Antipsychotic Drug Use Doubled since 1996 in Tennessee Children_Why?

[Guest guest]

> SSRI-Research

> Thu, 2 Sep 2004 17:48:45 -0400

> [sSRI-Research] Antipsychotic Drug Use

> Doubled since 1996 in Tennessee Children_Why?

>

> ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

> Promoting openness and full disclosure

> http://www.ahrp.org

>

> FYI

>

> A Vanderbilt University study found that the use of

> antipsychotic drugs has

> doubled among poor children in Tennessee. " The

> increase, seen largely among

> children diagnosed with

> attention-deficit/hyperactivity disorder (ADHD),

> conduct disorder and affective disorders such as

> depression, has experts

> worried that young people who are not psychotic are

> being prescribed

> antipsychotic drugs for which there is no data on

> safety or effectiveness. "

>

> The atypical antipsychotics to which the children

> are being exposed are the

> most powerful of all currently promoted psychotropic

> drugs--pose severe,

> irreversible health hazards. See latest July 2004

> revision:

>

http://www.fda.gov/medwatch/SAFETY/2004/risperdal.htm

> This calls for a Congressional investigation.

>

> Another deeply disturbing development brought to

> public attention by the

> British Medical Journal, is the government's

> ill-advised intent to screen

> the entire US population for mental

> illness---children first. This has

> sparked a firestorm among conservatives and critics

> of the misuse of

> psychotropic drugs and the labeling of healthy

> children as mentally ill.

> See:

>

http://bmj.bmjjournals.com/cgi/content/full/328/7454/1458

> See:

>

http://www.illinoisleader.com/search/default.asp?query=screen+mental+illness

> & x=9 & y=2

>

> Illinois and Erie (NY) are the frontrunners in

> adopting screening policies

> recommended by the President's " New Freedom

> Commission " report. Inasmuch as

> there are no reliable, scientifically valid

> diagnostic tools for uncovering

> hidden mental illness, nor any effective preventive

> interventions, such

> screening has no valid medical purpose. There is,

> however no uncertainty

> that screening will increase the number of persons

> " diagnosed " with a mental

> illness, and screening is a sure fire way to

> increase the already

> skyrocketing use of psychotropic drugs.

>

> Whether one calls it a conspiracy or an illicit

> business partnership, the

> health and wealth of the nation are being undermined

> by the pharmaceutical

> industry and its beneficiaries in government,

> medicine, academia, and by

> providers of mental health services-all of whom are

> financially supported by

> the drug industry.

>

> Robert Caruano, deputy director of Columbia

> University's Carmel Hill Center

> for Early Diagnosis and Treatment, which administers

> a teenage screening

> program nationwide, is quoted in the Erie Times

> stating that TeenScreen is

> beneficial because:

> " It's not the kid that's crying in the corner of the

> room, " he said. " It's

> the quarterback, it's the prom queen, it's the 'A'

> student that might have a

> problem. "

>

> At the center of the screening controversy is the

> Texas Medication Algorithm

> Program (TMAP)-a medication practice manual that was

> developed in 1995, by

> a panel was composed of drug industry

> representatives, University of Texas

> psychiatrists, and the mental health and corrections

> systems of Texas.

> Lacking scientific evidence of the selected drugs'

> efficacy or safety, the

> panel relied on a survey and " expert opinion

> consensus " -this is a radical

> departure from evidence-based medicine.

>

> According to a whistleblower's lawsuit, TMAP was

> funded by Janssen

> Pharmaceutica/ Johnson & Johnson, Eli Lilly,

> Astrazeneca, Pfizer, Novartis,

> Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott,

> Bristol Myers Squibb,

> Wyeth-Ayerst and Forrest Laboratories. Both the

> experts and the survey

> questions were chosen by the industry sponsors: the

> drugs they selected are

> manufactured by the TMAP sponsors: Paxil, Zoloft,

> Prozac, Celexa,

> Wellbutron, Zyban, Remeron, Serzone, Effexor,

> Buspar, Adderall Risperdal,

> Zyprexa, Seroqual, Geodone, and Depakote

> See:

>

http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf

>

>

> Allen Jones, formerly with the Pennsylvania

> Inspector General who blew the

> whistle, said: " The same political/pharmaceutical

> alliance that generated

> the Texas project was behind the recommendations of

> the New Freedom

> Commission, " which was " poised to consolidate the

> T-MAP effort into a

> comprehensive national policy to treat mental

> illness with expensive,

> patented medications of questionable benefit and

> deadly side effects, and to

> force private insurers to pick up more of the tab. "

>

> Dr. Stefan Kruszewski, a clinical psychiatrist

> (Harvard Medical School

> alumnus), has documented the human cost of collusion

> between state officials

> and drug companies: those most abused by

> misprescribed psychotropic drugs

> are in state custodial care-dependent children, the

> disabled, and those in

> juvenile justice system.

