Posts Tagged ‘CHADD’

Big Pharma’s newest invention: Adult ADHD

Monday, October 1st, 2012

Who belongs to this untapped market? You do, of course

Salon Magazine, October 1, 2012

by By and , Alternet

It is no accident so many have drunk the ADHD Kool-Aid. Big Pharma has funded several patient front groups to sell the disease of ADHD without people knowing they are being sold.

“Immature adult market continues to offer greatest commercial potential,” read a 2008 press release to the pharmaceutical industry from the market research agency Datamonitor: “Estimated to be twice the size of the pediatric ADHD population, the highly prevalent, yet largely untapped, adult ADHD population continues to represent an attractive niche to target.”

So who might consider themselves part of this “untapped” market?

Like astrology in which anyone relates to Scorpio’s horoscope, almost everyone who takes an adult ADHD quiz will discover they are “sick.” To qualify as having attention deficit/hyperactivity disorder according to the most recent draft of the American Psychiatric Association’s DSM-5, soon to be published, you need to suffer from six or more of the following symptoms for at least six months.

  1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
  2. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or reading lengthy writings).
  3. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked;  fails to finish schoolwork, household chores, or tasks in the workplace).
  5. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized, work; poor time management; tends to fail to meet deadlines).
  6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, or reviewing lengthy papers).
  7. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, or mobile telephones).
  8. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
  9. Is often forgetful in daily activities (e.g., chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

Who doesn’t have six of those characterizations? And who doesn’t have a neighbor or an in-law who has all of them?

Although some people who are sufferers claim great improvements with ADHD drugs, the broad criteria and aggressive marketing from drug companies leave open the possibility that many more people will become medicated who really don’t need to.

Big Pharma is cashing in no doubt, but at what cost?

Big Pharma has funded several patient front groups to sell the disease of ADHD without people knowing they are being sold such as Children & Adults with Attention Deficit Disorder (CHADD)

Even people who say they or their children are sufferers can’t ignore the lucrative ADHD franchise Big Pharma has built off the disease. Examples of prices on ADHD drugs, for 100 pills at a middle dose at DrugStore.com in May 2011 were: Adderall $410, Adderall XR $791, Vyvanse $588, Intuniv $579, Ritalin $140, Ritalin SR $286, Ritalin LA $502, Concerta $651, Desoxyn $539, Dexedrine $741, and Strattera $635. The cost of one box of Daytrana 9-hour 20mg patches was $182.

It is no accident so many have drunk the ADHD Kool-Aid (one ADHD drug is actually a grape syrup marketed with the slogan “Give ‘em the Grape”). Big Pharma has funded several patient front groups to sell the disease of ADHD without people knowing they are being sold.

One astroturf group known as CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) received a total of $1,205,000, from Eli Lilly, Johnson & Johnson’s McNeil division, Novartis, Shire US and UCB during the 2007/2008 fiscal year–all ADHD drug manufacturers. (Eli Lilly makes Strattera; Johnson & Johnson makes Concerta; Novartis makes Ritalin and Focalin; Shire makes Adderall, Vyvanse, the Daytrana patch and Intuniv; and UCB makes Metadate CD.)

The next year it did almost as well–raking in $1,174,626, from Lilly, J&J’s McNeil division, Novartis and Shire according to its filing. There was even a little pork left over! Although the group listed its most significant activity that year as providing “support for individuals with Attention Deficit/Hyperactivity Disorders,” it also spent $330,000 on its annual conference and $114,950 on a 20th anniversary gala that year. Compensation for its then CEO, E Clarke Ross, was $187,747 and the next two highest paid officials earned $130,217 and $121,095.  Nice “non-profit” work if you can get it.

CHADD’s communications department produces the bimonthly magazine Attention, which has plenty of advertising space and is disseminated to CHADD members and “over 40,000 doctors’ offices.” Its list of Officers and Board of Directors for 2009-2010 includes psychiatrist Suzanne Vogel-Scibilia, whose credentials include being “a consultant for psychopharmacology projects at the National Institute of Mental Health,” but who is also a past president of themother of all patient front groups, the National Alliance on Mental Illness (NAMI.. Former CHADD CEO Ross also treads the primrose path between government and industry, working at NAMI and for the National Association of State Mental Health Program Directors.

In 2010, CHADD was lobbying for recognition of adult ADHD with the Social Security Administration and “the inclusion of AD/HD and other neurobiological disorders in the definitions/eligibility categories for government benefits programs such as SSI, SSDI, Medicaid, developmental disability, and vocational rehabilitation programs.” Hey, someone’s got to pay the outrageous $791 Adderall XR bill, why not taxpayers?

Apparently the ADHD adults might need cash payments as well. According to CHADD’s Leadership Blog, the group told a Social Security Administration advisory panel that: “A subset of adults with AD/HD is unable to be gainfully employed because of the chronic, substantial inattention and executive functioning challenges caused by the disorder.”

CHADD asked the SSA to recognize adult ADHD as “a disability that can inhibit the ability to work, and to ensure that reasonable job accommodations and supports are available for individuals who cannot engage in substantial and meaningful employment without them.”

Another ADHD front group called the Attention Deficit Disorder Association (ADDA), promotes itself as “the world’s leading adult ADHD organization.” Its president, Evelyn Polk-Green, says she has ADHD and both her kids have been diagnosed with it. She is also a paid speaker and consultant for J&J subsidiary, McNeil Pediatrics.

In 2009, McNeil sponsored a Facebook page to stimulate sales called “ADHD Allies: A Place for Adults with ADHD,” which listed Polk-Green as an Allies “Leader.” The Facebook page, which expired in August, mentioned no ADHD drugs but provided a link to an online ADHD self-assessment questionnaire, advising people to, “Take this test and discuss your answers with your healthcare professional.”

