Posts Tagged ‘Pfizer’

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Doctors, Drug Companies, Politicians & Corruptions

Friday, August 20th, 2010

The Asian Tribune, August 21, 2010

By Shenali Waduge

They say there’s no money in healthy people. But, why is the pharmaceutical industry the most profitable industry in the world? It is because they have mastered the art of concocting the disorder, creating the drug for the disorder and then bombarding the public with advertisements to convince them they’re afflicted, leaving little choice but to get “prescribed”.

The growth in the pharmaceutical industry began to expand towards the 1970s. Pharmaceutical companies began to form mutual partnerships and began dominating the production of medicines. Advertising boomed making it possible for consumers to be enticed into believing there were miracle cures or drugs that would make people look young forever, increase sexual libido, maintain youthful looking skin with zero after effects or side effects.

Companies spend billions on “inventing” new drugs…they also spend billions on marketing them, USD53billion to be precise. But, how “innovative” are these companies? Most research and clinical trials are carried out at universities and funded by Governments. What happens thereafter is that drug companies “buy these innovations” and quickly patent them and quickly set up manufacturing plants. The only “innovation” done by these companies is to modify the existing drug something as minor as changing the color of the coating! A patented drug generally lasts for 20 years. It is only after rigorous study and testing which takes a good 10 to 15 years that Governmental authorities grant permission to market and sell drugs.

Loopholes in patent systems ensure companies are able to keep generic competitors at bay for years. These patented branded drugs naturally provides high profit margins but before the patent expires and competitors enter with a generic drug sold at far lesser prices, owners of branded drugs put out a generic version before the branded version expires…giving his company a head start in the sale of generic drugs. In 2006, the world had spent US$643billion on prescription drugs with US accounting for almost half of global pharmaceutical market. The US pharmaceutical industry is the most profitable of all businesses in the US.

It would not surprise anyone that companies spent up to $11billion annually on free samples, $6billion on sales representatives, $3billion on vague advertisements, we can only guess how many more billions is spent on bribing doctors, bribing researchers, bribing universities, bribing health officers, pharmacists, providing kickbacks and even running bogus “medical education” programs.

Essentially, what drug companies’ end up doing is using tax payer’s money to pay for medical research which they buy off, they then spend on massive advertising campaigns aimed at misleading the public about the effects of these drugs and “encourage” doctors to prescribe them!

Year in and year out drug companies end up the most successful industry with stunning profits part of which are used to buy off politicians and further promote themselves as champions of social responsibility and good corporate ethics!

There are no business ethics in the pharmaceutical industry – the industry is synonymous with money, profits, power and control. Pharmaceutical companies have mastered how to market social phobia/anxiety disorders in order to sell mind altering drugs. Does it not surprise and make you wonder why scores of people are being treated for mental disorders?

There are teenagers on anti-depressants and anti-psychotics because pharmaceutical companies want to ensure they have customers for life! Some prescription drugs are sold at more than 500,000% markup over the actual cost of their raw ingredients, naturally drug companies will do anything to sell more pills and it is why they end up inventing fictitious diseases and force parents to make addicts out of their children. There are scores of drugs available that are “habit-forming” tranquilizers?

Despite the number of drugs available why are people sicker than ever? Drugs have not helped people instead drug companies have made people addicted to drugs and suffering further from the side-affects of taking so many different combinations of drugs. In the US, over 100,000 Americans die annually from prescription drugs while a further 2million are injured by them.

The dominating companies in global pharmaceutical industry today are MERCK, Roche (fined in the US and Europe for participating in illegal price fixing cartel), Pfizer (ranked no.1, the makers of viagra the wonder drug of the 90s…. and probably soon to put out a drug that may do the opposite of viagra!), Bayer the inventor of Asprin….however hundreds and thousands of people die every year from prescription drugs? 27,000 people died of vioxx which is a nosteroidal anti-inflammatory drug which has been withdrawn over safety concerns associated with heart attacks, strokes. (though first approved in 1999 but withdrawn in 2004) It is believed that over 80m worldwide prescribed it in 2003 and its producer Merck and Co made sales revenues of US$2.5billion.

What is ironic is that there is not a single chronic disease which has been cured as a result of taking prescription drugs. What these drugs have done is to only treat the symptoms. Has chemotherapy proved scientifically accurate? It does shrink tumors but it adds nothing to a patient’s lifespan. The world is becoming sicker, fatter and more depressed than ever. The advice that people should listen to is not being given…eat healthy, avoid processed foods, avoid refined carbohydrates, avoid soft drinks etc…are rarely highlighted.

What’s more our doctors are duping us too…! In the US some mid-sized drug companies have close upon 1000 representatives lobby with companies spending over $5billion annually on sending these representatives to physician offices. The US spends $19billion annually on promotions, influencing doctors and other health professionals. As a result the physicians are lured into prescribing drugs associated with particular drug companies who ensure these physicians are well looked after and patients end up paying far more than they are required to as well as end up having to take another set of prescribed drugs to cut off the side-affects associated with the earlier drug!

Doctors are even paid to conduct fraudulent clinical trials on patients who are encouraged to take drugs for a 12month period to see its affects while the drug company profits through that particular year and the doctors enjoy the kickbacks as well. Some doctors who prescribe a particular drug company’s products and avoided competing drugs are even paid “consulting fees”. It is all a scam, and a vast majority of physicians become party to these unethical medical acts, pocketing the benefits & dosing up their patients with whatever drugs they’ve been told to prescribe. Doctors today are recipients of airfares & hotel expenses, luxury vehicles, even repairs and tyre replacements!

What is poignant and significant is that while physicians who may attend academic sessions with the thought of updating their know-how they are at the risk of being manipulated by pharmaceutical companies who pay high-profile scientists/physicians to speak on topics relevant to their products. Similarly, medical journals also help to promote specific products whose manuscripts are written by the pharmaceutical companies.