>

> Some are raising questions about the mental health,

> ethics, and financial

> motives of those involved in formulating and

> promoting screening initiatives

> which increase the use of already overprescribed

> psychotropic drugs. When

> will the ACLU step up to the plate and challenge the

> legality of coercive

> screening and drugging?

>

> Although one after another drug company has been

> fined millions of dollars

> (some repeatedly) for engaging in a pattern of

> deception and fraud, one

> wonders why they brazenly continue to promote drugs

> whose safety and

> efficacy is either in doubt, or whose hazards are

> concealed?

> And why is this industry allowed to fleece the

> American taxpayer by charging

> more than double for mostly useless, but hazardous

> drugs?

>

> The answer is the power of money to corrupt

> medicine. A just released book

> by Dr. Marcia Angell, former editor of the New

> England Journal of Medicine,

> is packed with facts and documented $$ amounts that

> will astound many

> readers. For example, pharma sales in the US amount

> $200 billion annually,

> worldwide the figure is $400 billion. Pharma spends

> $54 billion in drug

> marketing--that staggering amount buys a lot of

> influence.

> See: The Truth About the Drug Companies: How they

> Deceive us and What To Do

> About It, Random House, 2004.

>

> Contact: Vera Hassner Sharav

> Tel: 212-595-8974

> e-mail: veracare

>

> ~~~~~~~~~~

> http://www.healthday.com/view.cfm?id=520474

> Use of Antipsychotics Doubles for Low-Income Kids

> Tennessee study suggests treatment decisions are

> behind trend

> By Amanda Gardner

> HealthDay Reporter

> WEDNESDAY, Aug. 4 (HealthDayNews) -- The use of

> antipsychotic drugs among

> low-income children in Tennessee nearly doubled

> between 1996 and 2001, a new

> study finds.

> The increase, seen largely among children diagnosed

> with

> attention-deficit/hyperactivity disorder (ADHD),

> conduct disorder and

> affective disorders such as depression, has experts

> worried that young

> people who are not psychotic are being prescribed

> antipsychotic drugs for

> which there is no data on safety or effectiveness.

>

> " The medicine certainly has hardly been studied at

> all in kids, " said Dr.

> William Cooper, an associate professor of pediatrics

> at Vanderbilt

> University in Nashville. His report appears in the

> Aug. 3 issue of the

> Archives of Pediatric Adolescent Medicine.

> Newer antipsychotic medications are approved for use

> in children with

> illnesses such as psychosis or Tourette syndrome.

> Other than that, the

> effect of their use is largely an unknown, at least

> in this population.

>

> Cooper started noticing an increase in the number of

> young patients he was

> seeing who were taking newer generation

> antipsychotics in the late 1990s.

> This led him to conduct an analysis of children aged

> 2 through 18 who were

> enrolled in TennCare, Tennessee's program for

> Medicaid enrollees and

> uninsured individuals. Patient files included

> demographic information as

> well as prescription information. Files on about

> 300,000 children and

> adolescents were available for each year from 1996

> to 2001.

>

> The proportion of TennCare children who were started

> on antipsychotics

> nearly doubled in six years, from 23 per 10,000

> children in 1996 to 45 per

> 10,000 children in 2001. The increases were most

> dramatic among those aged 6

> to 12 (a 93 percent rise) and those aged 13 to 18 (a

> 116 percent increase).

> Use among preschool children increased 61 percent.

>

> The use of the drugs for behavioral problems

> associated with ADHD and mood

> disorders more than doubled. Teens had a threefold

> increase in the use of

> these drugs for ADHD and conduct disorder, meaning

> that nearly one in every

> 100 adolescents covered under the program was taking

> antipsychotics for

> these reasons, the study found.

>

> Part of the explanation for the increase may have

> been the intro-duction, in

> the 1990s, of a new generation of antipsychotics

> that included clozapine,

> risperidone, olanzapine, quetiapine fumarate and

> ziprasidone hydrochloride,

> which may be perceived as safer by some physicians.

> Older antipsychotics

> such as Haldol had severe neurological side effects

> and were reserved for

> those who absolutely had to have them.