Madison Avenue Helps Sell ADHD

There is another way to sell the disease of adult ADHD and the costly drugs that treat it — screening. Just as Big Pharma seeks to screen kids for “mental problems,” expectant mothers for “depression” and teens for “bipolar,” it now screens for adult ADHD.

In 2009, Shire launched a Nationwide Adult ADHD Mobile Awareness Tour, which included a “mobile screening initiative” called the RoADHD Trip. The caravan, anchored by “the RoADHD Trip Tractor Trailer” which turned into a tented area with eight “self-screening stations,” traveled the country, visiting major cities such as Chicago, Indianapolis and Dallas. In each city, Shire said it was partnering with the Attention Deficit Disorder Association, “a leading adult ADHD patient advocacy organization, in an effort to assist up to 20,000 adults to self-screen for this disorder.”

And there was a doctor component, too. A “field-based team of experienced psychiatric nurses” would “provide in-office education to physicians and their staff on ADHD in adults,” promised Shire.

If you weren’t in one of the cities on the RoADHD trip, you did not have to miss out. J&J’s McNeil came up with a similarly edgy mass marketing scheme for Concerta the same year in New York City. “Pedestrians mulling around Times Square in New York City can learn more about ADHD by responding to an advertisement on the CBS jumbotron, via text message,” reported an article in Medical Marketing & Media.

The 15-second ad (no attention problems there) read “Can’t focus? Can’t sit still? Could you or your child have ADHD?” and ran on a 26×20-foot screen four times an hour. When pedestrians texted “ADHD” to a certain number, they “received a near-instantaneous text message in return containing a link to the ‘Concerta Mobile Web Experience,’ a branded mobile-optimized platform for McNeil’s ADHD drug,’” reported the article.

And wait, there was more. Visitors to the McNeil Web site got a coupon for a 30-day free trial of Concerta.

Disease-Mongering

What is the harm in advertising the “disease” of adult ADHD? Since there is no blood or other diagnostic test to confirm it and quizzes are just guesswork, the category easily grows with advertising, a phenomenon called disease-mongering. You have it when a clinician says you have it–which is just fine with Big Pharma.

Nor will you will ever know if you have adult ADHD (assuming it exists) because the ADHD drugs–Adderall, Vyvanse, Intuniv, Ritalin, Concerta, Desoxyn, Dexedrine, Strattera, Provigil, Nuvigil and the Daytrana patch–”work” the same on everyone.

Are you “treating your ADHD” or just doing what truck drivers, factory workers, athletes, students, people working two jobs, anyone not getting enough sleep and party animals have done for over 50 years? Using speed–a drug so pleasurable, meth dealers often say, “first taste free.” You’ll never know, but now that the pusher is Big Pharma, you are a patient, not a recreational drug user or worse.

An April 26, 2010 segment of “60 Minutes” reported on a survey of nearly 2,000 students at the University of Kentucky in Lexington, that found 34 percent of undergraduates had taken ADHD drugs without a prescription, with the number climbing the longer students were in school. Fifty to 60 percent of juniors and seniors were taking them, Alan DeSantis, a communications professor at the University of Kentucky who was shocked at the drugs’ popularity on campus, told Katie Couric.

Nor are students the only eager users. “60 Minutes” reported that in 2009 there were more than two million prescriptions written for Provigil, a stimulant first developed to treat the symptoms of the rare sleep disorder narcolepsy but now used by truck drivers on long hauls, doctors working around the clock and even fighter pilots on extended combat missions, approved by the Air Force.

This is not the first time the U.S. has threatened to become a nation of “legal speed freaks” noted pediatrician, Lawrence Diller, author of “Running on Ritalin: Should I Medicate My Child?” in a San Francisco Chronicle oped.

“There have been three previous waves of doctor-prescribed stimulant abuse since World War II, the last being Dexedrine for weight reduction in the 1970s,” Diller wrote. “In every previous case, American society, through Congressional hearings and state laws, decided that the overall harm of prescription stimulants to the society was greater than the good they provided.”

But it is the first time stimulants were sold on billboards in Times Square for an adult ADHD “market” of an estimated nine million people.

http://www.salon.com/2012/10/01/big_pharmas_newest_invention_adult_adhd/

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Harvard Expert Ties Mental Illness “Epidemic” to Big Pharma’s Agenda

Friday, July 29th, 2011

Minyanville
By Minyanville Staff
July 28, 2011

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

For any mental illness or passing mood swing that may trouble a person, the Diagnostic and Statistical Manual of Mental Disorders — better known as the DSM — has a label and a code. Recurring bad dreams? That may be a Nightmare Disorder, or 307.47. Narcolepsy uses the same digits in a different order: 347.00. Fancy feather ticklers? That sounds like Fetishism, or 302.81. Then there’s the ultimate catch-all for vague sadness or uneasiness, General Anxiety Disorder, or 300.02. That’s a label almost everyone can lay claim to.

These codes are used by doctors, psychologists, and regulators to maintain a mutual language; it’s a handy shorthand system for bureaucratic purposes. But over the past few decades, the staggering, ever-expanding influence of the ever-expanding DSM, which is published by the American Psychiatric Association, has also played a lead role in building wealth and off-label product uses for the major drug manufacturers. In an insightful essay in this week’s New York Review of Books, Marcia Angell, a senior lecturer in social medicine at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine, explains how.

The medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported."

