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Wednesday, 30 November 2011

ANTIPSYCHOTICS - WHY ARE 8% OF FOSTER CARE CHILDREN IN U.S. ON 'HEAVY DUTY' ANTIPSYCHOTICS


Why Are So Many Foster Care Children Taking Antipsychotics?
By Maia Szalavitz Tuesday, November 29, 2011
 

More than 8% of children in foster care have received antipsychotic medication, and just over one quarter of those in foster care who also receive disability benefits take these drugs, according to a recent study in the journal Pediatrics.

The question is why? Children in foster care have typically been neglected or abused — indeed, simply removing a young child from his or her parents, even abusive ones, is in itself traumatic — so, not surprisingly, kids in foster care are more likely to suffer from psychiatric and behavioral problems than those who have stable families. Previous data suggest that foster-care children are about twice as likely as those outside the system to receive psychiatric medications.

Whether these problems are leading to higher rates of antipsychotic use, however, is not clear. "I think we have clinicians facing some very challenging situations," says Susan dosReis, associate professor at the University of Maryland School of Pharmacy and lead author of the study. "But we don't have information as to why the prescribers decided on these medications for [these particular] youths."

Read more: http://healthland.time.com/2011/11/29/why-are-so-many-foster-care-children-taking-antipsychotics/#ixzz1fDxPAror

ANTIPSYCHOTICS - AL JAZEERA ENGLISH CHANNEL - EXCELLENT ARTICLE AND VIDEO ON THE EPIDEMIC OF ANTIPSYCHOTICS FOR CHILDREN IN THE U.S. AND WHY THE DRUG COMPANIES HAVE HAD TO MAKE SOME HUGE PAYOUTS TO SETTLE CLASS ACTION LAW SUITS ON THESE POTENT ANTIPSYCHOTICS.

ENGLISH


http://www.aljazeera.com/indepth/opinion/2011/07/20117313948379987.html

CLICK ON LINK ABOVE OR TITLE.

PROTECTING BIG PHARMA. WHAT ABOUT PROTECTING CHILDREN WITH THE FORCE OF THE LAW?
"MASS PSYCHOSIS BREAKS OUT IN U.S."
-How Big Pharma got Americans hooked on anti-psychotic drugs.
James Ridgeway Last Modified: 12 Jul 2011 06:20

Drug companies like Pfizer are accused of pressuring doctors into over-prescribing medications to patients in order to increase profits, and further exploit their deliberate 'business model' colonosing the minds of young people.

AN UNACCEPTABLE BOUNDARY INCURSION!

Has America become a nation of psychotics? 

You would certainly think so, based on the explosion in the use of antipsychotic medications. In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux.

Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses - primarily schizophrenia and bipolar disorder - to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.

It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry's development of a new class of medications known as "atypical antipsychotics." Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. More importantly, they lacked the most noxious side effects of the older drugs - in particular, the tremors and other motor control problems.

The atypical anti-psychotics were the bright new stars in the pharmaceutical industry's roster of psychotropic drugs - costly, patented medications that made people feel and behave better without any shaking or drooling. Sales grew steadily, until by 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million.  Suddenly, antipsychotics weren't just for psychotics any more.

Not just for psychotics anymore

By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. "Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective," says Dr. Adriane Fugh-Berman, whose PharmedOut project tracks the industry's influence on American medicine, and who last month hosted a conference on the subject at Georgetown. A shrink can't give you a blood test or an MRI to figure out precisely what's wrong with you. So it's often a case of diagnosis by prescription. (If you feel better after you take an anti-depressant, it's assumed that you were depressed.) As the researchers in one study of the drug industry's influence put it, "the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence." For this reason, they argue, it's particularly important that the guidelines for diagnosing and treating mental illness be compiled "on the basis of an objective review of the scientific evidence" - and not on whether the doctors writing them got a big grant from Merck or own stock in AstraZeneca.

Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: "Psychiatrists are in the pocket of industry." Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association's most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.

"The use of psychoactive drugs - including both antidepressants and antipsychotics - has exploded...[yet] 'the tally of those who are disabled...increased nearly two and a half times."

Marcia Angell, former editor of the New England Journal of Medicine

In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent "raging epidemic of mental illness" among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children." Under the tutelage of Big Pharma, we are "simply expanding the criteria for mental illness so that nearly everyone has one." Fugh-Berman agrees: In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people."

Cost benefit analysis

What's especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old - vulnerable groups who often do not make their own choices when it comes to what medications they take. Investigations into antipsychotic use suggests that their purpose, in these cases, may be to subdue and tranquilize rather than to treat any genuine psychosis.

