Citizens Commission on Human Rights International | Mental Health Watchdog

The FDA has finally decided to “stiffen warnings” about Atypical (the newer) antipsychotic drugs for causing birth defects and other problems to newborns when taken by pregnant mothers.  The article below states that the “FDA said it had received 69 reports of problems with newborns linked to the drugs before 2008.”     We’re not sure what data they are looking at, but CCHR International has decoded the thousands of pages of FDA adverse side effects, and we found 159 instances of adverse reactions for the age -1 to 0 age category.

Moreover, the article says “some infants recovered within days, others required prolonged hospitalization.”  That clearly seems like downplaying the facts, when the actual reports include neonatal deaths, cerebral hemorrhage, heart malformations along with a host of other birth defects attributed to the Atypical Antipsychotic drugs, many of which were reported to the FDA by MDs.  Keep in mind the Medwatch reports that CCHR International decoded only include instances where the adverse reaction being reported was directly attributed to the drug in question being the primary suspect drug that caused it.  In other words, when multiple drugs were suspected as the cause, we excluded these in our decrypted reports.    See the information for yourself: In the drop down menu scroll all the way down past the individual names of drugs to the broad categories and select Atypical Antipsychotics, in the  range chose 0 to -1, in the Gender category select Both Male/Female and then hit Generate Report. And if you want to really be horrified, try the same search with 0 to 10 year olds.   And keep in mind, only 1-10% of side effects are ever reported to the FDA and that you are only searching one class of drug.    Try the same search for Antidepressants, Stimulants, Antipsychotics (not Atypical, just Antipsychotics), Anti-Anxiety drugs etc. Double click on any word (such as medical terms) for a pop up window giving a definition of the word/medical condition being reported.

Psychiatric Drug Side Effects Reported to the U.S. FDA Search Engine

Click Here: http://www.cchrint.org/psychdrugdangers/medwatch_psych_drug_adverse_reactions.php

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ABC News – Feb 23, 2011

by Dr.  Stefan Kruszewski, Psychiatrist and CEO of Kruszewski & Associates, a Pennsylvania based firm specializing in illuminating healthcare and financial fraud.

"In fact, no one in the medical industry is a bigger offender when it comes to mistreatment than those of us in psychiatry."

With a few exceptions, when physicians talk, they recommend. Take this. Try that. They satisfy the expectation that automatically comes with a patient’s visit or phone call. The physician is compelled to make a recommendation — a pill, a device or a procedure. Both the physician and medical supplier financially benefit. But is your doctor’s advice always in your best interest?

Not always.

In a 2000 JAMA publication, Julie Magno Zito of the University of Maryland and her coauthors stated that there had been an explosion in psychotropic prescriptions for pre-schoolers without adequate safety and long-term studies and generally without FDA approvals.

Dr. Joseph Coyle of Harvard Medical School editorialized on this “troubling change in practice.”

Likewise, in a 2001 JAMA article, Dr. Chunliu Zhan of the Agency for Healthcare Research and Quality and his colleagues found that American elderly patients are often overly and inappropriately medicated.

And, there are medical errors. Reports from the Institute of Medicine and HealthGrades indicate that there have been 400,000 to 1.2 million error-induced deaths in the United States from 1996 to 2006.

Excessive medications and procedures, adverse events and medical errors are endemic to medicine. In the early 1990s, surgeons were encouraged to perform quadruple bypass surgery for heart disease. Recent studies now suggest the surgery was, in many cases, a waste of time and money, improving neither morbidity nor mortality.

Surgeons are not the only medical professionals who misdiagnose and perform unnecessary procedures. In fact, no one in the medical industry is a bigger offender when it comes to mistreatment than those of us in psychiatry.   With psychoactive diagnoses and medications, I’m currently seeing a trend among doctors prescribing adolescents with stimulants for bogus reports of ADD. In the most common occurrence, the doctor misses the diagnoses of daily marijuana abuse, alcohol abuse and oxycodone abuse.

Many doctors fail to perform a simple urine drug screen, treating instead the residual drug-related symptoms of inattention, lack of motivation, poor academic performance and forgetfulness with amphetamines, antidepressants or antipsychotics.