Essentially the public is at risk as a result of the direct and indirect relationships between pharmaceutical industry and the physicians. It certainly does breach professional ethics and may even bring dangers to patients.

Read the rest of this article here:  http://www.asiantribune.com/news/2010/08/21/doctors-drug-companies-politicians-corruptions

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Professor of Bioethics—Co-opted by market forces, clinical drug trials are now just covert instruments for promoting drugs

Friday, August 20th, 2010

MinnPost.com

By Susan Perry |

In the September issue of Mother Jones magazine, Dr. Carl Elliott, a professor of bioethics at the University of Minnesota, writes about the suicide in 2004 of 26-year-old Dan Markingson, who was enrolled at the time in a U of M industry-funded clinical trial of the antipsychotic drug Seroquel (quetiapine).

It’s a disturbing tale (the unsuccessful efforts of Markingson’s mother to get her son released from the trial and into other treatment are particularly heartbreaking) and one that, as Elliott acknowledges, was first told in the Pioneer Press by Jeremy Olson and Paul Tosto.

But Elliott’s purpose in writing the article wasn’t only to revisit the tragic details of Markingson’s story. “[T]he more I examined the medical and court records, the more I became convinced that the problem was worse than the Pioneer Press had reported,” he writes. “The danger lies not just in the particular circumstances that led to Dan’s death, but in a system of clinical research that has been thoroughly co-opted by market forces, so that many studies have become little more than covert instruments for promoting drugs. The study in which Dan died starkly illustrates the hazards of market-driven research and the inadequacy of our current oversight system to detect them.”

Those hazards include questionable informed consent (is a young man who’s experiencing psychotic episodes competent to give his consent?) and financial conflicts of interest. According to Elliott, the U of M psychiatry department earned $15,648 for each person it enrolled in the Seroquel study. In addition, the study’s two U of M investigators, Drs. Charles S. Schulz and Stephen C. Olson, personally earned a combined $811,045 between 2002 and 2008 from Big Pharma, including $261,364 from AstraZeneca, the maker of Seroquel.

At the time Markingson entered the Seroquel study, reports Elliott, the investigators were having serious problems recruiting subjects. Did that factor lead them to enroll someone into the study who shouldn’t have been?

“Even by the standards of a fairly ugly history [of clinical drug trials with ethical breaches] in medical history — even by those standards, this [case] jumps up,” Elliott told me in an interview last week. “There were so many things that went wrong — the consent process, the commitment order under which [Markingson] was recruited into the trial, the financial incentives of the university, the financial incentives of the investigators, and the sheer worthlessness of the trial. Anyone who looked into this and knew anything about clinical research would say this is terrible.”

Elliott sees the trial’s worthlessness as a particularly abhorrent part of the story. The Seroquel study was designed as a marketing tool, he suggests, not as a true scientific inquiry. Such studies, he writes, present a huge ethical problem that isn’t being properly addressed by the oversight systems currently in place:

What is simply assumed [when bioethicists and regulators debate the risks of a clinical trial], without much consideration at all, is that the research is being conducted to produce scientific knowledge. This assumption is codified in a number of foundational ethics documents, such as the Nuremberg Code, which was instituted following Nazi experiments on concentration camp victims. … But what if a research study is not really aimed at producing genuine scientific knowledge at all? The documents emerging in litigation [involving various prescription drugs] suggest that pharmaceutical companies are designing, analyzing, and publishing trials primarily as a way of positioning their drugs in the marketplace. This raises a question unconsidered in any current code of research ethics. How much risk to human subjects is justified in a study whose principal aim is to “generative commercially attractive messages”?

Or, as Elliott told me: “I don’t think anybody who enrolls in a clinical trial thinks, “I know this study is risky, but I think it’s worth it to help Pfizer or AstraZeneca market their drug.”

Read the rest of this article here:  http://www.minnpost.com/healthblog/2010/08/20/20742/disturbing_suicide_tale_u_of_m_professor_reexamines_ethics_questions_of_drug_trial

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People & Power—Drug Money

Tuesday, August 17th, 2010

A 23 minute TV expose on Big Pharma by ALJAZEERA (see video at bottom of this page)

This piece pulls no punches exposing the rampant fraud, fatal drug side effects, off label marketing, criminal practices  and “absolutely jaw dropping” payouts Pharma makes to psychiatrists/doctors.

  • “There is so much money to be made in stealing from the United States Healthcare system,” says Patrick Byrnes, Taxpayers Against Fraud.
  • Lewis Morris, US Department of Health states, “One of the things we are now looking at is going after the executives in these companies and holding them personally accountable.”
  • Sharon Ormsky, FBI Financial Crimes Unit states, “Pharmaceutical fraud is one of our top three threats — everybody is touched by these frauds in the extent that when you look at the billions of dollars that go into healthcare for the United States, a good percent,  3-10% of that is believed to be siphoned off into fraud—that’s  money that  could be going to very needy patients.”

Now the U.S. government is fighting back.  In the last two years alone, the  government has fined six of America’s  top ten pharmaceutical companies for fraud.  Investigations are ongoing against another three.  In this period the industry has had to pay out over 5 billion dollars in fines, and topping the list is drug giant Pfizer, having recently settled civil & criminal charges resulting in $2.3 billion dollars —the biggest fraud case, the biggest criminal case, the biggest false claims act in U.S. history.   ALJAZEERA also exposes Pfizer’s “interesting way of doing business.  Witnesses in the case revealed just how the company persuaded doctors to prescribe its drugs. It entertained them in strip clubs, it told them that the blues teenagers feel when they don’t make the football team was signs of treatable depression and it paid them to endorse Pfizer drugs. One doctor received $150,000 in a year.