Carl Elliott reports in Mother Jones magazine: "Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003." And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

A remarkable series published in the Palm Beach Post in May true revealed that the state of  Florida's juvenile justice department has literally been pouring these drugs into juvenile facilities, "routinely" doling them out "for reasons that never were approved by federal regulators." The numbers are staggering: "In 2007, for example, the Department of Juvenile Justice bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children…That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day." Further, the paper discovered that "One in three of the psychiatrists who have contracted with the state Department of Juvenile Justice in the past five years has taken speaker fees or gifts from companies that make antipsychotic medications."

In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for a host of off-label uses. In one particularly notorious episode, the drugmaker Eli Lilly pushed Zyprexa on the caregivers of old people with Alzheimer's and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan "five at five"—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. The practice persisted even after FDA had warned Lilly that the drug was not approved for such uses, and that it could lead to obesity and even diabetes in elderly patients.

In a video interview conducted in 2006, Sharham Ahari, who sold Zyprexa for two years at the beginning of the decade, described to me how the sales people would wangle the doctors into prescribing it. At the time, he recalled, his doctor clients were giving him a lot of grief over patients who were "flipping out" over the weight gain associated with the drug, along with the diabetes. "We were instructed to downplay side effects and focus on the efficacy of drug…to recommend the patient drink a glass a water before taking a pill before the  meal and then after the meal in hopes the stomach would expand" and provide an easy way out of this obstacle to increased sales. When docs complained, he recalled, "I told them, ‘Our drug is state of the art. What's more important? You want them to get better or do you want them to stay the same--a thin psychotic patient or a fat stable patient.'"

For the drug companies, Shahrman says, the decision to continue pushing the drug despite side effects is matter of cost benefit analysis: Whether you will make more money by continuing to market the drug for off-label use, and perhaps defending against lawsuits, than you would otherwise. In the case of Zyprexa, in January 2009, Lilly settled a lawsuit brought by with the US Justice Department, agreeing to pay $1.4 billion, including "a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind,''the Department of Justice said in announcing the settlement." But Lilly's sale of Zyprexa in that year alone were over $1.8 billion.

Making patients worse


People and Power: Drug Money

As it turns out, the atypical antipsychotics may not even be the best choice for people with genuine, undisputed psychosis.

A growing number of health professionals have come to think these drugs are not really as effective as older, less expensive medicines which they have replaced, that they themselves produce side effects that cause other sorts of diseases such as diabetes and plunge the patient deeper into the gloomy world of serious mental disorder. Along with stories of success comes reports of people turned into virtual zombies.

Elliott reports in Mother Jones: "After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

Bottom line: Stop Big Pharma and the parasitic shrink community from wantonly pushing these pills across the population.

James Ridgeway writes for The Guardian newspaper, and is the senior Washington correspondent for Mother Jones magazine.


ANTIPSYCHOTICS -Mass psychosis in the US - Opinion - Al Jazeera English - INCLUDING EXCELLENT ENGLISH VIDEO

AMERICAN SOCIAL CONTROL BY DRUGGING CHILDREN

Mass psychosis in the US - Opinion - Al Jazeera English 

CLICK ON TITLE ABOVE TO WATCH EXCELLENT VIDEO. 


Has America become a nation of psychotics? 

You would certainly think so, based on the explosion in the use of antipsychotic medications. In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux.

Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses - primarily schizophrenia and bipolar disorder - to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.

It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry's development of a new class of medications known as "atypical antipsychotics." Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. More importantly, they lacked the most noxious side effects of the older drugs - in particular, the tremors and other motor control problems.

The atypical anti-psychotics were the bright new stars in the pharmaceutical industry's roster of psychotropic drugs - costly, patented medications that made people feel and behave better without any shaking or drooling. Sales grew steadily, until by 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million.  Suddenly, antipsychotics weren't just for psychotics any more.

Not just for psychotics anymore

By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. "Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective," says Dr. Adriane Fugh-Berman, whose PharmedOut project tracks the industry's influence on American medicine, and who last month hosted a conference on the subject at Georgetown. A shrink can't give you a blood test or an MRI to figure out precisely what's wrong with you. So it's often a case of diagnosis by prescription. (If you feel better after you take an anti-depressant, it's assumed that you were depressed.) As the researchers in one study of the drug industry's influence put it, "the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence." For this reason, they argue, it's particularly important that the guidelines for diagnosing and treating mental illness be compiled "on the basis of an objective review of the scientific evidence" - and not on whether the doctors writing them got a big grant from Merck or own stock in AstraZeneca.

Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: "Psychiatrists are in the pocket of industry." Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association's most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.

