Treating children as young as 4 for bipolar - WSJ

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[sSRI-Research] Treating children as young as 4 for bipolar - WSJ

Treating children as young as 4 for bipolar - WSJ

 

http://www.ahrp.org/infomail/05/05/26.php

 

Thu, 26 May 2005

 

A report in The Wall Street Journal should raise serious concerns

about the legitimacy of psychiatric diagnosing and drug prescribing

for children.

 

The Journal reports that close to 20,000 US children are being

diagnosed with bi-polar disorder, a condition that had, until

recently been very rare according to responsible child

psychiatrists. " The number of children diagnosed as bipolar rose 26%

from 2002 to 2004, to 19,776 cases " according to patient records kept

by health-care information company NDCHealth Corp. " Increased use of

antipsychotic medicines, such as Seroquel and Risperdal, was a big

driver of pediatric drug costs last year, according to pharmacy-

benefit manager Medco Health Solutions Inc. "

 

Yet, the Journal reports that a heated debate is brewing between two

camps of powerful child psychiatrists--all of whom are proponents of

psychotropic drugs. Leading child psychiatrists disagree about

whether children should even have to meet the diagnostic threshold

for a diagnosis of bipolar before being prescribed some of the most

powerful mind altering psychotropic drugs on the planet. Their

decisions may irrevocably harm children.

 

Bipolar disorder is a severe, disabling psychiatric condition broadly

defined in the diagnostic bible of psychiatry--the DSM IV. To meet

the diagnostic criteria for bipolar in adults, patients must exhibit:

Inflated self-esteem or grandiosity; Decreased need for sleep;

Increased or pressured speech; Flight of ideas/racing thoughts;

Distractibility; Increased goal-directed activity; Risk-taking

behavior-- " bipolar disorder causes people to cycle between manic,

euphoric highs and crushing, depressive lows that last a week or

more. " Presumably, a psychiatrist prescribing powerful mind-altering

drugs to a patient meeting those symptoms would be justified.

 

The drugs prescribed for bipolar disorder are the so-called 'atypical

antipsychotics'--including Risperdal (risperidone), Zyprexa

(olanzapine), Seroquel (quetiapine). These drugs have not been

approved for children. Neither were they approved initially for

bipolar disorder in adults. These antipsychotics were at first

approved only for schizophrenia--the most severe, debilitating

psychiatric disorder in which psychosis, hallucinations, hearing

voices, are the core symptoms, affecting 1% of the population.

 

Unfathomably, these powerful--and harmful--psychotropic drugs have

beome blockbuster sellers, enriching Eli Lilly, Johnson & Johnson and

Bristol Myers Squibb, while producing diabetes in more than 30% of

youth.

 

Since doctors diagnosing children disagree about the basis for

diagnosing and treating children, their practice method may be

legitimately characterized as child abuse with chemical restraints.

Psychiatry's rather broad diagnostic criteria were established by a

group of leading psychiatrists. Therefore, current efforts to lower

those standards--both in terms of prevalence (quantity) and severity

(quality) of the symptoms, is a radical departure from psychiatry's

own standards such as they are: " A bipolar child can flip between a

high and low several times a day. There also is disagreement over

what constitutes the highs, with some doctors saying the manic phase

in children often reveals itself as extreme rages, violence and

emotional outbursts, rather than the traditional euphoria. "

 

The push by an influential group of child psychiatrists at Harvard

may lie at the root of what is an epidemiological mystery: what

disaster can account for the staggering number of children being

diagnosed with bipolar disorder? It appears that the most radical of

child psychiatrists who recommend prescribing antipsychotics for

children are at Harvard. They are pressuring the profession to

prescribe antipsychotics for children --even without the criteria

establshed by their profession, and even in the knowledge that the

risks of harm for children are irrevocable.

 

Parents need help from Congress to stop the abuse. Parents and

healthcare public policy makers have a right to demand from state

licenced medical professionals that they adhere to evidence-based

medicine: what constitutes a legitimate psychiatric diagnosis in

children? What constitutes a scientifically valid diagnosis of

bipolar disorder in children? Clearly, it is not in a child's best

interst to be exposed to powerful drugs that alter brain function on

the basis of " vague " symptoms of attention derficit hyperactivity

(ADHD).

 

How can a drug approved for a very small group of very disabled

patients, become Eli Lilly's best selling drug?

 

How many millions of dollars has Harvard and the members of its

psyciatry department received from the makers of these drugs?

 

Contact: Vera Hassner Sharav

212-595-8974

 

 

The Wall Street Journal

Treating Children for Bipolar Disorder; Doctors Try Powerful Drugs On

Kids

as Young as Age 4; An Overlap With ADHD

Leila Abboud.

May 25, 2005. p. D.1