>

> " In the mid-1990s there were some newer

> antipsychotics which were as

> powerful but didn't have the side effects, so people

> began to think maybe

> these are safe, " Cooper said. " It turns out you

> really are trading

> neurologic side effects for other side effects,

> including obesity, type 2

> diabetes and, rarely, heart arrhythmia. From

> preliminary studies, it looks

> as if those problems [side effects] are more

> pronounced in kids. "

> Another concern, according to Cooper, is that the

> newer drugs weren't

> designed for treating problems such as ADHD,

> although there is some evidence

> they may help with severe disruptive behavior, he

> added.

>

> Dr. Melvin Oatis, an assistant professor of clinical

> psychiatry at New York

> University Child Study Center in New York City, said

> he has also noticed an

> increase in the use of these drugs for children and

> teens who aren't

> psychotic.

>

> When they are prescribed to a non-psychotic child,

> " it's because of a severe

> conduct disorder, a child who sets fires, is cruel

> to cats, skips school,

> someone who is headed towards trouble, " he said.

> " Those are the kids that we

> would give antipsychotic medication to sooner in the

> hopes that it is going

> to thwart some of their misbehaviors. "

> Antipsychotic drugs may also be given to children

> who are autistic and in

> danger of harming themselves or their caregivers,

> Oatis said. " Giving them

> antipsychotics has been very beneficial in terms of

> controlling behavior, "

> he said. But, he added, he could not say if the

> increase he is seeing among

> his patients in New York City is similar in any way

> to the one Cooper

> noticed among his Tennessee population.

>

> Whether the drugs are beneficial or not, to Cooper

> the point is still clear.

> " We need to study these medications, " he said. In

> the meantime, he is

> starting research to see if the same

> drug-prescription patterns can be

> observed nationally among insured children.

> More information

>

> Visit the American Academy of Child & Adolescent

> Psychiatry for more on

> psychiatric medication for children.

> SOURCES: William O. Cooper, M.D., associate

> professor, pediatrics,

> Vanderbilt University Medical Center, Nashville,

> Tenn.; Melvin Oatis, M.D.,

> assistant professor, clinical psychiatry, New York

> University Child Study

> Center, New York City; Aug. 3, 2004, Archives of

> Pediatric Adolescent

> Medicine

> Copyright C 2004 ScoutNews LLC All rights reserved.

> ~~~~~~~~~

>

>

http://www.illinoisleader.com/news/newsview.asp?c=19137

>

> Illinois Leader

> Illinois, eye of national mental health storm

> Tuesday, August 31, 2004

> By Rhonda Robinson,

>

> Exertpt:

>

> SPRINGFIELD -- When members of the Illinois House

> voted to pass the Illinois

> Children's Mental Health Act in 2003, Rep. Mary

> Flowers (D-Chicago, 31st

> Dist.] predicted, " I'm sure [the bill] is gonna fly

> out of here, but I

> guarantee each and every last one of you that this

> will be revisited. "

> Flowers was one of only five representatives to vote

> against the measure.

> Flowers was right.

>

> As Illinois prepares to become the first state to

> implement President Bush's

> New Freedom Commission on Mental Health, controversy

> is brewing around the

> nation over its " Orwellian " mandates, as one

> observer called them.

> So far, only Internet sites are exploring the

> controversy, with newfound

> information traveling throughout a nationwide

> network of " intelligence "

> gatherers and disseminators on a daily basis.

>

> The concerns are sweeping - over pharmaceutical

> influence on the Food and

> Drug Administration and medical profession, over

> lack of or faulty clinical

> trials, and over political corruption. The Illinois

> Children's Mental Health

> Partnership, charged with putting the Children's

> Mental Health Act into

> action and overseeing its implementation, stated in

> its preliminary plan

> last month it will " explore strategies for

> maximizing the purchase of

> psychotropic drugs from the state Pharmacy at

> discount prices. "

>

> In Pennsylvania, Dr. Stefan Kruszewski, a clinical

> professor of psychiatry

> has filed a federal lawsuit against state officials

> and six pharmaceutical

> companies, alleging they, " through the use of

> political friendships, money

> and other emoluments, effectively achieved a level

> of influence with

> Pennsylvania's state government that allowed them to

> abuse state finances

> and state citizens with impunity. "

>

> Kruszewski conducted medical reviews and appeals for

> the Pennsylvania

> Department of Public Welfare and was a consultant

> for the Bureau of Program

> Integrity. Kruszewski's lawsuit " centers upon making

> money at the expense of

> public finances through the improper use of state

> employees and custodial

> populations including dependent children. "

> Kruszewski charged the misuse of medications on

> innocent humans, deaths of

> children under the care of the Pennsylvania Office

> of Medical Assistance,

> and the improper adoption of drug company sponsored

> algorithms.