Angell’s essay is based on a review of three current books examining the psychiatric industry: The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker, and Unhinged: The Trouble with Psychiatry–A Doctor’s Revelations About a Profession in Crisis, by Daniel Carlat. She also cites the DSM-IV, the most recent edition of the manual, while her review traces big pharma’s role in our current mental disorder epidemic to the DSM-III, published in 1980.

To begin, Angell describes the psychiatric profession’s backlash against a developing perception in the 1960s and 1970s that the practice was a “soft” almost pseudo science:

In the late 1970s, the psychiatric profession struck back–hard. As Robert Whitaker tells it in Anatomy of an Epidemic, the medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported,” and he launched an all-out media and public relations campaign to do exactly that. Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible.

Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

These efforts to enhance the status of psychiatry were undertaken deliberately. The APA was then working on the third edition of the DSM, which provides diagnostic criteria for all mental disorders. The president of the APA had appointed Robert Spitzer, a much-admired professor of psychiatry at Columbia University, to head the task force overseeing the project. The first two editions, published in 1952 and 1968, reflected the Freudian view of mental illness and were little known outside the profession. Spitzer set out to make the DSM-III something quite different. He promised that it would be “a defense of the medical model as applied to psychiatric problems,” and the president of the APA in 1977, Jack Weinberg, said it would “clarify to anyone who may be in doubt that we regard psychiatry as a specialty of medicine.”

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

Despite its lack of citations, that DSM named 265 disorders doctors were meant to identify by matching (or mostly matching) a list of symptoms in the book with symptoms described by a patient. The drug companies were quick to see this radical shift in psychiatry as an opportunity. From the 1980s until now, as Angell demonstrates, the drug makers have supported the move away from talk therapy to the drug therapy, which also benefits practitioners, since doling out drugs and tweaking prescriptions earns a psychiatrist more money for less time spent with a patient.

Here Angell explains how companies influence the DSM itself. The bold typeface is ours.

Drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers. Called “key opinion leaders” (KOLs) by the industry, these are the people who through their writing and teaching influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them. Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), almost all of whom would be described as KOLs, ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

The drug industry, of course, supports other specialists and professional societies, too, but Carlat asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness—no lab data or MRI findings—and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.

Eli Lilly gave $551,000 to NAMI

In addition to the money spent on the psychiatric profession directly, drug companies heavily support many related patient advocacy groups and educational organizations. Whitaker writes that in the first quarter of 2009 alone, “Eli Lilly gave $551,000 to NAMI [National Alliance on Mental Illness] and its local chapters, $465,000 to the National Mental Health Association, $130,000 to CHADD (an ADHD [attention deficit/hyperactivity disorder] patient-advocacy group), and $69,250 to the American Foundation for Suicide Prevention.”

And that’s just one company in three months; one can imagine what the yearly total would be from all companies that make psychoactive drugs. These groups ostensibly exist to raise public awareness of psychiatric disorders, but they also have the effect of promoting the use of psychoactive drugs and influencing insurers to cover them. Whitaker summarizes the growth of industry influence after the publication of the DSM-III as follows:

“In short, a powerful quartet of voices came together during the 1980’s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH [National Institute of Mental Health] put the government’s stamp of approval on the story. NAMI provided a moral authority.”

And now here we are in 2011, with almost everyone we know taking two or three different mood disorder drugs. (This trend is not limited to mental disorder, mind you. See Disease Branding.)

Work started on the DSM-V in 1999, which is due out in 2013. It will contain many new disorders, such as “binge eating” and “restless leg disorder.” It will also expand existing categories by tacking on words like “spectrum” to the end of a known disorder, Angell reports. “It looks as though it will be harder and harder to be normal,” she writes.

But the curtain gets pulled back further still.

In her review of Daniel Carlat’s book, Angell calls attention to the “disillusioned insider’s” frank admission that when he prescribes a drug, his decision process is largely guesswork. Carlat’s view is that although any psychiatrist will acknowledge that he or she has had great success with mental disorder drugs for say, depression or anxiety, no doctor can say with certainty whether the drugs are working or if a placebo effect has taken effect.

[Carlat's] work consists of asking patients a series of questions about their symptoms to see whether they match up with any of the disorders in the DSM. This matching exercise, he writes, provides “the illusion that we understand our patients when all we are doing is assigning them labels.” Often patients meet criteria for more than one diagnosis, because there is overlap in symptoms. For example, difficulty concentrating is a criterion for more than one disorder. One of Carlat’s patients ended up with seven separate diagnoses. “We target discrete symptoms with treatments, and other drugs are piled on top to treat side effects.” A typical patient, he says, might be taking Celexa for depression, Ativan for anxiety, Ambien for insomnia, Provigil for fatigue (a side effect of Celexa), and Viagra for impotence (another side effect of Celexa).

As for the medications themselves, Carlat writes that “there are only a handful of umbrella categories of psychotropic drugs,” within which the drugs are not very different from one another. He doesn’t believe there is much basis for choosing among them. “To a remarkable degree, our choice of medications is subjective, even random. Perhaps your psychiatrist is in a Lexapro mood this morning, because he was just visited by an attractive Lexapro drug rep.”

Messy. And, of course, the whole system is now being exported to China and other countries where the middle class is growing and the mental health industry is still in a developing stage.

Angell’s latest book is The Truth About the Drug Companies: How They Deceive Us and What to Do About It.