Also highlighted is the current scandal regarding antipsychotic drugs, including state law suits, dangerous documented side effects and how federal investigators are now looking into claims drug company Johnson & Johnson illegally marketed their antipsychotic drug Risperdal to children, paying “some of the most influential doctors in the field” in order to accomplish this.  And leading that pack sits none other than the  [now] infamous psychiatrist Joseph Biederman, who has been “credited” with the huge increase of children prescribed psychiatry’s most powerful/dangerous drugs, antipsychotics, while receiving millions in Pharma kickbacks that he failed to disclose.   Biederman is shown on tape being questioned under oath, and when asked “What rank are you?” Biederman responds, “Full Professor.” When asked “What comes after that?” Biederman responds, “GOD.”

This is a 23 minute expose well worth watching.

This is one of the best exposé’s on Big Pharma we’ve seen:

People & Power —Drug Money, produced by ALJAZEERA.  This piece pulls no punches exposing the rampant fraud, fatal drug side effects, off label marketing, criminal practices  and “absolutely jaw dropping” payouts Pharma makes to psychiatrists/doctors.

* “There is so much money to be made in stealing from the United States Healthcare system,” says Patrick Byrnes, Taxpayers Against Fraud.

* Louis Morris, US Department of Health states, “One of the things we are now looking at is going after the executives in these companies and holding them personally accountable.”

*Sharon Ormsky, FBI Financial Crimes Unit states,  ”Pharmaceutical fraud is one of our top three threats — everybody is touched by these frauds in the extent that when you look at the billions of dollars that go into healthcare for the United States, a good percent,  3-10% is believed to be siphoned off into fraud that’s  money that  could be going to very needy patients.”

Now the U.S. government is fighting back.  In the last two years alone, the  government has fined six of America’s 10 pharmaceutical companies for fraud.  Investigations are ongoing into another three.  In this period the industry has had to pay out over 5 billion dollars in fines, and topping the list is drug giant Pfizer, having recently settled civil & criminal charges resulting in $2.3 billion dollars —the biggest fraud case, the biggest criminal case, the biggest false claims act in U.S. history.   ALJAZEERA also exposes Pfizer’s “interesting way of doing business.  Witnesses in the case revealed just how the company persuaded doctors to prescribe its drugs. It entertained them in strip clubs, it told them that the blues teenagers feel when they don’t make the football team was signs of treatable depression and it paid them to endorse Pfizer drugs. One doctor received $150,000 in a year.

Also highlighted is the current scandal regarding antipsychotic drugs, including state law suits, dangerous documented side effects and how federal investigators are now looking into claims drug company Johnson & Johnson illegally marketed their antipsychotic drug Risperdal to children, paying “some of the most influential doctors in the field” in order to accomplish this.  And leading that pack sits none other than the  [now] infamous psychiatrist Joseph Biederman, who has been “credited” with the huge increase of children prescribed psychiatry’s most powerful/dangerous drugs, antipsychotics, while receiving millions in Pharma kickbacks that he failed to disclose.   Biederman is shown on tape being questioned under oath, and when asked “What rank are you?” Biederman responds, “Full Professor.” When asked “What comes after that?” Biederman responds, “GOD.”

This is a 23 minute expose well worth watching.

http://www.youtube.com/watch?v=1TwdsYVHjGA&feature=player_embedded#!

This is one of the best exposé’s on Big Pharma we’ve seen:

People & Power —Drug Money, produced by ALJAZEERA.  This piece pulls no punches exposing the rampant fraud, fatal drug side effects, off label marketing, criminal practices  and “absolutely jaw dropping” payouts Pharma makes to psychiatrists/doctors.

* “There is so much money to be made in stealing from the United States Healthcare system,” says Patrick Byrnes, Taxpayers Against Fraud.

* Louis Morris, US Department of Health states, “One of the things we are now looking at is going after the executives in these companies and holding them personally accountable.”

*Sharon Ormsky, FBI Financial Crimes Unit states,  ”Pharmaceutical fraud is one of our top three threats — everybody is touched by these frauds in the extent that when you look at the billions of dollars that go into healthcare for the United States, a good percent,  3-10% is believed to be siphoned off into fraud that’s  money that  could be going to very needy patients.”

Now the U.S. government is fighting back.  In the last two years alone, the  government has fined six of America’s 10 pharmaceutical companies for fraud.  Investigations are ongoing into another three.  In this period the industry has had to pay out over 5 billion dollars in fines, and topping the list is drug giant Pfizer, having recently settled civil & criminal charges resulting in $2.3 billion dollars —the biggest fraud case, the biggest criminal case, the biggest false claims act in U.S. history.   ALJAZEERA also exposes Pfizer’s “interesting way of doing business.  Witnesses in the case revealed just how the company persuaded doctors to prescribe its drugs. It entertained them in strip clubs, it told them that the blues teenagers feel when they don’t make the football team was signs of treatable depression and it paid them to endorse Pfizer drugs. One doctor received $150,000 in a year.

Also highlighted is the current scandal regarding antipsychotic drugs, including state law suits, dangerous documented side effects and how federal investigators are now looking into claims drug company Johnson & Johnson illegally marketed their antipsychotic drug Risperdal to children, paying “some of the most influential doctors in the field” in order to accomplish this.  And leading that pack sits none other than the  [now] infamous psychiatrist Joseph Biederman, who has been “credited” with the huge increase of children prescribed psychiatry’s most powerful/dangerous drugs, antipsychotics, while receiving millions in Pharma kickbacks that he failed to disclose.   Biederman is shown on tape being questioned under oath, and when asked “What rank are you?” Biederman responds, “Full Professor.” When asked “What comes after that?” Biederman responds, “GOD.”

This is a 23 minute expose well worth watching.

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US Department of Justice Probes Corruption in Big Pharma; Glaxo, Pfizer, Bristol-Myers Squibb, Eli Lilly & Merck

Friday, August 13th, 2010

Financial Times
By Stephanie Kirchgaessner
August 12, 2010

The US Department of Justice is scrutinising payments by leading pharmaceuticals companies for hospitality, consultants, licensing agreements and charitable donations in markets around the world as part of a wide-ranging corruption probe.

