Use of Antipsychotics by the Young Rose Fivefold

[Guest guest]

[You can read something about the ignorance and crimes of medicine and the

pharmaceutical industry every day. It can appall you; it can distress you.

But what will you doing about it? Please think about how you can

help. --]

FYI

The New York Times reports that an analysis of a national survey of doctors

prescribing practice by Columbia University psychiatrists found:

1. " that antipsychotic medications were prescribed to 1,438 per 100,000

children and adolescents in 2002, up from 275 per 100,000 in the two-year

period from 1993 to 1995. "

2. " The total number of visits that resulted in prescriptions for the drugs

increased to 1,224,000 in 2002 from 201,000 1993 to 1995. "

3. " most of the patients were boys, predominantly Caucasian children, who

were significantly more likely to see psychiatrists than other ethnic

groups. "

The lead investigator, Dr.l Mark Olfson is quoted stating: " to me the most

striking thing was that nearly one in five psychiatric visits for young

people included a prescription for antipsychotics. "

This is documented evidence of major medical malpractice. Psychiatrists are

prescribing the most toxic of all psychotropic drugs for one in five

children though the drugs have not approved for children because they have

not been found to be safe.

Nowhere in the world do physicians have such a professional disregard for

the welfare of children. American psychiatrists who prescribe highly toxic

psychotropic drugs for children do so even though poor patient outcomes

suggest that other treatment modalities must replace drugs because these

drugs worsen and actually cause debilitating symptoms of chronic disease.

It demonstrates psychiatry's dependence on drugs and the commercial impact

on the profession's reckless prescribing practices.

How can one justify exposing children to drugs that have lethal risks and

cause: chronic mental dysfunction: disrupt normal brain chemistry and

interfere with normal functioning of the central nervous system, the

hormonal system, the metabolic system, the endocrine system?

The drugs induce de novo insulin resistance and diabetes mellitus; and

cardiac abnormalities.

Furthermore, once these drugs are continually ingested, the body becomes

drug dependent: " The rate of discontinuation due to adverse events was

significantly greater with olanzapine than placebo (13% vs 7%). The term

" Adverse' appears 76 times in the Zyprexa label.

The drugs carry black box warnings of lethal risks, and additional warnings

about lethal risks. These include:

" increased mortality in the elderly; Hyperglycemia and Diabetes Mellitus;

Neuroleptic Malignant Syndrome (NMS); Cognitive and motor impairment;

Disruption of the body's ability to reduce core body temperature; Aspiration

pneumonia is a common cause of morbidity and mortality; Suicide. "

" intentional injury " and " suicide attempt " are listed as occurring

" infrequently " -not rarely!

See: Zyprexa label: http://pi.lilly.com/us/zyprexa-pi.pdf ]

Additionally, Janssen Pharmacia's antipsychotic, Risperdal (risperidone)

carries warnings about the drug causing Tardive Dyskinesia:

" A syndrome of potentially irreversible, involuntary, dyskinetic movements

may develop in patients treated with antipsychotic drugs. Although the

prevalence of the syndrome appears to be highest among the elderly,

especially elderly women, it is impossible to rely upon prevalence estimates

to predict, at the inception of antipsychotic treatment, which patients are

likely to develop the syndrome. Whether antipsychotic drug products differ

in their potential to cause tardive dyskinesia is unknown.

The risk of developing tardive dyskinesia and the likelihood that it will

become irreversible are believed to increase as the duration of treatment

and the total cumulative dose of antipsychotic drugs administered to the

patient increase. However, the syndrome can develop, although much less

commonly, after relatively brief treatment periods at low doses. " The term

" Adverse " appears 56 times on the Risperdal label See:

http://www.risperdal.com/active/janus/en_US/assets/common/company/pi/risperd

al.pdf

The recent findings of the CATIE study confirm the severity of these drugs'

adverse effect profile.

It is not plausible, therefore, that those prescribing the drugs never

noticed the harm being caused to patients.

See: http://www.ahrp.org/cms/content/view/132/80/

Last month, Yale University reported its highly controversial, so-called

" schizophrenia prevention study " failed to demonstrate a benefit. The

investigators have yet to report the adverse events that the study

subjects-some as young as 12-had suffered.

" We are using these medications and don't know how they work, if they work,

or at what cost, " said Dr. March, a professor of child and adolescent

psychiatry at Duke University. " It amounts to a huge experiment with the

lives of American kids, and what it tells us is that we've got to do

something other than we're doing now " to assess the drugs' overall impact. "

The inordinate influence of the pharmaceutical industry--both through an

army of sales reps and a highly paid band of academic " experts " who render

opinions-in lieu of evidence-has shaped the practice of American

psychiatry. These industry paid " experts " have designated antipsychotics as

" first line " treatment.

What is the responsibility of the academic experts who issued consensus

statements about Treatment Guidelines recommending antipsychotics for

children--despite evidence the drugs are causing harm?

Two such consensus panels: the Texas Medication Algorithm Project (TMAP) and

another under the auspices of the American Academy of Child and Adolescent

Psychiatry, recommended antidepressants and antipsychotics for children. (to

be posted on the AHRP website)

Contact: Vera Hassner Sharav

veracare@...

visits, found that antipsychotic medications were prescribed to 1,438 per

100,000 children and adolescents in 2002, up from 275 per 100,000 in the

two-year period from 1993 to 1995.

The findings augment earlier studies that have documented a sharp rise over

the last decade in the prescription of psychiatric drugs for children,

including antipsychotics, stimulants like Ritalin and antidepressants, whose

sales have slipped only recently. But the new study is the most

comprehensive to examine the increase in prescriptions for antipsychotics.