Read the rest of her essay, which examines the controversial use of brain chemistry drugs to treat children, here.

http://www.minyanville.com/dailyfeed/2011/07/25/harvard-expert-links-our-mental/

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The Illusions of Psychiatry

Monday, June 20th, 2011

New York Review of Books  – From the July 14, 2011 issue

by Marcia Angell

United Artists/Photofest Lan Fendors, Louise Fletcher, and Jack Nicholson in One Flew Over the Cuckoo's Nest, 1975

In my article in the last issue, I focused mainly on the recent books by psychologist Irving Kirsch and journalist Robert Whitaker, and what they tell us about the epidemic of mental illness and the drugs used to treat it.1 Here I discuss the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)—often referred to as the bible of psychiatry, and now heading for its fifth edition—and its extraordinary influence within American society. I also examine Unhinged, the recent book by Daniel Carlat, a psychiatrist, who provides a disillusioned insider’s view of the psychiatric profession. And I discuss the widespread use of psychoactive drugs in children, and the baleful influence of the pharmaceutical industry on the practice of psychiatry.

One of the leaders of modern psychiatry, Leon Eisenberg, a professor at Johns Hopkins and then Harvard Medical School, who was among the first to study the effects of stimulants on attention deficit disorder in children, wrote that American psychiatry in the late twentieth century moved from a state of “brainlessness” to one of “mindlessness.”2 By that he meant that before psychoactive drugs (drugs that affect the mental state) were introduced, the profession had little interest in neurotransmitters or any other aspect of the physical brain. Instead, it subscribed to the Freudian view that mental illness had its roots in unconscious conflicts, usually originating in childhood, that affected the mind as though it were separate from the brain.

But with the introduction of psychoactive drugs in the 1950s, and sharply accelerating in the 1980s, the focus shifted to the brain. Psychiatrists began to refer to themselves as psychopharmacologists, and they had less and less interest in exploring the life stories of their patients. Their main concern was to eliminate or reduce symptoms by treating sufferers with drugs that would alter brain function. An early advocate of this biological model of mental illness, Eisenberg in his later years became an outspoken critic of what he saw as the indiscriminate use of psychoactive drugs, driven largely by the machinations of the pharmaceutical industry.

When psychoactive drugs were first introduced, there was a brief period of optimism in the psychiatric profession, but by the 1970s, optimism gave way to a sense of threat. Serious side effects of the drugs were becoming apparent, and an antipsychiatry movement had taken root, as exemplified by the writings of Thomas Szasz and the movie One Flew Over the Cuckoo’s Nest. There was also growing competition for patients from psychologists and social workers. In addition, psychiatrists were plagued by internal divisions: some embraced the new biological model, some still clung to the Freudian model, and a few saw mental illness as an essentially sane response to an insane world. Moreover, within the larger medical profession, psychiatrists were regarded as something like poor relations; even with their new drugs, they were seen as less scientific than other specialists, and their income was generally lower.

In the late 1970s, the psychiatric profession struck back—hard. As Robert Whitaker tells it in Anatomy of an Epidemic, the medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported,” and he launched an all-out media and public relations campaign to do exactly that. Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible.

These efforts to enhance the status of psychiatry were undertaken deliberately. The APA was then working on the third edition of the DSM, which provides diagnostic criteria for all mental disorders. The president of the APA had appointed Robert Spitzer, a much-admired professor of psychiatry at Columbia University, to head the task force overseeing the project. The first two editions, published in 1952 and 1968, reflected the Freudian view of mental illness and were little known outside the profession. Spitzer set out to make the DSM-III something quite different. He promised that it would be “a defense of the medical model as applied to psychiatric problems,” and the president of the APA in 1977, Jack Weinberg, said it would “clarify to anyone who may be in doubt that we regard psychiatry as a specialty of medicine.”

When Spitzer’s DSM-III was published in 1980, it contained 265 diagnoses (up from 182 in the previous edition), and it came into nearly universal use, not only by psychiatrists, but by insurance companies, hospitals, courts, prisons, schools, researchers, government agencies, and the rest of the medical profession. Its main goal was to bring consistency (usually referred to as “reliability”) to psychiatric diagnosis, that is, to ensure that psychiatrists who saw the same patient would agree on the diagnosis. To do that, each diagnosis was defined by a list of symptoms, with numerical thresholds. For example, having at least five of nine particular symptoms got you a full-fledged diagnosis of a major depressive episode within the broad category of “mood disorders.” But there was another goal—to justify the use of psychoactive drugs. The president of the APA last year, Carol Bernstein, in effect acknowledged that. “It became necessary in the 1970s,” she wrote, “to facilitate diagnostic agreement among clinicians, scientists, and regulatory authorities given the need to match patients with newly emerging pharmacologic treatments.”3

The DSM-III was almost certainly more “reliable” than the earlier versions, but reliability is not the same thing as validity. Reliability, as I have noted, is used to mean consistency; validity refers to correctness or soundness. If nearly all physicians agreed that freckles were a sign of cancer, the diagnosis would be “reliable,” but not valid. The problem with the DSM is that in all of its editions, it has simply reflected the opinions of its writers, and in the case of the DSM-III mainly of Spitzer himself, who has been justly called one of the most influential psychiatrists of the twentieth century.4 In his words, he “picked everybody that [he] was comfortable with” to serve with him on the fifteen-member task force, and there were complaints that he called too few meetings and generally ran the process in a haphazard but high-handed manner. Spitzer said in a 1989 interview, “I could just get my way by sweet talking and whatnot.” In a 1984 article entitled “The Disadvantages of DSM-III Outweigh Its Advantages,” George Vaillant, a professor of psychiatry at Harvard Medical School, wrote that the DSM-III represented “a bold series of choices based on guess, taste, prejudice, and hope,” which seems to be a fair description.