GlaxoSmithKline, Pfizer, Bristol-Myers Squibb and Eli Lilly, among others, have disclosed being contacted by the DoJ and Securities and Exchange Commission in connection with the investigation. Merck, the US drugs group, announced last week that it had also been contacted and was co-operating with investigators.

An industry attorney familiar with the probe said that the DoJ was looking at whether pharma companies had ignored a “systematic risk” inherent in the global drugs business and ignored obligations under local and US anti-bribery law.

The highly regulated nature of the business, combined with the fact that healthcare officials in many non-US markets were government funded, made the industry a natural target for such a probe, the person added.

The investigation is at a relatively early stage but is considered a priority for the DoJ.

While hospitality – including meals and all expenses-paid travel for conferences – has long been considered a potential risk for pharma groups, the DoJ’s probe is looking at all aspects of companies’ dealings in non-US markets, people familiar with the matter say. That includes the recruitment of physicians for clinical trials. In some markets, the same physicians may serve on regulatory boards that approve or deny drugs.

The DoJ declined to comment. But last November, Lanny Breuer, head of the DoJ’s criminal division, announced that investigators would be focusing on international corruption in the pharmaceuticals industry for “years”.

Mr Breuer warned a conference of pharmaceutical industry lawyers that prosecutors were gearing up for an investigation of international corruption in the sector. The drugs companies took notice.

That threat has now become a reality. Merck, AstraZeneca, Eli Lilly, Baxter, SciClone, and Bristol-Myers Squibb have in recent months received inquiries from the DoJ and the Securities and Exchange Commission in connection with an industry-wide bribery ­investigation.

GlaxoSmithKline, the UK drugmaker, told the Financial Times on Thursday that it too had received “inquiries” from US authorities, but that it disclosed the issue “reactively” only to selected reporters in April.

Pfizer, the world’s largest pharmaceutical group, said in February that it had voluntarily provided the DoJ and SEC with information concerning potentially improper payments outside the US and was exploring resolution of the matter.

There is perhaps no industry that is as vulnerable to violations of US anti-bribery laws as the pharmaceutical industry. In markets round the world, the companies deal, sometimes thousands of times in a single day, with doctors, clinicians, hospital operators and regulators who are considered under US law to be government officials, because they are employed by state-owned facilities.

Under the Foreign Corrupt Practices Act, the US anti-bribery law, companies may not offer items of value to foreign government officials for profit. One industry lawyer involved in the matter said global pharmaceutical companies operating in countries with state-run medical institutions deal with government officials at every turn of their business: whether it is seeking the go-ahead for a manufacturing site; obtaining drug licences; conducting clinical trials; importing drugs; selling and marketing drugs to physicians; or getting a product on to a hospital’s approved list.

“What most companies will find is that all of these areas are risky and, if they don’t train and educate their people, they are going to find themselves with issues. For example, if you have hired customs brokers, how do you know they aren’t bribing officials?” the attorney said.

According to the law firm Arnold & Porter, the DoJ is particularly interested in corrupt payments that may have influenced the reliability or integrity of data in clinical trials performed outside the US. A recent report by the Department of Health and Human Services found 80 per cent of marketing applications for drugs approved by the Food and Drug Administration in the US had relied on at least one foreign trial.

“Companies may find themselves facing critical legal issues if approval of products rested on the results of studies the DoJ deems corrupt,” Arnold & Porter said in an advisory letter to clients last month.

A person familiar with the investigation confirmed that clinical trials were one of several areas the DoJ was examining.

Alexandra Wrage, the president of Trace, a non-profit organisation that helps companies establish anti-corruption practices, said that alleged wrong­doing at pharmaceutical companies could often centre on inappropriately lavish hospitality, such as wining and dining doctors from state-run hospitals at conferences in Bali or Monaco.

Read entire article here:  http://www.ft.com/cms/s/0/9a8e8f90-a63e-11df-8767-00144feabdc0.html
(free registration required)

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Chantix & Violence: What Patients Have In Common

Thursday, July 22nd, 2010

Pharmalot
By Ed Silverman
July 22, 2010

For the past three years, the Chantix smoking cessation pill has caused a stir after being associated with suicidal behavior and vivid dreams (see here and here). Consequently, the government banned the Pfizer drug for pilots and licenses wouldn’t be issued to truck drivers taking the med (see this). The FDA subsequently imposed a risk management program and Pfizer added warnings.

Now, a new study in The Annals of Pharmacotherapy finds Chantix is not only associated with violent and agressive thoughts and acts, but has also identified some of the common characteristics among people using the pill and their subsequent behavior. The drug “does have warnings about psychiatric side effects, but it skims over aggression/violence towards others to focus mainly on suicidal behaviors,” says Thomas Moore, one of the co-authors and a senior scientist at the Institute for Safe Medication Practices, a non-profit that has issued reports previously about Chantix side effects.

“We believe this may be the first scientific report to examine the characteristics of aggression/violence as a psychiatric side effect for any prescription drug. What do these cases look like? A question answered for possibly the first time. We found the details striking and chilling. This is the first time we know of that aggression/violence has been clearly documented as a side effect in a peer reviewed scientific journal. This raises the question of whether (Chantix) is suitable for use in the military, by police and others who are already in stress situations. One key characteristic of these events is uncontrollable rage. Not a good side effect for people paid to carry guns.”

The researchers obtained 78 adverse event reports from the FDA MedWatch database containing medical terms describing possible acts or thoughts of aggression/violence; four more cases came from clinical trials, and three others came from published literature. Ultimately, they used 26 case reports for study and these described 10 events with assault, nine cases of homicidal ideation and seven instances of other thoughts or acts of aggression/violence. They noted that the patient population was predominantly middle-aged women, but “an unlikely age group and sex for assault and acts of violence toward others.”