"The use of psychoactive drugs - including both antidepressants and antipsychotics - has exploded...[yet] 'the tally of those who are disabled...increased nearly two and a half times."

Marcia Angell, former editor of the New England Journal of Medicine

In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent "raging epidemic of mental illness" among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children." Under the tutelage of Big Pharma, we are "simply expanding the criteria for mental illness so that nearly everyone has one." Fugh-Berman agrees: In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people."

Cost benefit analysis

What's especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old - vulnerable groups who often do not make their own choices when it comes to what medications they take. Investigations into antipsychotic use suggests that their purpose, in these cases, may be to subdue and tranquilize rather than to treat any genuine psychosis.

Carl Elliott reports in Mother Jones magazine: "Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003." And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

A remarkable series published in the Palm Beach Post in May true revealed that the state of  Florida's juvenile justice department has literally been pouring these drugs into juvenile facilities, "routinely" doling them out "for reasons that never were approved by federal regulators." The numbers are staggering: "In 2007, for example, the Department of Juvenile Justice bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children…That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day." Further, the paper discovered that "One in three of the psychiatrists who have contracted with the state Department of Juvenile Justice in the past five years has taken speaker fees or gifts from companies that make antipsychotic medications."

In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for a host of off-label uses. In one particularly notorious episode, the drugmaker Eli Lilly pushed Zyprexa on the caregivers of old people with Alzheimer's and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan "five at five"—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. The practice persisted even after FDA had warned Lilly that the drug was not approved for such uses, and that it could lead to obesity and even diabetes in elderly patients.

In a video interview conducted in 2006, Sharham Ahari, who sold Zyprexa for two years at the beginning of the decade, described to me how the sales people would wangle the doctors into prescribing it. At the time, he recalled, his doctor clients were giving him a lot of grief over patients who were "flipping out" over the weight gain associated with the drug, along with the diabetes. "We were instructed to downplay side effects and focus on the efficacy of drug…to recommend the patient drink a glass a water before taking a pill before the  meal and then after the meal in hopes the stomach would expand" and provide an easy way out of this obstacle to increased sales. When docs complained, he recalled, "I told them, ‘Our drug is state of the art. What's more important? You want them to get better or do you want them to stay the same--a thin psychotic patient or a fat stable patient.'"

For the drug companies, Shahrman says, the decision to continue pushing the drug despite side effects is matter of cost benefit analysis: Whether you will make more money by continuing to market the drug for off-label use, and perhaps defending against lawsuits, than you would otherwise. In the case of Zyprexa, in January 2009, Lilly settled a lawsuit brought by with the US Justice Department, agreeing to pay $1.4 billion, including "a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind,''the Department of Justice said in announcing the settlement." But Lilly's sale of Zyprexa in that year alone were over $1.8 billion.

Making patients worse


People and Power: Drug Money

As it turns out, the atypical antipsychotics may not even be the best choice for people with genuine, undisputed psychosis.

A growing number of health professionals have come to think these drugs are not really as effective as older, less expensive medicines which they have replaced, that they themselves produce side effects that cause other sorts of diseases such as diabetes and plunge the patient deeper into the gloomy world of serious mental disorder. Along with stories of success comes reports of people turned into virtual zombies.

Elliott reports in Mother Jones: "After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

Bottom line: Stop Big Pharma and the parasitic shrink community from wantonly pushing these pills across the population.

James Ridgeway writes for The Guardian newspaper, and is the senior Washington correspondent for Mother Jones magazine.