Not only did the DSM become the bible of psychiatry, but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions. That is an astonishing omission, because in all medical publications, whether journal articles or textbooks, statements of fact are supposed to be supported by citations of published scientific studies. (There are four separate “sourcebooks” for the current edition of the DSM that present the rationale for some decisions, along with references, but that is not the same thing as specific references.) It may be of much interest for a group of experts to get together and offer their opinions, but unless these opinions can be buttressed by evidence, they do not warrant the extraordinary deference shown to the DSM. The DSM-III was supplanted by the DSM-III-R in 1987, the DSM-IV in 1994, and the current version, the DSM-IV-TR (text revised) in 2000, which contains 365 diagnoses. “With each subsequent edition,” writes Daniel Carlat in his absorbing book, “the number of diagnostic categories multiplied, and the books became larger and more expensive. Each became a best seller for the APA, and DSM is now one of the major sources of income for the organization.” The DSM-IV sold over a million copies.

As psychiatry became a drug-intensive specialty, the pharmaceutical industry was quick to see the advantages of forming an alliance with the psychiatric profession. Drug companies began to lavish attention and largesse on psychiatrists, both individually and collectively, directly and indirectly. They showered gifts and free samples on practicing psychiatrists, hired them as consultants and speakers, bought them meals, helped pay for them to attend conferences, and supplied them with “educational” materials. When Minnesota and Vermont implemented “sunshine laws” that require drug companies to report all payments to doctors, psychiatrists were found to receive more money than physicians in any other specialty. The pharmaceutical industry also subsidizes meetings of the APA and other psychiatric conferences. About a fifth of APA funding now comes from drug companies.

Drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers. Called “key opinion leaders” (KOLs) by the industry, these are the people who through their writing and teaching influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them. Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), almost all of whom would be described as KOLs, ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.5

The drug industry, of course, supports other specialists and professional societies, too, but Carlat asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness—no lab data or MRI findings—and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.

In addition to the money spent on the psychiatric profession directly, drug companies heavily support many related patient advocacy groups and educational organizations. Whitaker writes that in the first quarter of 2009 alone,

Eli Lilly gave $551,000 to NAMI [National Alliance on Mental Illness] and its local chapters, $465,000 to the National Mental Health Association, $130,000 to CHADD (an ADHD [attention deficit/hyperactivity disorder] patient-advocacy group), and $69,250 to the American Foundation for Suicide Prevention.

And that’s just one company in three months; one can imagine what the yearly total would be from all companies that make psychoactive drugs. These groups ostensibly exist to raise public awareness of psychiatric disorders, but they also have the effect of promoting the use of psychoactive drugs and influencing insurers to cover them. Whitaker summarizes the growth of industry influence after the publication of the DSM-III as follows:

In short, a powerful quartet of voices came together during the 1980’s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH [National Institute of Mental Health] put the government’s stamp of approval on the story. NAMI provided a moral authority.

Read the rest of the article here: http://www.nybooks.com/articles/archives/2011/jul/14/illusions-of-psychiatry/

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Campaign to “Stop the Stigma” of Mental Illness—Is a Pharmaceutical Marketing Campaign

Monday, December 20th, 2010

The Citizens Commission on Human Rights, (CCHR) has launched a new video to expose the hypocracy of the pharmaceutically driven campaign to “Stop the Stigma” of mental illness.    With its seemingly altruistic sounding agenda to eliminate “stigma”  the fact is the real  “stigmatization” is coming from those behind this campaign—pharma, psychiatry and pharma-funded front groups such as  NAMI and CHADD to name but a few.    There are currently 20 million kids & adolescents labeled with mental “disorders” that are based solely on a checklist of behaviors, no brain scans, x-rays, genetic or blood tests can prove they are “mentally ill”,  yet they are being stigmatized with psychiatric labels, which will be part of their permanent medical record,  and prescribed dangerous, life-threatening psychiatric drugs.

Child drugging is a $4.8 billion-a-year industry, and the industry knows where to put its funding to get the most bang for its buck.    For example, take NAMI’s campaign to stop the “stigma” and “end discrimination” against the mentally ill—the “Founding Sponsors” were Abbott Labs, Bristol-Myers Squibb, Eli Lilly, Janssen, Pfizer, Novartis, SmithKline Beecham and Wyeth-Ayerst Labs. (For an in-depth look at what else Pharma funds and how this funding not only helps set mental health policies but campaigns such as this, read Pharmaceutical Industry Agenda Setting in Mental Health Policies at the bottom of this post)

The real stigmatization is coming from those that benefit from labeling behaviors as diseases to be “cured” or “treated” despite the complete lack of  medical/biological evidence to support them.  George Orwell coined the term Doublespeak, meaning words redefined to mislead, distort and disguise, and no better example exists than psychiatry’s pathologizing and redefining behaviors into mental “illness”.      For example,  If an adolescent is strong willed,  this is redefined as  “oppositional defiant disorder.” If a kid acts like a kid,   sometimes losing pencils or toys, or acting “on the go” then this has been pathologized into  “ADHD.” If a teenager has normal adolescent mood swings, then this has been repackaged as “bi-polar disorder.” And shyness?  Doesn’t exist.  It is now called  “social anxiety disorder.” Moreover, once labeled, these kids are stigmatized for life.

Psychiatric labels are the stigma.

Various canned press releases and “studies” circulated by the Psycho/Pharmaceutical industry profess,  “more people now believe that illnesses like schizophrenia and depression are caused by chemical imbalances in the brain.”  This is marketing at its best—say people believe in a chemical imbalance so you don’t have to bother pointing out the fact that there is no chemical imbalance .  How can the layperson be sure of this? It’s simple. Find one person who has a lab test showing their chemical imbalance.  Not one of the millions of people taking drugs to cure their “chemical imbalance” has a lab test showing they have an imbalance.

So when it comes to “stigmatization” one need look no further than those who benefit from labels which are simply based on opinion—not science, and not medicine. Now it really doesn’t take a rocket scientist to figure that out… does it?