“In all 26 cases,” they write, “the acts or thoughts of violence appeared to be inexplicable and unprovoked. A woman struck her 17-year-old daughter in the mouth while the daughter was driving a car, with a young granddaughter also present. A 42-year-old man punched a stranger at a bowling alley. The stranger and two friends responded and knocked out the subject’s front teeth. A 24-year-old female started beating her boyfriend in bed because he “looked so peaceful” and she later attempted suicide. A 29-year-old female struck an acquaintance twice in the face, and then started smashing doors in her own home and beating on her truck.”

Read entire article:  http://www.pharmalot.com/2010/07/chantix-and-violence-what-patients-have-in-common/

*The package insert for Chantix shows that it contains a type of chemical compound that is better known as benzodiazepine—benzodiazepines are otherwise known as anti-anxiety drugs.

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SSRIs Render Unfriendly Skies—FOIA documents reveal what FAA failed to consider in allowing pilots on antidepressants to fly

Wednesday, July 14th, 2010

Scoop Independent News
By Evelyn Pringle
July 14, 2010

The SSRI antidepressant makers are desperate to find new customers, so they recently have been focusing on capturing groups for which the drugs were usually considered off limits. The latest marketing coup managed to open up sales to roughly 614,000 American pilots.

Under a new policy announced on April 5, 2010, pilots diagnosed with depression can seek permission from the Federal Aviation Administration to take one of four SSRIs, including Eli Lilly’s Prozac, Pfizer’s Zoloft, and Forest Laboratories’ Celexa and Lexapro.

“The FAA should reverse its ruling before it’s too late and hundreds of lives are lost when a pilot becomes impulsive, suicidal or violent–or just loses his sharpness–under the influence of antidepressant medication,” said SSRI expert, Dr Peter Breggin, in an April 19, 2010 Huffington Post commentary.

The Citizens Commission on Human Rights is also calling on the FAA to rethink allowing pilots to take SSRI in light of a new report issued last month by the National Transportation Safety Board, on a February 1, 2008 plane crash in North Carolina, by a crazy acting pilot on Zoloft, that killed all six persons on board

The report said the pilot failed to maintain control of the plane during instrument flying conditions and “deliberately descended below the minimum descent altitude.” The plane stalled and crashed while circling after an aborted landing.

“Review of the cockpit voice recorder (CVR) audio revealed that the pilot had displayed some non-professional behavior before initiating the approach,” the NTSB reported.

The CVR recorded the pilot singing: “Save my life I’m going down for the last time,” before beginning a commentary in which he told passengers: “If anybody back there believes in the good Lord, I believe now would be a good time to hit your knees.”

A review of medical records documented that “from December 4, 2006 through December 31, 2007, the pilot had filled 6 prescriptions for 30 tablets of 50 mg sertraline (Zoloft),” the report said.

The records indicated that he had been treated previously with two other antidepressant medications for “anxiety and depression” and a history of “impatience” and “compulsiveness,” the NTSB noted.

An investigation of another plane crash, resulting in two fatalities in Kingsport, Tennessee, in August 2003, found Zoloft in the blood and liver of a private flight instructor, according to an accident report by the NTSB.

In the policy statement published in the Federal Register, the FAA seems to justify the use of these drugs via the fully debunked “chemical imbalance in the brain” theory when writing: “All these medications are SSRIs, antidepressants that help restore the balance of serotonin, a naturally occurring chemical substance found in the brain.”

“Increasingly accepted and prevalently used, these four antidepressants may be used safely in appropriate cases with proper oversight and have fewer side effects than previous generations of antidepressants,” the FAA wrote, with no citation to any scientific paper to back up this assertion.

In fact, the current labels on SSRIs warn that “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients treated for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric.”

“Even when not severe, these reactions impair judgment and increase the likelihood of accidents and violence,” according to Dr Breggin.

CCHR has set up a great website with a one-of-a-kind search engine that allows the public and officials to access the database on side effects reported to the FDA on SSRIs, and every other psychiatric drug. The site also has a search engine to access all the International warnings and studies on psychiatric drugs which have been summarized so they are easy to understand, even to a lay person.

Input Only From the Choir

On April 6, 2010, Bob Fiddaman, author of the long-running popular website and blog, “Seroxat Sufferers,” sent a request to the FAA, under the Freedom of Information Act, seeking information on the change in policy.

In the Federal Register, the FAA claims it came to its decision after “careful consideration.” However, in the 58 pages of documents sent to Fiddaman on June 9, 2010 (and kindly shared with this author), there is no mention of consultations with any of the prominent SSRI experts who may have offered a contrary view. Like Peter Breggin for instance.

The FAA’s response to Fiddaman shows the agency has been discussing the policy change since at least 2008. In response to a request for “minutes of meetings where the change in the policy was on the agenda,” as well as a list of “members present and a declaration of interests of each of the members,” the FAA sent a copy of a July 18, 2008, Memorandum, with a summary from one consultants meeting. Three outside experts attended but there were no declarations of interests, or lack thereof, by anyone at the meeting.

The summary noted that the consultants “unanimously agreed that the concept of allowing certain airmen taking antidepressant medication was reasonable and safe.” But the “unanimous consensus” was that only Prozac and Zoloft “were appropriate medications due to the longevity of their use and overall safety.”

“They also felt that only these two should be considered initially, and no other medications considered at this time,” the summary reported.

In responding to the question of whether the new policy would apply to Air Traffic Controllers, the FAA said the “new policy does not presently apply to Air Traffic Control Specialist (ATCS) because the administrative details of the monitoring and follow-up of these employees are yet to be determined. The plan is that ATCSs will eventually be included in a program of this type.”

In response to a request for any information “given to FAA from outside parties that relate to the FAA’S recent change in policy regarding pilots on antidepressant medication,” the FAA sent copies of documents received from the Aerospace Medical Association, the Airline Pilots Association Aeromedical Office, the International Airline Pilots Association, and the United States Army.

“In developing the new policy, the FAA also utilized a variety of medical research literature available in the public domain,” the response said. “We used internet sites such as, but not limited to: The National Library of Medicine PubMed site and the FDA Medwatch.”

