics has become somewhat of a personal mission for Pitts, who was formerly FDA’s associate commissioner for external relations, and is now senior vice president for global health affairs at the PR firm Manning, Selvage & Lee. He’s bent on getting industry to stand up and speak its mind–and he leads by example. His blog takes on politicians, journalists, medical journals, or, he says, “anybody out there with a score to settle…” http://goliath.ecnext.com/coms2/summary_0199-6902441_ITM
He also takes on (or more accurately resorts to personal attacks and name calling) anyone with a name that has the courage and ethics to try to make a difference for the better.
HorusCat
pg,
You don’t have children, but you have an awful lot of opinions about how other people should raise theirs. Like other “activists” in other areas, you don’t actually care about the individuals involved–you only care about the abstract. Your endless little links divorced from any personal experience (other than watching YouTube) render you sterile.
There was schizophrenia before antipsychotics. And those schizophrenics progressed into total mental degeneration, just as do untreated schizophrenics today. Autopsy of their brains showed ventricular enlargement and cortical atrophy. What was the cause of this, I wonder, absent malicious pharmaceutical industries and negligent physicians?
BTW, mommies have always worked. From farms to factories to the endless duties necessary simply to keep a family functioning from prehistoric times to the present, women have worked. Up until recently, the children did also. The luxury of “staying home” with one’s children is an artifact of modern society. Most of society has moved beyond the concept of barefoot, pregnant and in the kitchen, pg, or haven’t you noticed? Not all of us have the leisure to take our showers at 2 in the afternoon and just be getting out of the house…
Gotta run. Gotta take the duct tape off the kids’ mouths and pull them out of the closet where I keep them while I play on the internet. I guess maybe I’ll feed them tonight and let them urinate before I strap them into their beds. They’ve got an early morning tomorrow–no school for them! It’s off to the salt mines; gotta earn my retirement for me.
pg
Gee PharmaCat. You ASSUME a lot. And you’re almost always wrong. You ASSUME I don’t have children. You ASSUME that commentors know nothing about the issues. You ASSUME that comments you don’t agree with have ‘no personal experience’.
Generally you ASSUME far too much.
pg
As to “There was schizophrenia before antipsychotics. And those schizophrenics progressed into total mental degeneration, just as do untreated schizophrenics today. Autopsy of their brains showed ventricular enlargement and cortical atrophy. What was the cause of this, I wonder, absent malicious pharmaceutical industries and negligent physicians? …’
We know little of how the brain works NOW, what autopsies of brains before antipsychotics - weren’t they around in the 1950’s? - would have had the technology that would be able to SUGGEST (as they do now) that ventricular enlargement and cortical atrophy was due to schizophrenia in the 1940’s?
pg
http://www.cafepharma.com/boards/showthread.php?t=264688
truthman30
“pg
http://www.cafepharma.com/boards/showthread.php?t=264688
“I got banned at Pharmalot!
If you go to the Melody Petersen thread on Pharmalot, you can find my posts under HorusCat. Pharmalot will no longer accept my posts, and they pulled the last few I made. Seems that Ed can’t tolerate anyone who doesn’t buy the “Evil Pharma” schtick and who actually uses evidence to support arguments instead of engaging in shrill fear-mongering and woe-is-me pharma bashing.
I have to admit that some of my posts weren’t always very “nice,” but then no one has ever accused me of being nice. I am a snarky curmudgeon. Those people just make me want to slap them”
It seems HC has a bit of explaining to do!!!
So what’s the deal HC?
You just come to pharmalot to inflame is that it?
HorusCat
pg,
Got under your skin, did I? Since Ed and I are cool, what you think doesn’t much matter, does it?
pg
HorusCat, you don’t get under my skin - what makes you think you do?
truthman30
I think you should stick to posting on cafepharma HC, now that it is obvious what your agenda is..