Mass psychosis in the US How Big Pharma got Americans hooked on anti-psychotic drugs. James Ridgeway Last Modified: 12 Jul 2011 06:20 inShare2 Email Article Email Print Article Print Share article Share Send Feedback Feedback Listen to this page using ReadSpeaker Drug companies like Pfizer are accused of pressuring doctors into over-prescribing medications to patients in order to increase profits [GALLO/GETTY] Has America become a nation of psychotics? You would certainly think so, based on the explosion in the use of antipsychotic medications. In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux. Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses - primarily schizophrenia and bipolar disorder - to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis. It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry's development of a new class of medications known as "atypical antipsychotics." Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. More importantly, they lacked the most noxious side effects of the older drugs - in particular, the tremors and other motor control problems. The atypical anti-psychotics were the bright new stars in the pharmaceutical industry's roster of psychotropic drugs - costly, patented medications that made people feel and behave better without any shaking or drooling. Sales grew steadily, until by 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million. Suddenly, antipsychotics weren't just for psychotics any more. Not just for psychotics anymore By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. "Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective," says Dr. Adriane Fugh-Berman, whose PharmedOut project tracks the industry's influence on American medicine, and who last month hosted a conference on the subject at Georgetown. A shrink can't give you a blood test or an MRI to figure out precisely what's wrong with you. So it's often a case of diagnosis by prescription. (If you feel better after you take an anti-depressant, it's assumed that you were depressed.) As the researchers in one study of the drug industry's influence put it, "the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence." For this reason, they argue, it's particularly important that the guidelines for diagnosing and treating mental illness be compiled "on the basis of an objective review of the scientific evidence" - and not on whether the doctors writing them got a big grant from Merck or own stock in AstraZeneca. Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: "Psychiatrists are in the pocket of industry." Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association's most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies. "The use of psychoactive drugs - including both antidepressants and antipsychotics - has exploded...[yet] 'the tally of those who are disabled...increased nearly two and a half times." Marcia Angell, former editor of the New England Journal of Medicine In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent "raging epidemic of mental illness" among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children." Under the tutelage of Big Pharma, we are "simply expanding the criteria for mental illness so that nearly everyone has one." Fugh-Berman agrees: In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people." Cost benefit analysis What's especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old - vulnerable groups who often do not make their own choices when it comes to what medications they take. Investigations into antipsychotic use suggests that their purpose, in these cases, may be to subdue and tranquilize rather than to treat any genuine psychosis. Carl Elliott reports in Mother Jones magazine: "Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003." And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug." A remarkable series published in the Palm Beach Post in May true revealed that the state of Florida's juvenile justice department has literally been pouring these drugs into juvenile facilities, "routinely" doling them out "for reasons that never were approved by federal regulators." The numbers are staggering: "In 2007, for example, the Department of Juvenile Justice bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children…That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day." Further, the paper discovered that "One in three of the psychiatrists who have contracted with the state Department of Juvenile Justice in the past five years has taken speaker fees or gifts from companies that make antipsychotic medications." In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for a host of off-label uses. In one particularly notorious episode, the drugmaker Eli Lilly pushed Zyprexa on the caregivers of old people with Alzheimer's and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan "five at five"—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. The practice persisted even after FDA had warned Lilly that the drug was not approved for such uses, and that it could lead to obesity and even diabetes in elderly patients. In a video interview conducted in 2006, Sharham Ahari, who sold Zyprexa for two years at the beginning of the decade, described to me how the sales people would wangle the doctors into prescribing it. At the time, he recalled, his doctor clients were giving him a lot of grief over patients who were "flipping out" over the weight gain associated with the drug, along with the diabetes. "We were instructed to downplay side effects and focus on the efficacy of drug…to recommend the patient drink a glass a water before taking a pill before the meal and then after the meal in hopes the stomach would expand" and provide an easy way out of this obstacle to increased sales. When docs complained, he recalled, "I told them, ‘Our drug is state of the art. What's more important? You want them to get better or do you want them to stay the same--a thin psychotic patient or a fat stable patient.'" For the drug companies, Shahrman says, the decision to continue pushing the drug despite side effects is matter of cost benefit analysis: Whether you will make more money by continuing to market the drug for off-label use, and perhaps defending against lawsuits, than you would otherwise. In the case of Zyprexa, in January 2009, Lilly settled a lawsuit brought by with the US Justice Department, agreeing to pay $1.4 billion, including "a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind,''the Department of Justice said in announcing the settlement." But Lilly's sale of Zyprexa in that year alone were over $1.8 billion. Making patients worse People and Power: Drug Money As it turns out, the atypical antipsychotics may not even be the best choice for people with genuine, undisputed psychosis. A growing number of health professionals have come to think these drugs are not really as effective as older, less expensive medicines which they have replaced, that they themselves produce side effects that cause other sorts of diseases such as diabetes and plunge the patient deeper into the gloomy world of serious mental disorder. Along with stories of success comes reports of people turned into virtual zombies. Elliott reports in Mother Jones: "After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed." Bottom line: Stop Big Pharma and the parasitic shrink community from wantonly pushing these pills across the population. James Ridgeway writes for The Guardian newspaper, and is the senior Washington correspondent for Mother Jones magazine.

ANTIPSYCHOTICS - ABSTRACTS OF ACADEMIC ARTICLES REGARDING THE RISKS OF THESE 'HEAVY DUTY' DRUGS.