The documents Fiddaman received show consideration of a 2003 study of aviation accidents that found SSRIs in 61 pilot fatalities between 1990-2001, in which the psychological condition and/or the drug use was determined to be the cause, or a factor in 16 of the accidents, or 31%.

However, there was no mention of a later November 2006 study titled, “Pilot Medical History and Medications Found in Post Mortem Specimens for Aviation Accidents,” led by Dennis Canfield, from the FAA’s Civil Aerospace Medical Institute, in the “Aviation, Space, and Environmental Medicine” journal.

For this study, toxicological evaluations were performed on 4,143 pilots involved in fatal aviation accidents during the period between January 1, 1993, through December 31, 2003, to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions.

The evaluations found one-hundred dead pilots with SSRIs in their systems including forty with Prozac, twenty-six with Zoloft, twenty-one with Paxil, and thirteen with Celexa.

Less than a month after the new policy was announced, in “Aviation International News,” on May 1, 2010, Matt Thurber reported that in a review of 127 accidents in the NTSB database since 1991, containing the word “antidepressant,” only three were nonfatal.

“In 124 of those accidents, 211 people were killed,” Thurber said. “In accident after accident, antidepressants … were found in the tissues of dead pilots, and the pilots had falsified their medical certificate applications to show that they had never been treated for psychiatric problems.”

Read the rest of this article here:  http://www.scoop.co.nz/stories/HL1007/S00116.htm

Read FOIA documents here: http://fiddaman.blogspot.com/p/faa-respond-to-freedom-of-information.html

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Pfizer Makes Bank from DrugsThat Can Kill You—To say Pfizers been accused of wrongdoing is like saying BP had an oil spill

Monday, July 12th, 2010

AlterNet
By Martha Rosenberg
July 10, 2010

The drug company Pfizer is best known for Lipitor, a drug that brings cholesterol down and Viagra, a drug that brings other things up.

But the “world’s largest research-based pharmaceutical company” which sits between Goldman Sachs and Marathon Oil on the Fortune 500, is also closely associated with a seemingly never-ending series of scandals.

To say Pfizer’s been accused of wrongdoing is like saying BP had an oil spill. Other drug companies have a portfolio of products, Pfizer has a portfolio of scandals including, but not limited to, Chantix, Lipitor, Viagra, Geodon, Trovan, Bextra, Celebrex, Lyrica, Zoloft, Halcion and drugs for osteoarthritis, Parkinson’s disease, kidney transplants and leukemia.

During one week in June Pfizer 1) agreed to pull its 10-year-old leukemia drug Mylotarg from the market because it caused more, not less patient deaths 2) Suspended pediatric trials of Geodon two months after the FDA said children were being overdosed 3) Suspended trials of tanezumab, an osteoarthritis pain drug, because patients got worse not better, some needing joint replacements (pattern, anyone?) 4) Was investigated by the House for off-label marketing of kidney transplant drug Rapamune and targeting African-Americans 5) Saw a researcher who helped established its Bextra, Celebrex and Lyrica as effective pain meds, Scott S Reuben, MD, trotted off to prison for research fraud 6) was sued by Blue Cross Blue Shield to recoup money it overpaid for Bextra and other drugs 7) received a letter from Sen. Charles Grassley (R-Iowa) requesting its whistleblower policy and 8 ) had its appeal to end lawsuits by Nigerian families who accuse it of illegal trials of the antibiotic Trovan in which 11 children died, rejected by the Supreme Court. And how was your week?

Nor does Pfizer back down when faced with legal troubles.

Even as it was under the probation of a 5-year Corporate Integrity Agreement (CIA) with Health and Human Services for withholding $20 million in Lipitor rebates owed to Medicaid in 2002, it off-label marketed its seizure drug Neurontin and entered into another CIA in 2004.

Read entire article:  http://www.alternet.org/story/147467/

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Senator Grassley Investigates Big Pharma’s Treatment of Drug Company Whistleblowers Who File Complaints

Thursday, July 1st, 2010

Bloomberg
By David Voreacos
July 1, 2010

U.S. Senator Charles Grassley asked 16 drugmakers, including Pfizer Inc., AstraZeneca Plc and Eli Lilly & Co., to reveal how they treat whistleblowers who file complaints under the False Claims Act.

Grassley, an Iowa Republican, sent letters June 28 that posed eight questions such as how companies notify employees of the law, how they treat whistleblowers and what changes they have made in response to a 2009 law extending anti-retaliation protections. Grassley’s office provided copies of the letters.

The False Claims Act lets private citizens sue on behalf of the government and share in any recovery. Whistleblowers were paid $2.39 billion from 1987 to 2009, or 16 percent of the $15.19 billion collected in False Claims lawsuits in which the U.S. government joined the case, according to the Justice Department.

“What measures does Pfizer have in place to ensure fair treatment to those filing complaints?” Grassley wrote to Chief Executive Officer Jeffrey Kindler. “Of employees who have filed complaints, have any complained of unfair treatment and/or retaliation after the filing of the complaint?”

The False Claims Act was passed by Congress in 1863 and strengthened three times since 1986. Citizens file so-called qui tam cases that remain sealed from public view as the Justice Department investigates the claims and decides whether to join the suit. Twenty-five U.S. states have their own versions of the law.

Large Settlements

Drugmakers have reached some of the largest settlements in recent years. Pfizer agreed to pay $2.3 billion over improper drug marketing, Lilly paid more than $1.6 billion to settle claims over its marketing of the drug Zyprexa, and AstraZeneca paid $520 million over marketing of its drug Seroquel.

