Posts Tagged ‘New England Journal of Medicine’

The Drugging of America

Thursday, September 29th, 2011

The Journal – September 29, 2011

by Barry Evans

The theory that psychological problems are mainly caused by a chemical imbalance in the brain can be traced back 60 years, when French researchers accidentally discovered that Thorazine (chlorpromazine) dramatically improved the emotional behavior of institutionalized mental patients. Within a few years, the anti-psychotic properties of Thorazine and related drugs led to the trend in this country to reintegrate into society people who had previously been confined to mental hospitals (“deinstitutionalization”).

Prozac advertisement

Today, the “chemical imbalance” revolution is almost complete, as one in 10 Americans over the age of 6 take antidepressants. As Marcia Angell, former editor-in-chief of The New England Journal of Medicine, wrote in a controversial two-part essay in The New York Review of Books (June 23 and June 30, 2011), the pharmaceutical solution to psychological disorders has now become the norm, as more and more health professionals accept the theory that mental illness, including depression and anxiety, is essentially caused by a chemical imbalance in the brain.

The wholesale acceptance of this theory, by both the medical profession and the public, came with the introduction of Prozac (fluoxetine) in 1987. While Thorazine was thought to correct a deficiency of dopamine, Prozac was marketed as an SSRI (selective serotonin reuptake inhibitor), designed to compensate for a presumed deficit of the neurotransmitter serotonin. (SSRIs block neurons from re-absorbing serotonin, leaving more of it available to activate adjacent neurons.) Because SSRIs alleviate depression, researchers speculated that depression was caused by too little serotonin in the brain.

Maybe. Or maybe not. Angell argues that by the same logic “one could argue that fevers are caused by too little aspirin.” Perhaps SSRIs do something quite unrelated to neurotransmitters, and depression is unrelated to serotonin levels.

Whether the “chemical imbalance” theory is true or not, the real question is, Do antidepressants work better than placebos? Psychologist Irving Kirsch, one of the authors reviewed by Angell, used the Freedom of Information Act to obtain drug companies’ records of their negative studies from the FDA. Unlike the positive results, negative results are normally not published. (Incredibly to this writer, negative results are considered proprietary and therefore confidential.) Taking both positive and negative results into consideration, Kirsch discovered that six popular drugs — Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor — scored unimpressively when compared with placebos. Yet, as Angell writes, “because the positive studies were extensively publicized, while the negative ones were hidden, the public and the medical profession came to believe that these drugs were highly effective antidepressants.” It gets more surreal. When depressed patients were prescribed drugs such as opiates, sedatives, stimulants and even herbal remedies, Kirsch and others found their symptoms were relieved to about the same degree as with SSRI-type antidepressants.

Angell’s essay was, as I say, controversial. One of the more curious responses, published as an opinion piece in the New York Times on July 9, came from Dr. Peter Kramer, author of the 1993 best-seller Listening to Prozac. This book-length endorsement of the drug (which predicted a Brave New World-style “cosmetic psychopharmacology” future for us all) probably did more than anything else to turn Americans on to SSRIs. In his Times piece, Kramer largely sidestepped the alarming questions posed by Angell and the three books she reviewed. Instead, he focused on the difficulties of distinguishing the effects of placebos from those of real drugs. And as he had done in his book, he relied largely on unconvincing anecdotal evidence to make his case.

What we do know about placebos is that they’re not dangerous. However, even as increasing numbers of adults and children take powerful psychoactive drugs (because more of us are suffering?), researchers still have no clear handle on their potentially damaging long-term effects.

Barry Evans  gets depressed just thinking about antidepressants.

http://www.northcoastjournal.com/outdoors/2011/09/29/drugging-america/

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Are Psychiatric Medications Making Us Sicker?

Monday, September 19th, 2011

The Chronicle of Higher Education – September 18, 2011
by By John Horgan

American psychiatry, in collusion with the pharmaceutical industry, is perpetrating what may be the biggest case of iatrogenesis—harmful medical treatment—in history.Dave Plunkert for The Chronicle Review

Three years ago, I was reminded in dramatic fashion of the chasm between psychiatry and more-effective branches of medicine. My 14-year-old son, Mac, while playing lacrosse, emerged from a collision with his right arm askew. I drove him to a local hospital, where an orthopedic surgeon on duty immediately diagnosed the injury: dislocated elbow. He gave Mac an oral and local anesthetic and put him in a portable X-ray machine that showed Mac’s elbow joint on a screen, in real time. Watching the screen, the doctor quickly snapped Mac’s elbow back into place.