Trends in the Use of Typical and Atypical Antipsychotics in Children and Adolescents

Nick C. Patel Pharm.D., Ph.D., M. Lynn Crismon Pharm.D. Corresponding Author Contact Information, E-mail The Corresponding Author, Kimberly Hoagwood Ph.D., Michael T. Johnsrud Ph.D., Karen L. Rascati Ph.D., James P. Wilson Pharm.D., Ph.D., Peter S. Jensen M.D.
Purchase
Dr. Patel is with the Departments of Pharmacy Practice and Psychiatry, University of Cincinnati; Drs. Crismon, Rascati, Wilson, and Johnsrud are with the Center for Pharmacoeconomic Studies, Divisions of Pharmacy Practice and Administration, The University of Texas at Austin; and Drs. Hoagwood and Jensen are with the Department of Psychiatry, Columbia University, New York

Accepted 4 January 2005. Available online 1 November 2009.
ABSTRACT
Objective

To estimate prevalence rates of antipsychotic use in children and adolescents from 1996 to 2001 in three state Medicaid programs (midwestern [MM], southern [SM], and western [WM]) and one private managed care organization (MCO).
Method

Prescription claims were used to evaluate antipsychotic prevalence, defined as the number of children and adolescents up to the age of 19 years with at least one prescription claim for an antipsychotic per 1,000 enrolled youths.
Results

From 1996 to 2001, the prevalence of total antipsychotic use increased in each program (MM: 4.7 to 14.3 per 1,000; SM: 6.3 to 15.5; WM: 4.5 to 6.9; and MCO: 1.5 to 3.4). Typical antipsychotic use decreased (MM: 3.7 to 2.0 per 1,000; SM: 4.6 to 1.5; WM: 4.4 to 1.3; and MCO: 1.2 to 0.9), while atypical antipsychotic use dramatically increased (MM: 1.4 to 13.1 per 1,000; SM: 2.5 to 14.9; WM: 0.3 to 6.2; and MCO: 0.4 to 2.7).
Conclusions

The increased prevalence of antipsychotic use in children and adolescents from 1996 to 2001 was attributed to increased use of atypical antipsychotics. Given the limited data with atypical antipsychotics in youths, this emphasizes the need for additional studies of these agents and other treatment modalities in this population.

Key Words: antipsychotics; pharmacoepidemiology
Article Outline

    METHOD
        Data Sources
        Measures
        Data Analysis
    RESULTS
        Population Characteristics
        Total and Antipsychotic Subclass Prevalence
        Age-Specific Prevalence of Antipsychotic Use
        Gender-Specific Prevalence of Antipsychotic Use
        Geographic and Payer System Variations in Antipsychotic Prescribing
    DISCUSSION
        Antipsychotic Prevalence Findings
        Geographic and Payer System Variation Findings
        Clinical Implications of drugs

  REFERENCES


   
Metabolic side effects of atypical antipsychotics in children: a literature review.
(PMID:16166191)



Fedorowicz VJ, Fombonne E
McGill University, Montreal Children's Hospital, Montreal, QC, Canada H32 1P2.
Journal of Psychopharmacology (Oxford, England) [2005, 19(5):533-50]

Type:  Journal Article, Meta-Analysis, Review

DOI: 10.1177/0269881105056543

The objective of this review is to summarize the data about metabolic side effects of atypical antipsychotics in children. Original research articles about side effects of atypical antipsychotics used in children were reviewed. The data was obtained mainly through Medline searches, identifying articles focusing on the use of atypical antipsychotics in children. Forty studies that addressed the issue of metabolic side effects were selected. The use of atypical antipsychotics in children has been consistently associated with weight gain and moderate prolactin elevation, while only a few case reports address the issue of glucose dysregulation and dyslipidaemia. The risk of weight gain and hyperprolactinaemia might be higher in younger children. Other risk factors have also been associated with antipsychotic-induced metabolic disturbances. These changes seem to be reversible, at least in some cases. Metabolic side effects of atypical antipsychotics could lead to serious complications in children who are prescribed these medications. Serious considerations should be given before initiating treatment and consistent clinical monitoring is essential. More research is needed, especially regarding glucose dysregulation and dyslipidaemia.


ANTIPSYCHOTICS - INCREASED ADIPOSITY AND DIABETES FOR CHILDREN ON THESE 'HEAVY DUTY' DRUGS



http://youtu.be/DFhuKWz-quA/

CLICK ON LINK ABOVE OR ON TITLE TO WATCH THIS INFORMATIVE VIDEO

ANTIPSYCHOTICS - THE LAW IS FLAUTED FOR $1,500 PER HOUR



http://youtu.be/q3EAnZlSRuk


CLICK ON LINK ABOVE TO WATCH POWERFUL VIDEO ABOUT THE ILLEGAL PAYMENTS BY DRUG COMPANIES TO THEIR 'SPEAKERS LIST.'