Read entire article:  http://www.bloomberg.com/news/2010-06-30/grassley-seeks-data-from-pfizer-lilly-on-how-whistleblowers-are-treated.html

By David Voreacos

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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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Australian Psychiatrist Patrick McGorry Wants His Pre-Drugging Agenda to Go Global

Wednesday, June 16th, 2010


“Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.” — Patrick McGorry

By CCHR International
June 16, 2010

A Public Service Announcement on Australian TV features Australian of the Year, psychiatrist  Patrick McGorry,  claiming that nearly half the population will experience mental ill-health during their lifetime. Considering that after World War II, psychiatrists claimed that one in 20 people had a mental disorder, and now it’s every second one of us, that’s a damning 1000 percent failure rate for psychiatrists in reducing “mental illness.” Let’s get real; the reason psychiatrists claim more people are mentally ill is because they can keep  inventing new ways to label them mentally ill—but the press and governments are  starting to catch on, evidenced by all the controversy surrounding psychiatry’s upcoming edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM)—better known as psychiatry’s billing bible. Yet of all the proposed “mental disorders” ranging from overeating to kids throwing tantrums, no proposed model of mental disorder is more  insidious and dangerous than that of Patrick McGorry, who promotes diagnosing people before they develop a so-called mental disorder—drugging them before they become “mentally ill.” Yet the Australian government has bought into it hook, line and sinker—despite the fact McGorry’s plan is so outrageous, even his peers, such as psychiatrist Allen Frances, former Chair of the DSM task force, have called it ”the most ill-conceived and potentially harmful.”

Make no mistake, the pre-drugging agenda is Patrick McGorry’s baby—his dream for a new paradigm in mental health, one that has the power to diagnose and drug people before they become mentally ill—welcome to the Brave New World of Patrick McGorry. And he isn’t stopping with Australia; his plan is to go global. As he recently stated, “Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.”[1]

The fact that McGorry’s agenda is so controversial—it even has other psychiatrists protesting it—has not deterred the Australian government from funding this “ill-conceived” plan. A recent letter to Citizens Commission on Human Rights states, “The Australian Government is providing $25.5 million over four years from 2010-2011 to expand Early Psychosis Prevention and Intervention Centre (EPPIC) model,” developed by McGorry who founded EPPIC and the Orygen Youth Health in Victoria, Australia.

The Australian Government has already been criticized for massive expenditure on psychotropic drugs increasing more than 660 percent during the last decade—with a whopping 3,100 percent increase on antipsychotic drugs (with at least 15 Australian deaths in the under 19 year olds as a tragic consequence of this).  This can only get worse when under McGorry’s plan, with an enormous client base that can be prescribed drugs despite the fact they are not yet  “mentally ill.” It’s called prodrome (prodromos meaning the forerunner of an event)—referring to “a period of prepsychotic disturbance” that may or may not develop into psychosis or “schizophrenia”[2]—in other words, the crystal ball theory.

Australia Meets the US in Pre-Drug Scam

McGorry’s plan for Australia to “lead the change” in world mental health is happening—to the detriment of those who may be forced to undergo drug treatment based on a psychiatrist’s hunch that they might, one day, become ill. In the U.S., on May 13, 2009, the Department of Health and Human Services convened a Technical Expert Panel (TEP) discussed “emerging evidence around psychopharmacological interventions for first episode schizophrenia” citing the research efforts of McGorry and others.[3]

The push for pre-diagnosing and pre-drugging has even those within the psychiatric profession calling foul; Dr. Richard Warner, professor of psychiatry at the University of Colorado, counters the idea that science drives McGorry’s pre-disorder assessment, stating, “Given the expected number of false positives, the potential for harm is significant.”[4]

However, as Anthony Pelosi, honorary professor, Department of Psychiatry, Hairmyres Hospital, wrote in a counter to McGorry in the British Medical Journal last year, “this has not stopped their skillful lobbying of politicians, journalists, patients, and carers with upbeat messages about the prevention.”

“Skillful lobbying” is right.

In 2006 McGorry and other researchers, including psychiatrist Michael Berk, Karen Hallam, Craig McNeil, Linda Kaler and psychologist Melissa Hasty reported in the Medical Journal of Australia, “Evidence increasingly indicates that earlier identification may allow for appropriate pharmacological and psychosocial treatments….”[5]

Could they have a Pharma incentive behind this agenda? Berk is financially linked to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Organon, Novartis, Mayne Pharma, Servier, Sanofi-Synthelabo, Solvay, and Wyeth and Pfizer.[6] Hallam disclosed received speaker fees from Janssen-Cilag; McNeil received consultancy fees, speaker fees and travel assistance from Eli Lilly, Janssen-Cilag and Sanofi-Aventis; and Hasty and Linda received financial assistance to attend conferences from or Janssen-Cilag, maker of the antipsychotic Risperdal (resperidone).[7]

McGorry has received grant support from Eli Lilly, Janssen-Cilag, Bristol Myers Squibb, Astra-Zeneca, Pfizer, and Novartis.[8] He is a paid consultant for, and has received speaker’s fees from all or most of these companies.[9] Studies published in the British Medical Journal in 2005 and 2008 declared McGorry’s “early intervention studies have received partial support in the form of investigator-initiated unrestricted research grants from Janssen-Cilag.”[10]

The U.S. has already begun adopting the “early intervention” fad, which looks more like a trade in children’s lives and a business opportunity for increased pharmaceutical sales. In March 2010, the Department of Health & Human Services Substance Abuse & Mental Health Service Administration Center for Mental Health Services announced $16.5 million in funding for “Mental Health Transformation Grants,” including the “Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP).”[11]

EDIPP is the American sister of McGorry’s EPPIC.  It was originally bankrolled by a $14.4 million grant from the Robert Wood Johnson Foundation. According to investigative journalist Evelyn Pringle, “The founder of RWJF, Robert Wood Johnson, was chairman of Johnson & Johnson for over 30 years, from 1932 to 1963, as a member of the drug maker’s founding family. Throughout the years, the majority of the Foundation’s money has come from investments in J&J stock.”

In an article in Behavioral Healthcare, in 2008, the Mid-Valley Behavioral Care Network (MVBCN), an intergovernmental Medicaid government insurance-managed healthcare organization situated in Oregon, was recommended to study EPPIC used at Orygen and EDIPPP.