Overcome with gratitude to the doctor, I was leading my groggy son out of the hospital when my cellphone rang. An old friend, whom I’ll call Phil, was on the line. He was in the psychiatric ward of a New York hospital, to which his 16-year-old son had been committed. The boy, who was taking antidepressants for depression, had threatened to commit suicide, not for the first time. Thedoctors were recommending electroconvulsive therapy, or ECT.

Knowing that I had written about shock therapy and other psychiatric treatments, Phil asked my opinion. The fact that Phil had called me, a mere journalist, for advice in such a dire situation spoke volumes about the troubles of modern psychiatry.

I first took a close look at treatments for mental illness 15 years ago while researching an article for Scientific American. At the time, sales of a new class of antidepressants, selective serotonin reuptake inhibitors, or SSRI’s, were booming. The first SSRI, Prozac, had quickly become the most widely prescribed drug in the world. Many psychiatrists, notably Peter D. Kramer, author of the best seller Listening to Prozac, touted SSRI’s as a revolutionary advance in the treatment of mental illness. Prozac, Kramer said in a phrase that I hope now haunts him, could make patients “better than well.”

Clinical trials told a different story. SSRI’s are no more effective than two older classes of antidepressants, tricyclics and monoamine oxidase inhibitors. What was even more surprising to me—given the rave reviews Prozac had received from Kramer and others—was that antidepressants as a whole were not more effective than so-called talking cures, whether cognitive behavioral therapy or even old-fashioned Freudian psychoanalysis. According to some investigators, treatments for depression and other common ailments work—if they do work—by harnessing the placebo effect, the tendency of a patient’s expectation of improvement to become self-fulfilling. I titled my article “Why Freud Isn’t Dead.” Far from defending psychoanalysis, my point was that psychiatry has made disturbingly little progress since the heyday of Freudian theory.

In retrospect, my critique of modern psychiatry was probably too mild. According to Anatomy of an Epidemic (Crown Publishers, 2010), by the journalist Robert Whitaker, psychiatry has not only failed to progress but may now be harming many of those it purports to help. Anatomy of an Epidemic has been ignored by most major media. I learned about it only after Marcia Angell, former editor of The New England Journal of Medicine and now a lecturer on public health at Harvard, reviewed the book in The New York Review of Books in June. If Whitaker is right, American psychiatry, in collusion with the pharmaceutical industry, is perpetrating what may be the biggest case of iatrogenesis—harmful medical treatment—in history.

As recently as the 1950s, Whitaker contends, the four major mental disorders—depression, anxiety disorder, bipolar disorder, and schizophrenia—often manifested as episodic and “self limiting”; that is, most people simply got better over time. Severe, chronic mental illness was viewed as relatively rare. But over the past few decades the proportion of Americans diagnosed with mental illness has skyrocketed. Since 1987, the percentage of the population receiving federal disability payments for mental illness has more than doubled; among children under the age of 18, the percentage has grown by a factor of 35.

Between 1985 and 2008, sales of antidepressants and antipsychotics multiplied almost fiftyfold, to $24.2-billion.

This epidemic has coincided, paradoxically, with a surge in prescriptions for psychiatric drugs. Between 1985 and 2008, sales of antidepressants and antipsychotics multiplied almost fiftyfold, to $24.2-billion. Prescriptions for bipolar disorder and anxiety have also swelled. One in eight Americans, including children and even toddlers, is now taking a psychotropic medication. Whitaker acknowledges that antidepressants and other psychiatric medications often provide short-term relief, which explains why so many physicians and patients believe so fervently in the drugs’ benefits. But over time, Whitaker argues, drugs make many patients sicker than they would have been if they had never been medicated.

Whitaker compiles anecdotal and clinical evidence that when patients stop taking SSRI’s, they often experience depression more severe than what drove them to seek treatment. A multination report by the World Health Organization in 1998 associated long-term antidepressant usage with a higher rather than a lower risk of long-term depression. SSRI’s cause a wide range of side effects, including insomnia, sexual dysfunction, apathy, suicidal impulses, and mania—which may then lead patients to be diagnosed with and treated for bipolar disorder.