ANTIPSYCHOTICS FOR CHILDREN VIDEOS - INCLUDING THE LARGEST CLASS ACTION AGAINST A DRUG COMPANY VIDEO

DRUG COMPANY LILLY SUED FOR HUGE DAMAGES


http://tmap.wordpress.com/videos/

CLICK ON LINK ABOVE TO WATCH THESE VIDEOS

ANTIPSYCHOTICS OVER-PRESCRIBED IN THE CARE SYSTEM IN THE U.S. -VIDEO OF A FOSTER CHILD WHO HAD HAD 26 DIFFERENT DRUGS - COURTESY OF THE WATCH LIST. + TWO ARTICLES

 


Drugs in the system: Foster children and antipsychotic medication - CLICK ON THE LINK ABOVE TO WATCH.

By
Shoshana Guy
June 3, 2011

This week on our investigative series The Watch List: An update to our story on the use and potential over-use of powerful antipsychotic drugs on children in the nation’s foster care systems.

Nearly one in every 10 American children is diagnosed with a mental health disorder. Often the treatment prescribed is medication. Children in foster care are prescribed drugs at a much higher rate than that of other kids. And concern over their well-being — not to mention the amount it costs to treat them — has prompted the government accountability office to investigate potentially abusive prescribing practices in state foster care systems. The GAO findings are expected to come out later this year. Need to Know correspondent Shoshana Guy provides an update on a story we first aired in January.

  
Foster kids get more antipsychotics: study
By Kerry Grens | Reuters – Tue, Nov 22, 2011

   NEW YORK (Reuters Health) - Kids in foster care are more likely to have long-term prescriptions for more than one type of antipsychotic medication than kids who are also on government assistance, but not in foster care, a new study finds.

The results, published in the journal Pediatrics, point to prescribing practices that have known risks, but uncertain benefits, researchers say.

"We have very little evidence for antipsychotic use in kids, and no evidence to support two medications," lead author Susan dosReis, a professor at the University of Maryland School of Pharmacy, told Reuters Health.

DosReis and her colleagues examined antipsychotic prescriptions given to nearly 17,000 children on Medicaid in 2003.

Medicaid is the state and federal health insurance for the poor.

Most of the children in the study were in foster care, some also had a disability, others were adopted out of foster care during the study period. For comparison, the researchers also looked at kids on Medicaid who had disabilities or were receiving aid for needy families, but were not in foster care.

More than a third of the kids in foster care without disabilities had multiple antipsychotic prescriptions for longer than 90 days. Those who were not adopted had the highest rates of all -- 38 out of every 100 children.

In comparison, 26 out of every 100 children who were on public assistance but not in foster care had more than one prescription for an antipsychotic.

The medications are used to treat schizophrenia and bipolar disorder, and go by brand names such as Zyprexa, Risperdal and Seroquel.

Doctors also prescribe them for other psychiatric disorders.

Dr. Michael Naylor, a professor at the University of Illinois at Chicago, said he was not surprised by the results.

"You can't imagine a more perfect storm for severe emotional and behavioral psychiatric disturbance" than someone who ends up in foster care, said Naylor, who was not involved in the study.

Children are often born into unstable, neglectful and abusive situations, in addition to having a psychiatric illness, Naylor told Reuters Health.

Though such kids present challenges in treating their mental or behavioral illnesses, the high rates of multiple prescriptions for antipsychotics raises red flags.

"When we see a subsample of kids getting more than one antipsychotic for an extended period of time, that is concerning because we're moving toward a practice that isn't supported by evidence showing that's effective," DosReis said.

In addition, antipsychotics can have some serious side effects.

"It's putting some kids at risk for some more medical problems with the weight gain (and) the possibility of type 2 diabetes" associated with antipsychotic medications, Naylor said.

Some previous research, including a study published Monday in the same issue of Pediatrics, links modern antipsychotics to increased risk of developing diabetes.

A pediatric advisory panel recently urged the Food and Drug Administration to determine whether the benefits of antipsychotics outweigh the risks (see Reuters Health story of September 23, 2011).

Naylor's concern is that the children are being prescribed one drug to help with a conduct or psychiatric disorder, and a second drug to help with sleep.

"I don't think that's good medicine," he said.

DosReis and her colleagues did not determine why the medications were being prescribed.

"I would advocate for better monitoring for efficacy, symptoms, and side effects," she said. "We don't have that system to monitor how well these treatments are working for kids."

SOURCE: http://bit.ly/tssjl5 Pediatrics, online November 21, 2011.