Watch video: Psychiatry—Stigmatizing Kids with Bogus ‘Mental Disorders’ http://www.youtube.com/watch?v=Wv49RFo1ckQ

For more information  about pharmaceutical front groups see this:  http://www.cchrint.org/psycho-pharmaceutical-front-groups/

For an in-depth look at this topic, read Pharmaceutical Industry Agenda Setting in Mental Health Policies

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Stop the Stigma of Mental Illness? Try Stopping the Pharma Funded Campaigns & Groups Behind the “Stigmatizing”

Friday, September 17th, 2010

(Image taken from: http://herinst.org/sbeder/corppower/pharm-agenda.html)

by CCHR Int

A new study, the result of a joint collaboration between Indiana University and Columbia University, and published  by the American Journal of Psychiatry, reports that prejudice and discrimination still exists among people with serious mental illness.  Headlines include “Mental Illness Stigma Hard to Shake, Survey Finds” and “Despite Deeper Understanding of Mental Illness, Stigma Lingers.”

So what exactly is behind this study? Taking aside the fact that Columbia University is well known for its collaboration with pharmaceutical companies, its medical center having collaborated with AstraZeneca, GlaxoSmithKline, Janssen Pharmaceutica, Merck, Novartis and Pfizer. Or the fact that Indiana University received a $1 million grant from Eli Lilly.

With a seemingly altruistic agenda, the fact is the campaign to end the “stigma” of mental illness is one driven and funded by those who benefit from more and more people being labeled mentally ill—pharma, psychiatry and pharmaceutical front groups such as  NAMI and CHADD to name but a few.   For example, take NAMI’s campaign to stop the “stigma” and “end discrimination” against the mentally ill—the “Founding Sponsors” were Abbott Labs, Bristol-Myers Squibb, Eli Lilly, Janssen, Pfizer, Novartis, SmithKline Beecham and Wyeth-Ayerst Labs. (For an in-depth look at what else Pharma funds and how this funding not only helps set mental health policies but campaigns such as this, read Pharmaceutical Industry Agenda Setting in Mental Health Policies at the bottom of this post)

The fact is that the  “stigmatization ” is coming from those that benefit from people being labeled/stigmatized with mental disorders that have no medical/biological evidence. Case in point, if you are rebellious, you are “stigmatized” with the label “oppositional defiant disorder.” If your kid acts like a kid he is “stigmatized” with the label “ADHD.” If you are sad, unhappy (even temporarily) you are “stigmatized” with the label “depressive” or “bi-polar disorder.” If you are shy you are “stigmatized” with the label “social anxiety disorder.” Moreover, you or your child are now stigmatized for life as this label, which is based solely on opinion, is now part of your medical record, despite the fact there is no medical evidence to prove you are “mentally ill”.

This is also true of people diagnosed “schizophrenic.” There is no medical test to verify someone has a brain abnormality or medical condition of schizophrenia. And while no one claims  people can’t become psychotic, the fact remains there is no biological evidence to support schizophrenia as a brain disease or chemical abnormality.  And consider this, if people do become psychotic, or irrational,  is it in fact caused by some  underlying medical (not psychiatric) problem?   And why did a 15-year multiple follow up study find that there was a 40% recovery rate for those diagnosed schizophrenic who did not take antipsychotics, versus a 5% rate for those who did?  What happened to their supposed “brain disease?” Did it simply vanish?  Moreover, if they could recover from such a mental state, do they deserve the “stigma” of “schizophrenia” still being part of their permanent medical record?  For life?   Think about it.  Imagine you were extremely overweight—obese.  You lose all the weight so you are no longer obese.  Yet your medical records continue to say that you are.

And if schizophrenia is in fact a “disease” despite the fact there is no medical or biological evidence (note we did not say speculation, or theories, but evidence) then why is it that psychiatrist Loren Mosher, the former Chief of Schizophrenia Research for the National Institute of Mental Health (NIMH) openly state that there is no biological condition of schizophrenia as a disease or brain malfunction? And why didn’t the mental health industry take advantage of his 2-year-outcome studies proving that those diagnosed schizophrenic could recover without the use of drugs? Is it because this proved that recovery was possible and thereby disproved the theory that something was wrong with their brain? Or was it the fact that they recovered without the use of drugs, thereby threatening a multi-billion dollar pharmaceutical industry?  Maybe this explains why Mosher was fired from his position at NIMH (http://www.moshersoteria.com/)

As a final note regarding “stigmatization,” keep in mind that psychiatrists admit there is no recovery from “mental illness.” They admit no cures. So once you are labeled—game over.

The new “study” also reports, ” more people now believe that illnesses like schizophrenia and depression are caused by chemical imbalances in the brain.”  This is marketing at its best—say people believe in a chemical imbalance so you don’t have to bother pointing out the fact that there is no chemical imbalance .  How can the layperson be sure of this? It’s simple. Find one person who has a lab test showing their chemical imbalance.  Not one of the millions of people taking drugs to cure their “chemical imbalance” has a lab test showing they have an imbalance.  Now it really doesn’t take a rocket scientist to figure that out… does it?

For more information  about pharmaceutical front groups see this:  http://www.cchrint.org/psycho-pharmaceutical-front-groups/

For an in-depth look at this topic, read Pharmaceutical Industry Agenda Setting in Mental Health Policies


Abstract: The development of political agenda-setting through the use of sophisticated public relations techniques is threatening to undermine the delicate balance of representative democracy. This has important ramifications for policies aimed at providing mental health services and the implementation of mental health laws. The principal agenda setters in this area are pharmaceutical companies with commercial reasons to promote public policies that expand the sales of their products. They have manufactured highly effective advocacy coalitions that incorporate front groups in order to set the policy agenda for mental health. However, policies tailored to their commercial purpose are not necessarily beneficial either for patients or the society at large.