Indeed, Whitaker suspects that antidepressants—as well as Ritalin and other stimulants prescribed for attention-deficit disorder—have catalyzed the recent spike in bipolar disorder. Though bipolar disorder was relatively rare just a half-century ago, reported rates of it have increased more than a hundredfold, to one in 40 adults. Side effects attributed to lithium and other common medications for bipolar disorder include deficits in memory, learning ability, and fine-motor skills. Similarly, benzodiazepines such as Valium and Xanax, which are prescribed for anxiety, are addictive; withdrawal from these sedatives can cause effects ranging from insomnia to seizures, as well as panic attacks.

Whitaker’s analysis of treatments for schizophrenia is especially disturbing. Antipsychotics, from Thorazine to successors like Zyprexa, cause weight gain, physical tremors (called tardive dyskinesia) and, according to some studies, cognitive decline and brain shrinkage. Before the introduction of Thorazine in the 1950s, Whitaker asserts, almost two-thirds of the patients hospitalized for an initial episode of schizophrenia were released within a year, and most of this group did not require subsequent hospitalization.

Over the past half-century, the rate of schizophrenia-related disability has grown by a factor of four, and schizophrenia has come to be seen as a largely chronic, degenerative disease. A decades-long study by the World Health Organization found that schizophrenic patients fared better in poor nations, such as Nigeria and India, where antipsychotics are sparingly prescribed, than in wealthier regions such as the United States and Europe.

A long-term study by Martin Harrow, a psychologist at the University of Illinois College of Medicine, found an inverse correlation between medication for schizophrenia and positive, long-term outcomes. Beginning in the 1970s, Harrow tracked a group of 64 newly diagnosed schizophrenics. Forty percent of the nonmedicated patients recovered—meaning that they could become self-supporting—versus 5 percent of those who were medicated. Harrow theorized that those who were heavily medicated were sicker to begin with, but Whitaker suggests that the medications may be making some patients sicker.

Several possible objections to Whitaker’s case against psychiatry come to mind. First of all, as Harrow speculates, over time heavily medicated patients may not fare as well as less-medicated patients because the former truly are sicker. Also, the recent surge in mental disability may stem, at least in part, from a decrease in the stigma associated with mental illness, spurring more people to seek and obtain treatment and government assistance. In her review, Marcia Angell called Whitaker’s book “suggestive, if not conclusive,” which seems right to me. At the very least, Whitaker’s claims warrant further investigation.

Between 1985 and 2008, sales of antidepressants and antipsychotics multiplied almost fiftyfold, to $24.2-billion.

Although Whitaker doesn’t address electroconvulsive therapy, its persistence strikes me as yet another symptom of the weakness of modern psychiatry. It fell out of favor in the 1970s, in part because of its negative portrayal in the 1975 film One Flew Over the Cuckoo’s Nest, and yet about 100,000 Americans a year still receive ECT. Studies suggest that the therapy can provide temporary relief from acute depression, but virtually everyone who receives electroconvulsive therapy relapses within a year without further treatment. Proponents claim that ECT has few significant side effects, but this year an FDA panel ruled that ECT should remain classified as a “high-risk” procedure because it can cause persistent memory loss and other side effects. If SSRI’s and other psychiatric medications were truly effective, ECT would long ago have been tossed into the dustbin of failed psychiatric treatments.

So what happened to Phil’s son? When Phil called me, I told him that if my son were suicidally depressed, I’d resist giving him shock treatment unless doctors convinced me there was absolutely no alternative. Phil decided against ECT, and his son, after being released from the hospital, gradually stopped taking antidepressants too. He still struggles with depression, and he smokes more marijuana than Phil would like. But he is healthy enough to be starting college this fall.

http://chronicle.com/article/Are-Psychiatric-Medications/128976/

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America conned: Psycho pharma drug pushing empire under fire

Tuesday, July 26th, 2011

NaturalNews – July 26, 2011

by Monica G. Young

"psychopharma is looking like an idea whose time has passed."

Is America truly stricken with widespread mental illness? Do tens of millions need mind-altering drugs? A recent flurry of media articles lead readers to a realization that Big Pharma and the “mental health” industry have deceived Americans on a grand scale.