At worst, kids receive all three medications together, which is dangerous in immeasurable ways. This also happens to adults.

When ‘Medicine’ Makes Things Worse

In the past, psychiatric physicians have diagnosed homosexuality, paraphrenia, paranoia, narcissism, neuroses, combat fatigue and other entities, treating those “disorders” with a variety of therapies, including pills.

More recently, psychiatrists diagnose bipolar disorder not otherwise specified (NOS), adult attention deficit disorder and pre-psychotic conditions, for which they may prescribe pills. The problem is that some of those earlier diagnoses like (homosexuality, neuroses, combat fatigue, paranoia and paraphrenia) no longer exist as entities recognized by the DSM-IV-TR — the most current compendium of mental conditions and disorders.

Virtually anyone at any given time can meet the criteria for bipolar disorder NOS or ADD. Anyone. And the problem is everyone diagnosed with even one of these illnesses triggers the pill dispenser.

Taking stimulants, antidepressants, antipsychotics or off-label use of anti-convulsants often obscures the real problem and instead adds a new layer of unintended adverse events that only make conditions worse.

My advice to doctors: It’s OK not to prescribe anything. It’s OK to listen, to do no harm, to offer compassionate and helpful living advice. It can be therapeutic to recommend abstinence from cigarettes, drugs and alcohol, to eat more nutritiously, to sustain a relationship, lose weight, volunteer, meditate, pray, walk, laugh, sing, play music and embrace kindness.

It’s also OK to offer the patient a metaphorical motivational kick and advise them to just do something to help themselves. That may do more to improve outcomes and reduce adverse events and unnecessary prescribing than an injudiciously prescribed pill or procedure.

Many doctors fail to perform a simple urine drug screen, treating instead the residual drug-related symptoms of inattention, lack of motivation, poor academic performance and forgetfulness with amphetamines, antidepressants or antipsychotics.

At worst, kids receive all three medications together, which is dangerous in immeasurable ways. This also happens to adults.

http://abcnews.go.com/Health/Wellness/prescribing-improve-outcomes/story?id=12973777

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Sydney Morning Herald – Feb 17, 2011

by Elizabeth Farrelly

I have an acquaintance who, apart from being a practising professional, successful academic and author of several important books, is a pianist capable of rendering entire Bach cantatas as casually as you or I might plunk out Chopsticks. He also has seven equally accomplished children, an undisclosed number of complex relationships, a flourishing side-career as a magician and a personal presence so intensively entertaining that catching up once every few years is enough.

These days, I imagine, he would be diagnosed with ADHD and medicated into normalcy. And it’s this that makes me wonder. Assuredly there are those who benefit from Ritalin, but a fourfold increase in seven years? And five times as many boys as girls, almost all of them pubescent? Surely this should give us pause for thought.

The Ritalin wars are usually treated as just another tussle between the pharmaceutical companies and the rest, but is there something else going on here as well? Is it part of a more generalised, covert war on boyhood?

Thirty years ago Australian primary schools employed five male teachers for every four females. By 2006 there was one male teacher for every four females. This overwhelming feminisation of primary education, and of culture generally, has made boy-type behaviour stuff to frown upon. Are we in danger of seeing boyhood itself as a disorder?

When Christopher Lane, author of Shyness: How Normal Behaviour Became a Sickness, quoted a psychoanalyst saying “We used to have a word for sufferers of ADHD; we called them boys”, he probably did not expect it to become the most famous line of his book.

Lane’s point was more general, about how personality traits that were once tolerated and even celebrated are now treated as disorders.

What was once introversion is now “avoidant personality disorder”, nervousness is “social anxiety disorder” (SAD) or dating anxiety disorder (DAD) and so on. It’s not that these disorders don’t exist, says Lane, a Guggenheim fellow studying the ethics of psychopharmacology, but that our definitions are so broad that the entire mysterious subconscious is reduced to chemical balance, and any deviation looks like disease.

Why, he asks, is ADHD so commonly diagnosed in boys? Is it new behaviour? Or just a new attitude to that behaviour?

A report last year by Dr James Scott and others in the Australian and New Zealand Journal of Psychiatry suggests the latter. Ritalin prescriptions have quadrupled in seven years, which might be explained by the drug being covered by a government subsidy were not the same thing happening overseas.