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Behind the Psychopharmaceutical Industrial Complex; Pharma-funded front groups masquerading as “patient advocates”

Tuesday, June 22nd, 2010

Scoop Independent News
By Evelyn Pringle
June 22, 2010

Non-Profit Advocacy Groups

As a main component of the Psychopharmaceutical Industrial Complex, the so-called “patient advocacy” organizations have become the leading force behind the American epidemic of mental illness over the past two decades.

Drug makers, and their foundations, funnel millions of dollars to these non-profits every year. In return, the leaders recruit their members as foot soldiers to carry out the latest marketing campaigns and to provide a fire-wall so that no money trail can be tracked back to the drug companies.

Gigantic Pyramid

The psychiatric front groups form a gigantic pyramid and once pharmaceutical money enters the system through a major organization, it gets channeled into a huge spider-web that weaves through many groups, making it nearly impossible to keep track of where it came from or where it all went. Often, when the grant reports of the drug companies list a large donation to one organization, the annual reports of the other groups will show smaller gifts from that same organization.

The “charity” groups are exempt from income tax and the “contributions” funneled through them are tax deductible. The money is used for disease mongering campaigns to both market disorders and pressure public health care programs and private insurers to pay for expensive treatments.

“Presenting themselves as patient advocacy groups is highly disingenuous not only to their membership, many of which may have a sincere desire to help a loved one or a family member with mental problems, but to legislators, the press and the American public — for they have consistently lobbied for legislation that benefits the mental health and pharmaceutical industries which fund them, and not patients they claim to represent,” according to Citizens Commission on Human Rights International, a mental health watchdog group.

In a June 2, 2010, commentary titled, “Psychiatric Fads and Overdiagnosis,” on the Psychology Today website, Dr Allen Frances points out that it “is too bad that there is no advocacy group for normality that could effectively push back against all the forces aligned to expand the reach of mental disorders.”

The leaders of the supposedly “non-profits” earn outrageously high salaries, along with excellent benefit packages, while many of the patients they claim to represent are encouraged to seek federal disability payments of under $700 a month, and apply for public housing, food stamps, and Medicaid, to make ends meet. The top officials will often move from a leadership role in one organization to a higher position in another.

The drug makers rely on the front groups to do their bidding any time profits are threatened. For instance, if the FDA is considering adding a black box warning about a deadly side effect to a drug’s label, which may result in a drop in sales, representatives of front groups will show up at the FDA advisory panel hearings to testify against adding the warning.

They will also lobby FDA panels whenever there is a chance to increase profits, such as enlarging the drug customer base. In June 2009, the Psychopharmacologic Drugs Advisory Committee was set to meet to evaluate AstraZeneca’s Seroquel, Pfizer’s Geodon and Eli Lilly’s Zyprexa for use with 13 to 17 year-olds diagnosed with schizophrenia, and 10 to 17 year-olds diagnosed with pediatric bipolar disorder.

On June 8, 2009, nine front groups issued a joint statement urging the panel to vote to approve all three drugs for kids. The groups signing the letter included the American Academy of Child and Adolescent Psychiatry, American Foundation for Suicide Prevention, American Psychiatric Association, Child and Adolescent Bipolar Foundation, Children and Adults with Attention-Deficit/Hyperactivity Disorder, Families for Depression Awareness, Mental Health America, National Alliance on Mental Illness, and the National Council for Community Behavioral Healthcare.

Read entire article:  http://www.scoop.co.nz/stories/HL1006/S00162.htm

Also see:  http://www.cchrint.org/psycho-pharmaceutical-front-groups/

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Mandating Mental Health Coverage—a blank check for Psycho/Pharma to get everyone diagnosed mentally ill & drugged

Wednesday, February 3rd, 2010

JBS.org
By Beverly K. Eakman
February 2, 2010

We’ve all heard of “urban sprawl.” But there is another kind of “sprawl” Americans should find more worrisome: legislative sprawl.

Mental health parity is one such example. Government-mandated parity of mental and physical ailments for insurance coverage is a back-door route to nationalized health care. Special interests have been pushing government to implement parity for years and last Friday, January 29, the Obama Administration acquiesced. Health plans will henceforth be required to provide (not merely “offer”) mental-health benefits that contain no zingers, such as separate annual deductibles or lesser rates for psychiatrists and social workers.  Instead, according to Andrew Sperling of the National Alliance on Mental Illness (NAMI), health insurers will be obliged to give the same level of coverage for treatment of emotional angst “as they do for cancer, diabetes and heart disease.” Mental health has morphed into a cottage industry with scores of advocating organizations and lobbyists — NAMI, the American Psychiatric Association, Children and Adults with Attention-Deficit/Hyperactivity Disorders (CHADD), the National Education Association and, of course, pharmaceutical companies. Industry bigwigs have repeatedly insisted that mental-health issues are no different than physical illnesses. The problem is that one cannot verify a mental illness — not with an X-ray, a blood test, a urinalysis or by any other means. Unlike brain injuries, Alzheimer’s and other clear-cut brain impairments due to strokes, high fevers and birth defects, mental illness per se is purely subjective. Perhaps someday researchers will discover issues at the cellular level that definitively cause a certain subset of behaviors, or which exacerbate stress, but at the moment they cannot. So it is no wonder that the various medications and therapies directed at curing, or even alleviating, emotional distress have virtually no track record of success.