The “New York Review of Books” two-part article by Dr. Marcia Angell, Senior Lecturer at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine, summarizes it extremely well. She analyzes three books by authors Irving Kirsch, Robert Whitaker, and Daniel Carlat. Each deconstructs the apparent mental illness epidemic and theory that mental disorders stem from brain chemical  imbalances which can be corrected by drugs.

Dr. Angell’s review has sparked a host of other journalists to applaud her and fuel the fire. An article in Forbes even concludes, “psychopharma is looking like an idea whose time has passed.”

As an overview:

Ten percent of Americans over age six take antidepressants. Antipsychotic drugs, once reserved for schizophrenics, have become the top-selling class of drugs in the US, with over $14 billion in sales in 2009. ADHD, bipolar and autism diagnoses have exploded in the past two decades with at least 5 million US kids now on psychiatric drugs.  Ten percent of boys take drugs for ADHD. Half a million kids take antipsychotics, including preschoolers.

The chemical imbalance theory rose to fame when Prozac hit the market in 1987, accompanied by massive hype that it corrected a chemical deficiency in the brain. In the years that followed, the number of people prescribed drugs for mental illness skyrocketed. Today, “treatment” for mental disorders is synonymous with psychoactive (mind-altering) drugs.

Tracing the origin of this theory shows it wasn’t that chemical imbalances were discovered in the mentally ill and then drugs were devised to correct the imbalance. Instead, drugs created for other purposes were incidentally found to also affect brain chemicals and blunt mental symptoms. Drug companies, hungry for new markets, and   psychiatry, eager to build stature in the medical arena, leapt on this. They conducted a vast campaign to popularize chemical imbalances as the cause of mental disturbance and push drugs as the answer.

As Dr. Angell writes, “instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug.” “Or similarly,” she says, “one could argue that fevers are caused by too little aspirin.”

Many scientific studies disprove the chemical imbalance theory. After fifteen years of research, Irving Kirsch – psychologist and author of “The Emperor’s New Drugs” – concludes, “It now seems beyond question that the traditional account of depression as a chemical imbalance in the brain is simply wrong.” Research studies show psychoactive medications actually disrupt brain chemistry and causes the brain to function abnormally. This year prominent neuroscientist, Dr. Nancy Andreason, announced proof that antipsychotics shrink the brain.

Studies also demonstrate that long-term recovery rates are higher for nonmedicated patients. For instance, the World Health Organization conducted an investigation in fifteen cities around the world and out of 740 depressed individuals studied, those that weren’t on psychiatric drugs had the best long term outcomes.

In the pre-medication era, it was known that with time, people usually recovered from depression. If kids had tantrums, were unruly or shy, they were apt to outgrow it. Today, individuals branded with disorders are likely to receive long-lasting diagnoses, endless prescriptions and the poorer ones tend to remain on disability for life.

Big Pharma manipulation

Dr. Marcia Angell says the author of each of the three books agrees on “the disturbing extent to which the companies that sell psychoactive drugs – through various forms of marketing, both legal and illegal, and what many people would describe as bribery – have come to determine what constitutes a mental illness and how the disorders should be diagnosed and treated.”

According to IMS Health, an information and consulting company, pharmaceutical companies spent $6.1 billion in 2010 in marketing to US doctors. Another $4 billion was spent on direct-to-patient advertising.

Drug trials, used to bring a drug to market, are funded by drug companies, heavily biased and misleading. Companies may sponsor as many trials as they like until they have just two positive ones to submit to the FDA. Great care is taken to hide negative trials. The highly positive results of placebo trials are downplayed: a high percentage of patients recover on a fake drug (like a sugar pill) – proving that the more a person believes he will benefit from a treatment, the more likely he will experience a benefit.

In regards the Diagnostic and Statistical Manual – the psychiatric bible of mental disorders, used in prescribing drugs – Dr. Angell points out “in all of its editions, it has simply reflected the opinions of its writers.” The majority of the psychiatrists involved in creating the current edition had financial ties to drug companies.

Author Daniel Carlat points out that “psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies.”

Crime against humanity

And where has the “mental health” industry and “drug therapy” brought our nation?

