What I have to write about here is both extremely complex and highly emotionally-charged. If you are prone to anger and rash judgments, please don’t read any further. You can’t think when you are angry.
Today, the New York Times published an article about drug companies behaving badly and psychiatrists who should know better. The story’s hook concerns young Anya Bailey, who was prescribed an antipsychotic for an eating disorder.
There is no FDA indication for treating eating disorders with antipsychotics, but it is standard practice for doctors to prescribe medications off-label for all manner of illnesses.
With an antipsychotic, doctors often use the side effect as the healing effect. For instance, Seroquel’s strong sedative effect is regularly employed as an off-label sleep aid, so much so that I used to joke to my old support group, “Welcome to the Seroquel Users Club.”
It is important to note that when Seroquel is used as a sleep aid it is prescribed in microscopically small doses – about 25 mg or so rather than the usual 300 mg.
Some antipsychotics cause huge weight gain. You can see where this is going. Anorexic girl in doctor’s office – samples for Risperdal in medicine cabinet. Bad decision. Antipsychotics are never to be prescribed lightly. They are built for extremely serious mental disorders, usually in emergency situations, and come fully-loaded with onerous side effects.
Poor Anya developed a serious back cramp, which she is still struggling with two years later.
Drug Industry Money
The New York Times article then reported that Anya’s supervising psychiatrist received some $7,000 in lecture fees from Johnson & Johnson, makers of Risperdal. The article went on to say that in the state of Minnesota – the only state that fully documents drug company pay-outs to doctors – while drug company payments to psychiatrists rose six-fold over five years, antipsychotic prescriptions to kids went up nine-fold. In addition, doctors who received $5,000 or more wrote three times the number of prescriptions for antipsychotics to kids than did doctors who failed to benefit from industry largesse.
An outrage? Yes. Most definitely. In the nine years I have been engaged in mental health reporting I have extensively documented the corrupting influence the drug industry has over psychiatry. The pharmaceutical industry, with the acquiesence of the psychiatric profession, literally sets the psychiatric agenda, from professional education courses to the articles that appear in medical journals to what gets researched to treatment protocols to what type of drugs reach the market.
Much of what goes on is totally unethical and contrary to the public interest. As I reported in a recent blog, the pharmaceutical industry is probably the only industry that pays no attention to its consumers, namely us.
Please restrain your anger. There is a thinking zone ahead:
Bipolar Kids
The New York Times article then points out that antipsychotics are being prescribed to kids for the controversial diagnosis of early-onset bipolar. It was the New York Times that in February broke the tragic story of Rebecca Riley, age four, who died from an overdose of antipsychotics. One of the reporters of today’s article, Benedict Carey, was also involved in the Rebecca Riley story, as well as a story involving an Eli Lilly cover-up concerning Zyprexa.
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