There’s also this: although, in Australia as elsewhere, the male-to-female ADHD ratio is 2.45:1, Ritalin rates are 5:1. Diagnosis is more than twice as likely in boys, and medication more than twice as likely again.

So the argument is not just about medication or even deviation. It’s also about gender. And as the hetero heart-throb morphs from John Wayne into Justin Bieber, it is worth wondering whether our behavioural expectations show a similar shift.

Consider the following story. There is an opportunity class in a public school that prides itself on nurturing the gifted, and displays the usual oestrogen-heavy teacher ranks. In the class is a boy – not mine – who is 10 years old. Let’s call him Jack. Opportunity classes are known to collect excitable kids, and Jack, even by opportunity class standards, is unusually clever; bright, funny, literary, sporty and artistic but also intensely emotional.

The school is so highly regarded that its roll swells and swells. With the extra classrooms and then, to top it off, one of Julia Gillard’s enormous new school halls, the playground becomes so reduced that lunchtime ball games are banned. Instead, crowded in, the kids play tip.

So when the fight comes it should be no surprise. The only surprise is no one is hurt. Sure, one boy is kicked and another kneeled on, but there is no real damage, no blood. Yet a complaint is made and all hell breaks loose. Violence? In our school? OMG.

There is no physical punishment, heaven forbid. But the substitute, from boy-perspective, is far worse. It’s talk. Regulation department-issue talk, certainly, but it spreads what might have been an afternoon’s pain (and pride) into half a dozen sessions across a week or more.

With various combinations of parents, teachers and child witnesses, Jack endures a heaping-on of emotional pressure, with dark mutterings about Matthew Newton, the actor accused of assaulting his partner, and recommendations of psychological therapy.

Now, I have nothing against talk, or talk therapy. In fact, being female, I like it. But talk is girl stuff. Not only are Jack’s parents made to feel they have a psychopath in their bosom, when it is really just a boy thing and small beer by Tom Sawyer standards, they also come away feeling primary schools in general “expect boys to act like girls”.

Jack has now moved on to an all-boy high school where his tutors say he is a pleasure to teach and they wish there were more like him.

Although there is no suggestion that Jack has ADHD, the attitudes are similar, and disturbing. ADHD, Dr Scott says, is characterised by “immaturity of the frontal lobes” the brain site for planning and organisation. This is why Ritalin, a stimulant, is prescribed for hyperactivity; it stimulates the control centres. It’s also why most ADHD sufferers eventually grow out of it.

But why the gender imbalance, and why now? We know that boys tend to be late maturers anyway, but Scott concedes there are also social and perceptual factors at play. Teachers with “less structured” teaching style and “more distracting” classroom environments, he says, yield many more of his clients than their more disciplined (my word) colleagues.

Whereas ADHD girls “sit quietly in a corner”, the boys are more disruptive and more noticed, more referred, more medicated. And although much the same is true of ”normal” boys and girls, the upshot is that ”girl” is a norm to which boys are expected to strive. Scott sees it as “an unintended consequence of how society operates”.

But consequences this important should be either clearly intentional, if girlifying boys is really what we want, or remedied. Personally, I reckon the crazily creative are types we’ll need more of, rather than fewer of, in the future, even if they are male.

http://www.smh.com.au/opinion/society-and-culture/sedation-nation-the-cost-of-taking-boisterous-out-of-boys-20110216-1awij.html

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New York Times

By JAMES DAO, BENEDICT CAREY and DAN FROSCH
Published: February 12, 2011

PAIN AND DEPRESSION Senior Airman Anthony Mena in Baghdad in 2007. After his death in 2009, a toxicologist found eight prescription medications in his blood

In his last months alive, Senior Airman Anthony Mena rarely left home without a backpack filled with medications.

He returned from his second deployment to Iraq complaining of back pain, insomnia, anxiety and nightmares. Doctors diagnosed post-traumatic stress disorder and prescribed powerful cocktails of psychiatric drugs and narcotics.

Yet his pain only deepened, as did his depression. “I have almost given up hope,” he told a doctor in 2008, medical records show. “I should have died in Iraq.”