As Americans line up at their local pharmacy, documented side effects are legion: weight gain, deadened emotions, diabetes, heart problems, liver damage, stunted growth in kids, shortened life spans and on and on. Those prescribed one psychoactive drug are commonly prescribed another to address side-effects, with many on daily cocktails of meds.

An estimated 2.2 million Americans are hospitalized each year for adverse drug reactions. Over 100,000 die from them.

Instead of decreasing, the number of adults on disability pay for mental illness has soared 250% since 1987 and for kids it’s a 35X increase.

The greatest  crime to humanity is the mass drugging of children. Yet it’s perpetrated within schools, doctors offices, foster homes and juvenile facilities daily.

There is good news. In the past few years, drug companies have faced a rise of multi-billion dollar class action suits. The key popularizer of childhood bipolar and antipsychotics for kids, Dr. Joseph Biederman, was publicly sanctioned by Harvard Medical School for failing to report $1.6 million he pocketed from drug companies. Some drugmakers are steering away from pursuing new psychoactive drugs.

Nazi chief propagandist Joseph Goebbels once said, “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”

This chemical-imbalance/drug therapy lie has been told big enough and repeated enough, that much of America believes it. Isn’t it time we all put a stop to it?

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Antidepressant Nation

Thursday, July 14th, 2011

Truthdig – July 14, 2011

10 percent of Americans over age six now take antidepressants

A serious conversation is under way in the United States on the subject of psychiatric drugs. The debate consists of three fundamental issues: first, whether antidepressants actually treat depression; second, the vast, growing body of evidence that psychotropic medications alter the brain permanently; and third, the pharmaceutical industry’s continuing, decades-old corruption of American psychiatrists, many of whom have been made by drug companies’ shenanigans into little more than handsomely paid industry shills.

A careful questioning of these issues written by the spectacularly decorated Harvard Medical School lecturer Dr. Marcia Angell appeared as a two-part essay published earlier this summer in The New York Review of Books. In addition to holding a medical degree from Boston University School of Medicine and undergraduate diplomas in both chemistry and mathematics, Angell is a Fulbright Scholar, a board-certified pathologist, author of two books, a member of numerous professional health care associations and a retired 20-year staffer at the New England Journal of Medicine, which she ultimately left as editor-in-chief.

The recent publication of three books, each of which takes up one of the issues raised above, provided the occasion for Angell’s essay. In it, she argues convincingly that antidepressants are not known to do what drug companies and many psychiatrists say they do. It is this claim that drew the attention of practicing psychiatrist and Brown University professor Dr. Peter D. Kramer, who in a New York Times commentary published last Sunday questioned some but not all of what Dr. Angell wrote.

Both articles deserve to be read, but there is a crucial difference between them. While Kramer points to much data that must be taken seriously, his wandering defense of the utility of antidepressants does not undo the diligent, methodical inquiry one would expect from someone with Angell’s credentials—and which she delivers. Otherwise, he too is a critic of Big Pharma’s shady dealings. Kramer nods with genuine concern toward the dangers associated with the prolonged use of psychotropics and, in his conclusion, expresses support for treatment via effective alternatives. Both professionals agree that serious research needs to be done to understand exactly what these drugs are doing. —ARK

Marcia Angell in The New York Review of Books:

Nowadays treatment by medical doctors nearly always means psychoactive drugs, that is, drugs that affect the mental state. In fact, most psychiatrists treat only with drugs, and refer patients to psychologists or social workers if they believe psychotherapy is also warranted. The shift from “talk therapy” to drugs as the dominant mode of treatment coincides with the emergence over the past four decades of the theory that mental illness is caused primarily by chemical imbalances in the brain that can be corrected by specific drugs. That theory became broadly accepted, by the media and the public as well as by the medical profession, after Prozac came to market in 1987 and was intensively promoted as a corrective for a deficiency of serotonin in the brain. The number of people treated for depression tripled in the following ten years, and about 10 percent of Americans over age six now take antidepressants. The increased use of drugs to treat psychosis is even more dramatic. The new generation of antipsychotics, such as Risperdal, Zyprexa, and Seroquel, has replaced cholesterol-lowering agents as the top-selling class of drugs in the US.

Read Part 1: The Epidemic of Mental Illness: Why?