Based on EDIPP and EPPIC, the MVBCN developed the Early Assessment and Support Team (EAST) in 2001.  In 2003, the Oregon state legislature allocated $4.3 million to disseminate early psychosis intervention statewide.  By March the following year, new programs had begun in 12 counties.[12]

EDIPPP also replicates the “Portland Identification and Early Referral,” or “PIER,” a treatment research program at the Main Medical Center, in Portland, Maine.[13] People typically are referred to PIER by high school guidance counselors, pediatricians, or other clinicians who attended presentations about PIER’s work, says Pringle. “Virtually every person entering the PIER program is prescribed antipsychotics, such as Risperdal or Invega, marketed by Johnson & Johnson,” she added.

Both PIER and EDIPPP are promoted in McGorry’s 2002 book, Implementing Early Intervention in Psychosis: A Guide to Establishing Early Psychosis Services.”[14] The book’s foreword is written by Dr. Jeffrey Lieberman, Professor of Psychiatry, Chairman Department of Psychiatry, Columbia University College of Physicians and Surgeons.[15] Lieberman has taken consulting fees and research grant support from AstraZeneca, Bristol-Myers Squibb, Upjohn Pharmacia, Novartis, Eli Lilly, Janssen, Pfizer, Hoechst AG, & AstraZeneca. He’s on the Speakers Bureaus for Astra Zeneca, Janssen, Eli Lilly and Pfizer.[16]

Lieberman is also the Vice President (North America) of the McGorry instigated group International Early Psychosis Association (IEPA), which was officially incorporated in Victoria in 1998.[17] McGorry is currently Treasurer of the Association.[18] Lieberman is a member of the psychiatric-pharmaceutical company front groups, National Alliance for the Mentally Ill (NAMI) and National Alliance for Research on Schizophrenia and Depression (NARSAD).

Between 1999 and 2003 IEPA received unrestricted education grants from Janssen-Cilag and AstraZeneca.[19] EIPA’s conferences are supported by Janssen-Cilag, AstraZeneca, Eli Lilly, and Bristol-Myers Squibb.[20]

The IEPA lists the “who’s who” of Pre-Psychosis Risk Syndrome (the official label given pre-psychotic symptoms) and many of its board or members disclose manufacturers of antipsychotics as companies they’ve received financing from.

On July 29-30, the First international Youth Mental Health Conference is being held in Melbourne, with keynote speakers, including McGorry. The conference is described by one advocate as an “important and innovative event, attracting the best in the business/industry to discuss the emerging issues of youth mental health.”[21]

It couldn’t have been more adequately stated: business and industry. Herein you see McGorry’s pitch again that Australia is a global leader in this latest psychiatric fad. His invitation online states, “This is an important event for Australia and the mental health field. We expect this to be the first of many similar conferences, bringing together innovators, practitioners, researchers, young people and families to showcase the best of youth mental health innovation from around the globe.”[22] [Emphasis added]

There’s no doubt that this conference, like his Australian award, will be used to demand more funding to increase the business stakes and drive more income into psychiatry’s pre-drugging efforts.  Despite the government already allocating $103 million to McGorry, including the $25 million to further research EPPIC, he continues to call for another $800 million in funding for programs for youth mental health over the next four years.[23]

McGorry recently stated, “You have to be able to give something of yourself to people, if you are going to help them.”[24] McGorry’s brand of “helping” entails stigmatizing children with psychiatric labels that have no basis in science or medicine and then drugging them. That does not qualify as “help.” It’s betrayal. If this agenda to pre-diagnose, and pre-drug is allowed to take hold, we will truly have entered a Brave New World; Patrick McGorry’s.

[1] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

[2] http://www.mentalhealth.com/mag1/scz/sb-prod.html

[3] U.S. Department of Health and Human Services, “ASPE Technical Expert Panel on Earlier Intervention for Serious Mental Illness: Summary of Major Themes,” The Lewin Group, 13 May, 2009.

[4] Richard Warner, MB, DPM, is director of Colorado Recovery in Boulder, Colorado, and professor of psychiatry at the University of Colorado, “Early intervention in psychosis: Future or fad?” Centre for Addiction and Mental Health website, http://www.camh.net/Publications/Cross_Currents/Winter_2007-08/futureorfad_crcuwinter0708.html.

[5] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[6] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[7] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[8] http://www.mhanet.ca/documents/2008/Research-Colloquium/0920%20-%20Keynote%20MCGORRY.pdf

[9] http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[10] http://bjp.rcpsych.org/cgi/content/full/187/48/s108; http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[11] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[12] http://www.behavioral.net/ME2/dirmod.asp?sid=9B6FFC446FF7486981EA3C0C3CCE4943&nm=Archives&type=Publishing&mod=Publications%3A%3AArticle&mid=64D490AC6A7D4FE1AEB453627F1A4A32&id=BFCD36BFD75E447CA63F662A633F41FB&tier=4

[13] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[14] http://books.google.com.au/books?id=lyLfMPsnvJ0C&pg=PA136&lpg=PA136&dq=Portland+Identification+and+Early+Referral+McGorry&source=bl&ots=lEp9tdT8ZV&sig=_zlnHeFk8oqxTHSjbvLf0XQmlY4&hl=en&ei=lP0RTKThLMWPcMnSzNAH&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBQQ6AEwAA#v=onepage&q&f=false

[15] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[16] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[17] http://www.iepa.org.au/ContentPage.aspx?pageID=10

[18] http://www.headspace.org.au/about/headspace-board/

[19] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[20] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[21] http://www.iymhconference.com.au/why-attend/

[22] http://www.iymhconference.com.au/

[23] Mental Health Update, GetUp! Action for Australia, 21 Apr. 2010, http://www.getup.org.au/blogs/view.php?id=1936&dc=1086,21560,1

[24] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

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