Airman Mena died instead in his Albuquerque apartment, on July 21, 2009, five months after leaving the Air Force on a medical discharge. A toxicologist found eight prescription medications in his blood, including three antidepressants, a sedative, a sleeping pill and two potent painkillers.

Yet his death was no suicide, the medical examiner concluded. What killed Airman Mena was not an overdose of any one drug, but the interaction of many. He was 23.

After a decade of treating thousands of wounded troops, the military’s medical system is awash in prescription drugs — and the results have sometimes been deadly.

By some estimates, well over 300,000 troops have returned from Iraq or Afghanistan with P.T.S.D., depression, traumatic brain injury or some combination of those. The Pentagon has looked to pharmacology to treat those complex problems, following the lead of civilian medicine. As a result, psychiatric drugs have been used more widely across the military than in any previous war.

But those medications, along with narcotic painkillers, are being increasingly linked to a rising tide of other problems, among them drug dependency, suicide and fatal accidents — sometimes from the interaction of the drugs themselves. An Army report on suicide released last year documented the problem, saying one-third of the force was on at least one prescription medication.

“Prescription drug use is on the rise,” the report said, noting that medications were involved in one-third of the record 162 suicides by active-duty soldiers in 2009. An additional 101 soldiers died accidentally from the toxic mixing of prescription drugs from 2006 to 2009.

“I’m not a doctor, but there is something inside that tells me the fewer of these things we prescribe, the better off we’ll be,” Gen. Peter W. Chiarelli, the vice chief of staff of the Army who has led efforts on suicide, said in an interview.

Growing awareness of the dangers of overmedicated troops has prompted the Defense Department to improve the monitoring of prescription medications and restrict their use.

In November, the Army issued a new policy on the use of multiple medications that calls for increased training for clinicians, 30-day limits on new prescriptions and comprehensive reviews of cases where patients are receiving four or more drugs.

The Pentagon is also promoting measures to prevent troops from stockpiling medications, a common source of overdoses. For instance, the Navy, which provides medical care for Marines, has begun pill “give back” days on certain bases. At Camp Lejeune, N.C., 22,000 expired pills were returned in December.

The Army and the Navy are also offering more treatments without drugs, including acupuncture and yoga. And they have tried to expand talk therapy programs — one of which, exposure therapy, is considered by some experts to be the only proven treatment for P.T.S.D. But shortages of mental health professionals have hampered those efforts.

Still, given the depth of the medical problems facing combat veterans, as well as the medical system’s heavy reliance on drugs, few experts expect the widespread use of multiple medications to decline significantly anytime soon.

The New York Times reviewed in detail the cases of three service members who died from what coroners said were toxic interactions of prescription drugs. All were classified accidents, not suicides.

Airman Mena was part of a military police unit that conducted combat patrols alongside Army units in downtown Baghdad. He cleaned up the remains of suicide bombing victims and was nearly killed by a bomb himself, his records show.

Gunnery Sgt. Christopher Bachus had spent virtually his entire adult life in the Marine Corps, deploying to the Middle East in 1991, Iraq during the invasion of 2003 and, for a short tour, Afghanistan in 2005. He suffered from what doctors called survivor’s guilt and came back “like a ghost,” said his brother, Jerry, of Westerville, Ohio.

Cpl. Nicholas Endicott joined the Marines in 2003 after working as a coal miner in West Virginia. He deployed twice to Iraq and once to Afghanistan, where he saw heavy combat. On one mission, Corporal Endicott was blown more than eight feet in the air by a roadside bomb, medical records show. He came home plagued by nightmares and flashbacks and rarely left the house.

Given the complexity of drug interactions, it is difficult to know precisely what killed the three men, and the Pentagon declined to discuss their cases, citing confidentiality. But there were important similarities to their stories.

All the men had been deployed multiple times and eventually received diagnoses of P.T.S.D. All had five or more medications in their systems when they died, including opiate painkillers and mood-altering psychiatric drugs, but not alcohol. All had switched drugs repeatedly, hoping for better results that never arrived.

All died in their sleep.

Read the rest of the article here: http://www.nytimes.com/2011/02/13/us/13drugs.html?_r=1&pagewanted=all

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