Monday, 28 November 2011

ANTIPSYCHOTICS ARE A RISK TO WEIGHT GAIN AND SUBSEQUENTLY DIABETES

ANTIPSYCHOTICS CAN CAUSE DIABETES


ScienceDaily:
"Use Of Antipsychotic Medications By Children And Adolescents Associated With Significant Weight Gain."


"These medications can be lifesaving for youth with serious psychiatric illnesses such as schizophrenia, classically defined bipolar disorder, or severe aggression associated with autism. However, given the risk for weight gain and long-term risk for cardiovascular and metabolic problems, the widespread and increasing use of atypical antipsychotic medications in children and adolescents should be reconsidered."

ScienceDaily (Oct. 27, 2009) — 

Many pediatric and adolescent patients who received second-generation antipsychotic medications experienced significant weight gain, along with varied adverse effects on cholesterol and triglyceride levels and other metabolic measures, according to a study in the October 28 issue of JAMA.
 

Treatment for psychotic disorders, bipolar disorder, and nonpsychotic mental disorders for children and adolescents in the United States often includes second-generation antipsychotic medications. "Increasingly, the cardiometabolic effects of second-generation antipsychotic medications have raised concern. Cardiometabolic adverse effects, such as age-inappropriate weight gain, obesity, hypertension, and lipid and glucose abnormalities, are particularly problematic during development because they predict adult obesity, the metabolic syndrome, cardiovascular morbidity, and malignancy," the authors write. The cardiometabolic effects of these medications have not been sufficiently studied in children and adolescent patients who have not previously received them, according to background information in the article.

Christoph U. Correll, M.D., of Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York, and colleagues conducted a study of weight and metabolic changes in a group of 272 pediatric patients (ages 4 to 19 years) who had not previously received antipsychotic medication. Patients had mood spectrum (47.8 percent), schizophrenia spectrum (30.1 percent), and disruptive or aggressive behavior spectrum (22.1 percent) disorders. Fifteen patients who refused participation or were nonadherent to medications served as a comparison group. Patients were treated with the antipsychotic medications aripiprazole, olanzapine, quetiapine, or risperidone for 12 weeks.

After a median (midpoint) of 10.8 weeks of treatment, weight increased by an average of 18.7 lbs. with olanzapine (n = 45), by 13.4 lbs. with quetiapine (n = 36), by 11.7 lbs. with risperidone (n = 135), and by 9.7 lbs. with aripiprazole (n = 41) compared with minimal weight change of 0.4 lbs. in the untreated comparison group (n = 15). "Each antipsychotic medication was associated with significantly increased fat mass and waist circumference," the authors write. "Altogether, 10 percent to 36 percent of patients transitioned to overweight or obese status within 11 weeks."

The researchers also found that adverse changes during the study period reached statistical significance for olanzapine and quetiapine for total cholesterol, triglycerides, non-HDL cholesterol, and ratio of triglycerides to HDL cholesterol. "With risperidone, levels of triglycerides increased significantly. Metabolic baseline-to-end-point changes were not significant with aripiprazole or in the untreated comparison group. Patients receiving quetiapine had modestly higher incidence rates of hyperglycemia and the metabolic syndrome and patients receiving olanzapine experienced the highest incidence rates."

The authors note that these results are concerning because they include fat mass and waist circumference, which are associated with the metabolic syndrome in adults treated with antipsychotic medications and heart disease in the general population. "Moreover, abnormal childhood weight and metabolic status adversely affect adult cardiovascular outcomes via continuation of these risk factors or independent or accelerated mechanisms."

"Our results, together with data from first-episode studies, suggest that guidelines for antipsychotic medication exposure for vulnerable pediatric and adolescent patients naive to antipsychotic medication should consider more frequent (e.g., biannual) cardiometabolic monitoring after the first 3 months of treatment. Finally, in view of poor physical health outcomes and suboptimal metabolic monitoring in the severely mentally ill, the benefits of second-generation antipsychotic medications must be balanced against their cardiometabolic risks through a careful assessment of the indications for their use, consideration of lower-risk alternatives, and proactive adverse effect monitoring and management," the authors conclude.

Editorial: Implications of Marked Weight Gain Associated With Atypical Antipsychotic Medications in Children and Adolescents

Christopher K. Varley, M.D., and Jon McClellan, M.D., of Seattle Children's Hospital, write in an accompanying editorial that these findings indicate there are other factors to consider regarding the use of atypical antipsychotic medications in children and adolescents.

"These medications can be lifesaving for youth with serious psychiatric illnesses such as schizophrenia, classically defined bipolar disorder, or severe aggression associated with autism. However, given the risk for weight gain and long-term risk for cardiovascular and metabolic problems, the widespread and increasing use of atypical antipsychotic medications in children and adolescents should be reconsidered."