>

> On August 27, New York State Attorney General Eliot

> Spitzer announced he had

> settled a major lawsuit against the pharmaceutical

> company GlaxoSmithKline,

> which manufactures the popular antidepressant,

> Paxil. Spitzer charged that

> GSK committed fraud by hiding Paxil study results

> that " not only failed to

> show any benefit for the drug in children but

> demonstrated that children

> taking Paxil were more likely to become suicidal

> than those taking a

> placebo, " according to the August 26 New York Times.

>

>

> The NFC recommends that states incorporate the Texas

> Medication Algorithm

> Project, known as T-MAP, as a model to follow. These

> are flowcharts

> prescribing the use of specific drugs for specific

> mental illness diagnoses.

> About T-MAP are questions of pharmaceutical

> influence among state policy

> makers, the safety of antidepressants in children,

> the FDA approval process,

> and program oversight.

>

> According to the British Medical Journal, the Texas

> project, which promotes

> only the newest, more expensive antidepressants,

> began in 1995 " as an

> alliance of individuals from the pharmaceutical

> industry, the University of

> Texas, and the mental health and corrections systems

> of Texas. The project

> was funded by a Robert Wood Johnson grant - and by

> several drug companies. "

> ..cut.

>

> C 2004 IllinoisLeader.com -- all rights reserved

> _______

>

> Schools' testing breaks new ground

> Erie first in nation to screen teens' mental health

> throughout district

> Aug. 18, 2004

> By KENDRA SNYDER

> kendra.snyder

>

> Excerpt:

>

> The Erie School District recently became the first

> in the nation to give

> students districtwide a mental-health screening

> aimed at identifying those

> who need treatment.

> In the spring, Erie ninth-graders took the

> TeenScreen survey, a program

> developed by researchers at Columbia University in

> the New York City to

> check students for mental-health illnesses.

>

> The 10-minute computer-assisted survey is meant to

> detect eight types of

> mental illnesses, including depression, anxiety,

> social phobias and

> substance-abuse problems, based on " yes " and " no "

> responses. And the results

> were surprising, said Tina Christiansen, the

> district's supervisor of

> student and community programs. A little more than

> 10 percent of the 831

> ninth-graders who voluntarily took the survey were

> identified as needing

> further evaluation.

>

> Health clinicians in the state's Student Assistance

> Program already were

> meeting with Erie students they felt needed

> mental-health assistance, but 61

> percent of the students identified with possible

> mental-health problems

> weren't receiving any kind of help.

> " It was amazing, " Christiansen said. " Not one of my

> staff predicted that we

> would identify many kids that we didn't already know

> of. And we did. "

>

> The survey produced such results because it " finds

> the internalizing

> disorders, " said Robert Caruano, deputy director of

> Columbia University's

> Carmel Hill Center for Early Diagnosis and

> Treatment, which administers the

> program. " They're the types of illnesses that you

> can't look at somebody and

> see, " Caruano said. " Teenagers are skilled at

> masking all types of things. "

>

> According to the National Mental Health Association,

> one in five children 17

> and younger nationally have a diagnosable mental,

> emotional or behavioral

> disorder, and up to one in 10 might have a serious

> emotional disturbance.

> The association also estimates that 70 percent of

> children do not receive

> mental-health services.

>

> Lack of diagnosis could be why suicide is the

> third-highest cause of teenage

> death in the nation, said Bill Grove, director of

> the Mental Health

> Association of Northwestern Pennsylvania.

> " Teens are often overlooked, " he said. " Sometimes

> clinical depression in

> mental health is looked at as just teenage ups and

> downs. " That's why

> Christiansen said she would like to see the

> screening become as accepted in

> schools as hearing and vision tests. School

> administrators have yet to

> determine how TeenScreen will fit into Erie schools.

>

> . cut .

>

> FAIR USE NOTICE: This may contain copyrighted (C )

> material the use of which

> has not always been specifically authorized by the

> copyright owner. Such

> material is made available for educational purposes,

> to advance

> understanding of human rights, democracy,

> scientific, moral, ethical, and

> social justice issues, etc. It is believed that this

> constitutes a 'fair

> use' of any such copyrighted material as provided

> for in Title 17 U.S.C.

> section 107 of the US Copyright Law. This material

> is distributed without

> profit.

>

>

>

>

> [Non-text portions of this message have been

> removed]