Read Part 2: The Illusions of Psychiatry

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Mass psychosis in the US—How Big Pharma got Americans hooked on anti-psychotic drugs

Tuesday, July 12th, 2011

ALJAZEERA – July 12, 2011

by James Ridgeway

Drug companies like Pfizer are accused of pressuring doctors into over-prescribing medications to patients in order to increase profits - GALLO/GETTY

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

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

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

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

Not just for psychotics anymore

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

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

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

Cost benefit analysis

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

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

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

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

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

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

Turning people into zombies

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

Read the rest of the article here: http://english.aljazeera.net/indepth/opinion/2011/07/20117313948379987.html

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Pharmaceutical companies deceive public—case in point; Antidepressants

Thursday, July 29th, 2010

The Star Phoenix
By Mark Lemstra
July 29, 2010

We could save $2 billion a year on health-care costs in Saskatchewan while improving health outcomes if we adopt evidence-based protocols.

To do so, we need to find about $40 million of efficiency in each of about 50 areas.

This is the third article in a five-part series on depression. My first column discussed the limitations in diagnosing depression. The second presented literature reviews that concluded antidepressants are no more effective than placebos in treating depression.

This column explains how the drug companies deceive us. Let’s start with some general information and proceed to specific examples for antidepressants.

In 2008, the editor of the New England Journal of Medicine wrote an editorial for the Journal of the American Medical Association, titled: Industry sponsored research: A broken system?

Based on her tenure as the editor of the world’s most prestigious medical journal, Dr. Marcia Angell made some accusations. She wrote that drug companies often design studies, conduct the data analysis, decide which data will be included or suppressed, write the papers, pay for prestigious clinicians to put their name on papers already written by the drug company, and then decide how and when the paper will be published.

Dr. Angell concluded: “Drug companies now finance most clinical research on prescription drugs, and there is mounting evidence that they often skew the research they sponsor to make their drugs look better and safer. Physicians can no longer rely on the medical literature for valid and reliable information.”

She also published a best selling and award-winning novel, The Truth about Drug Companies: How They Deceive Us and What to Do About It.

Let’s look at some examples from anti-depressants.

A research team from the United States, which was skeptical about the benefits of antidepressants, used the Freedom of Information Act to obtain results from the U.S. Food and Drug Administration for all placebo-controlled trials. The team was startled to learn that 40 per cent of the studies had been suppressed because of negative results.

When all the studies were included, incorporating the negative studies, the authors concluded that “antidepressants are little more than active placebos, drugs with very little specific benefit, but with serious side-effects.”

The resulting publication in Prevention and Treatment made headlines around the world. And although regulatory agencies in Europe have begun to respond, there has been no response in North America.

At this point, let’s discuss the potential side-effects of antidepressants in a review from Harvard Medical School, titled: What are the real risks of antidepressants?

The most serious of these includes the increased risk of attempted suicide, especially among children. Other side-effects include insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, diarrhea, reduced blood clotting capacity, stomach bleeding, uterine bleeding, tics, muscle spasms, trembling limbs, restlessness, severe anxiety, reduced sexual interest, reduced sexual performance, reduced sexual satisfaction, disturbed heart rhythms and reduced liver function.

There are also complications when antidepressants are taken with other drugs, and there is a long list of side-effects when antidepressant use is discontinued, including dizziness, loss of co-ordination, fatigue, burning sensations, blurred vision, insomnia, vivid dreams, nausea, diarrhea, flu-like symptoms, irritability, anxiety and crying spells.

Recently, the antidepressant Serzone was removed from the market after it was associated with hepatitis and liver failure.

The most worrisome side-effect is the increased risk of suicide attempt so let’s take a closer look.

Another review from the Food and Drug Administration found that not only do antidepressants provide no benefit to children, but the drugs are associated with a 50 per cent increase in suicidal behaviour.

Regrettably, these negative results, too, were buried by the drug companies.

Read the rest of this article here:  http://www.thestarphoenix.com/news/Pharmaceutical+companies+deceive+public/3336124/story.html

Previous articles in this series: Effect of antidepressants, placebos similar by Mark Lemstra
http://www.thestarphoenix.com/health/Effect+antidepressants+placebos+similar/3307896/story.html

Expanding mental disorders list adds to cost by Mark Lemstra
http://www.thestarphoenix.com/health/Expanding+mental+disorders+list+adds+cost/3280676/story.html

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