The explosion in the use of drugs, some experts said, can be traced in part

to the growing number of children and adolescents whose problems are given

psychiatric labels once reserved for adults and to doctors' increasing

comfort with a newer generation of drugs for psychosis.

Shrinking access to long-term psychotherapy and hospital care may also play

a role, the experts said.

The findings, published yesterday in Archives of General Psychiatry, are

likely to inflame a continuing debate about the risks of using psychiatric

medication in children. In recent years, antidepressants have been linked to

an increase in suicidal thinking or behavior in some minors, and reports

have suggested that stimulant drugs like Ritalin may exacerbate underlying

heart problems.

Antipsychotic drugs also carry risks: Researchers have found that many of

the drugs can cause rapid weight gain and blood lipid changes that increase

the risk of diabetes. None of the most commonly prescribed antipsychotics is

approved for use in children, although doctors can prescribe any medication

that has been approved for use.

Experts said that little was known about the use of antipsychotics in

minors: only a handful of small studies have been done in children and

adolescents.

" We are using these medications and don't know how they work, if they work,

or at what cost, " said Dr. March, a professor of child and adolescent

psychiatry at Duke University. " It amounts to a huge experiment with the

lives of American kids, and what it tells us is that we've got to do

something other than we're doing now " to assess the drugs' overall impact.

But many child psychiatrists say that antipsychotic medication is the best

therapy available for children in urgent need of help who do not respond

well to other treatments. Without them, they say, many unpredictable,

emotionally unstable children would end up institutionalized.

Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University

and the lead author of the study, financed in part by the National Institute

of Mental Health, said the popularity of antipsychotic drugs might result in

part from " the fact that psychiatrists have few other pharmacological

options in certain patients. "

The study, which looked at visits to pediatricians and other doctors, found

that psychiatrists were the most likely to prescribe antipsychotic drugs.

In light of how little these drugs have been studied in children, Dr. Olfson

said, " to me the most striking thing was that nearly one in five psychiatric

visits for young people included a prescription for antipsychotics. "

The Columbia investigators analyzed data from the National Center for Health

Statistics survey of office visits, which focuses on doctors in private or

group practices. They calculated the number of visits in which an

antipsychotic drug was prescribed to people under the age of 21 and

collected information on patients' medical histories. The total number of

visits that resulted in prescriptions for the drugs increased to 1,224,000

in 2002 from 201,000 1993 to 1995.

The researchers attributed some of the increase to the availability of a new

class of drugs for psychosis, called atypical antipsychotics, that were

introduced in the early and mid-1990's.

The newer drugs, heavily marketed by their makers, were attractive in part

because they appeared less likely than older types of antipsychotics to

cause side effects like tardive dyskinesia, a neurological movement disorder

similar to Parkinson's disease.

From 2000 to 2002, the new study found, more than 90 percent of the

prescriptions analyzed were for the newer medications, and most of the

patients were boys, predominantly Caucasian children, who were significantly

more likely to see psychiatrists than other ethnic groups.

Some experts also pointed to an increase in the diagnosis of bipolar

disorder in children as a contributing factor. In recent years,

psychiatrists have begun to diagnose the disorder in extremely agitated,

often aggressive children with mood swings - short surges of grandiosity or

irritation that alternate with periods of despair. These symptoms in

children are thought to be related to the classic euphoria and depressions

of adult bipolar disorder.

At the same time, several of the atypical antipsychotics, including

Risperdal from Janssen and Zyprexa from Eli Lilly, won approval for the

treatment of mania in adults.

Some psychiatrists now routinely prescribe atypical antipsychotics " off

label " for young people thought to have bipolar disorder, and researchers

have begun to study the drugs in children as young as preschool age.

In the new study, about a third of the children who received antipsychotics

had behavior disorders, which included attention deficit problems; a third

had psychotic symptoms or developmental problems; and another third were

suffering from mood disorders. Over all, more than 40 percent of the

children were also taking at least one other psychiatric medication.

" We feel the medications are effective in children with bipolar and have

some data to show that, " said Dr. DelBello, an associate professor

of psychiatry at the University of Cincinnati, who has done several studies

of the drugs.

Dr. DelBello said that the field " desperately needs more research " to

clarify the effects of the antipsychotic drugs but that many children

struggling with bipolar disorder got more symptom relief on these drugs than

on others, allowing psychiatrists to cut down on the overall number of

medications a child is taking.

Pedersen of Dallas, the mother of a 17-year-old boy being treated for

bipolar disorder, said he was unpredictable, hostile and suicidal before

psychiatrists found an effective cocktail of drugs, which includes a daily

dose of antipsychotic medication.

" Believe me, I would never choose having him on these meds, " Ms. Pedersen

said in a telephone interview. " It's not fun watching a child deal with the

side effects. But finding the right combination of medicine has made his

life worth living. "

Yet this process is one of trial and error for many children. Ms. Pedersen

said her son had responded badly to the first two antipsychotic drugs he

received. And some experts think the way that psychiatric drugs are

prescribed is obscuring any understanding of underlying disorders and the

optimal treatments.

" If you're going to put children on three or four different drugs, now

you've got a potpourri of target symptoms and side effects, " said Dr.

Magno Zito, an associate professor of pharmacy and medicine at the

University of land.

Dr. Zito added, " How do you even know who the kid is anymore? "

Regards,

" Human beings, who are almost unique in having

the ability to learn from the experience of others,

are also remarkable for their apparent disinclination

to do so. "

--