Friday, 25 November 2011

SHARP RISE IN ANTIPSYCHOTIC MEDICATIONS IN U.S. AND U.K. LINKS TO RECENT CHANNEL 4 NEWS PROGRAMME POST


"Sharp Rise in Use of Childhood Psychiatric Drugs Stirs Concern"- click on link above or title to watch the Channel 4 News item.
 
Jan 21, 2011 | 12:44 PM ET | by MyHealthNewsDaily.com, staff

Children are overprescribed medications for psychiatric conditions, psychologists and psychiatrics say.

In the United States, prescriptions for childhood antipsychotic drugs — prescribed to treat conditions such as bipolar disorder and schizophrenia — increased sixfold between 1993 and 2002, according to a study published the Archives of General Psychiatry in June 2006.

"Antipsychotic medications have substantially increased in the last 10 years, and caused a great deal of medical concerns for kids who are on them," said Dr. Paul Ballas, a child psychiatrist in Philadelphia.
"Often I wonder, kids who are on antipsychotics, whether they are being prescribed for an appropriate diagnosis," Ballas said.

Others are concerned about the use of stimulant medications, prescribed for conditions such as attention deficit hyperactivity disorder (ADHD ).

Prescriptions for amphetamines for children increased 120-fold between 1994 and 2009, according to statistics from the United Kingdom's National Health Service, said Dave Traxson, an educational psychologist in the U.K.

The experts all said that putting kids on medications unnecessarily is worrisome because the drugs, particularly antipsychotics, can have undesirable side effects. For instance, antipsychotics can cause weight gain and diabetes and stimulants can cause decreases in appetite and sleep problems, according to the National Institute of Mental Health. Further, too little is known about the long-term effects of taking these drugs.

However, they disagree over what exactly is causing the overmedication predicament.

Overprescription

The researchers said medications should be given only when a diagnosis calls for them and when evidence has shown that they work. Sometimes, the problem arises in making that diagnosis.

Traxson said doctors rely too heavily on information from parents to make diagnoses, and are wrongly labeling children with conditions like ADHD. He also said descriptions of some of these disorders, such as bipolar disorder , as written in the Diagnostic and Statistical Manual of Mental Disorders (DSM), are too broad, and encompass too many children.

But Ballas said the problem lies not with the DSM, but how doctors use it. Some symptoms described in the DSM are normal behaviors of children. "It’s the aggregation of symptoms, and what sets them off, that often lead to the diagnoses," he said.

For instance, a child with chronic sleep deprivation may be misdiagnosed as having ADHD, and be prescribed stimulants, Ballas said.

Misdiagnosis due to doctors inappropriately using the DSM is especially a danger when doctors do not have specialized training, Ballas told MyHealthNewsDaily.

"I'm concerned when primary care physicians or pediatricians make a diagnosis of bipolar disorder without additional training in psychiatry," Ballas said.
"I feel that the medical system in general is just becoming so taxed that there is increasing pressure for people with less experience to make these diagnoses," he said.

Beyond diagnoses, others say the overprescription problem stems from doctors being too quick to prescribe medications for conditions that could be treated another way, such as with psychotherapy. This may happen because psychotherapy is a more labor-intensive process and requires more time, said child psychologist Ronald Brown, vice president of academic affairs at Wayne State University in Detroit.

"Very frequently, medication is the first thing that providers turn to," Brown said. "This is an issue because there are often times some therapies that are as effective, or maybe even more effective, than medications," he said.

Brain damage?

The effects of continually medicating kids remain to be seen.

"We worry about what we don’t know…we don’t know the long-term effects," Brown said.

Some studies have suggested that the long-term use of stimulants may lead to changes in the brain. For example, children placed on stimulants for long periods have a buildup of the neurotransmitter dopamine in their brain, Traxson said. This buildup can damage the connections between nerve cells, he said.

But whether such changes translate to physiological problems has yet to be determined, Ballas said. He noted that stimulants have been used for 80 years to treat ADHD, and that much research suggests they are safe.

And while there has been some concern over cardiovascular risks, a recent study found that ADHD medications do not appear to pose a significant danger for children's hearts when taken over the long term.

However, more researchers need to investigate the consequences of these drugs, Brown said.

Traxson is calling for a national and international review of the use of psychiatric medications in children. He recently spoke about the issue at the annual conference of the Division of Educational and Child Psychology in Newcastle, U.K.

Pass it on: Children are overmedicated with psychiatric drugs, but experts disagree about the exact reason for this overprescription and what the consequences will be.