Read entire article:  http://www.jbs.org/jbs-news-feed/5917-legislative-sprawl-mandating-mental-health-coverage

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How Vested Interests Created the Perfect Marketing/Lobbying Machine: Mental Health “Advocacy” Groups—Funded by Pharma

Thursday, December 10th, 2009

by CCHR International

An ongoing U.S. Senate investigation headed by Senator Charles Grassley has  sought disclosure of pharmaceutical funding paid to researchers, physicians,  medical schools and medical journals.  Some of the nation’s most prominent psychiatrists have now been exposed for extensive conflicts of interest amounting to millions in undisclosed pharmaceutical funding, including Dr. Charles Nemeroff, Dr. Joseph Biederman, Dr. Melissa DelBello, Dr. Timothy Wilens, Dr. Thomas Spencer, Dr. Alan Schatzberg, Dr. Martin Keller, Dr. A. John Rush, Dr. Karen Wagner, Dr. Jeffrey Bostic and Dr. Frederick Goodwin — many of which serve as advisory board members to mental illness “advocacy groups” which are now also the subject of the Senate investigation for their undisclosed pharmaceutical funding.

The majority of the public may or may not be familiar with these so-called mental health advocacy organizations, such as the National Alliance on Mental Illness (NAMI), Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) or the myriad of bipolar, depression or ADHD “support groups” that are inundating the internet.

But they need to be.

These are groups operating under the guise of advocates for the “mentally ill,” which in reality are heavily funded pharmaceutical front groups – lobbying and working on state and federal laws which effect the entire nation — from our elderly in nursing homes to our military, pregnant women, nursing mothers and school children. Presenting themselves as patient advocacy groups is highly disingenuous not only to their membership, many of which may have a sincere desire to help a loved one or a family member with mental problems, but to legislators, the press and the American public — for they have consistently lobbied for legislation that benefits the mental health and pharmaceutical industries which fund them, and not patients they claim to represent.

Certainly any organization claiming to be for the rights of patients diagnosed mentally ill would have as their primary goal, full informed consent in the field of mental health – including full and complete disclosure of all drug risks, the right to refuse treatment, the right to know that psychiatric diagnoses are not medical conditions (evident by the fact there is not one confirmatory medical/scientific test). Above all such groups would provide patients with an abundance of information on non-harmful, non- drug, medical solutions and options considering the dangerous and well documented risks of psychiatric drugs by international drug regulatory agencies.

These groups do not.

A patients rights group for the mentally ill would never endorse something as absurd and obviously dangerous as giving electroshock to pregnant women, nor condone schools being able to require children to take a psychiatric drug as a condition of attending school. Furthermore, they would never be opposed to the FDA actually doing its job and finally issuing long overdue warnings that antidepressants can cause children to commit suicide, or issue warnings that ADHD drugs have serious and even deadly side effects. Yet these are just some of the actions condoned and promoted by these so-called patients rights groups.

As another example take the federally proposed bill, The Mothers Act; a previous version of this bill called on using a method of “screening” pregnant women and new mothers called EPDS, a screening method documented to triple the number of women diagnosed with Postpartum depression, according to a study published in Obstetrics & Gynecology. The Scandinavian Journal of Public Health stated that EPDS screening was unethical and should not be used. None of the so called advocacy groups for the mentally ill had any objections to this bill whatsoever, or endorsing such an unethical screening tool. They supported it. The bill would have passed with no objections from them whatsoever, if not for the dedication of real advocacy groups with no vested interests (ties to Pharma) opposing language in this bill that would have led to women being falsely diagnosed and put on dangerous psychiatric drugs to “treat” them, unnecessarily placing new mothers and their infants at great risk.

To put it simply, these groups are not what they appear to be. Yet their influence over legislation, lobbying, drug regulation (or lack thereof), and public relations campaigns is substantial and effects the entire nation. For they claim to be the voice of the “mentally ill.” But are they? Or are they the result of a brilliant marketing/lobbying campaign designed to benefit the industry that funds them—the Psycho/Pharmaceutical industry.

To find out how it all started click here: http://www.cchrint.org/psycho-pharmaceutical-front-groups/

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Grassley asks more mental health ‘patients rights’ groups (for ADHD, Bi-Polar, TeenScreen, etc.) to disclose Pharma $$

Tuesday, December 8th, 2009

For several years now, Senator Grassley has conducted extensive oversight and sought disclosure of financial ties with industry from research physicians, medical schools, medical journals, continuing medical education, and the patient advocacy community.   Now Senator Grassley has asked 33 medical groups for information about their financial backing they get from the medical device, insurance and pharmaceutical industries, including several psychiatric front groups such as Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), Depression and Bipolar Support Alliance, Mental Health America, NARSAD, Screening for Mental Health Inc. and the National Center for Mental Checkups at Columbia University (TeenScreen).  Senator Grassley’s previous inquiry into the National Alliance on Mental Illness (NAMI) found that the majority of funding received was from the pharmaceutical industry; more than $28 million from pharmaceutical companies in the last four years.

In just the last two years, Grassley investigated and exposed extensive financial conflicts of interest of prominent psychiatrists with the pharmaceutical industry amounting to millions of dollars including Dr. Charles Nemeroff, Dr. Joseph Biederman, Dr. Melissa DelBello, Dr. Timothy Wilens, Dr. Thomas Spencer, Dr. Alan Schatzberg, Dr. Martin Keller, Dr. A. John Rush, Dr. Karen Wagner, Dr. Jeffrey Bostic and former head of the National Institute of Mental Health, Dr. Frederick Goodwin.  Additionally, Grassley investigated the American Psychiatric Association and the funding they received from the pharmaceutical industry.

For the latest inquiry from Senator Grassley read this article: http://www.iowapolitics.com/index.iml?Article=179090

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