mindfreedom-news: Mother Jones_ exposes psychiatric drugging of kids

[Guest guest]

Sat, 23 Apr 2005 18:45:36 -0700

mindfreedom-news

Subject:_Mother Jones_ exposes psychiatric drugging of kids

 

 

The below superb article in the new _Mother Jones_

May/June 2005 issue ***EXPLODES*** the controversy

of psychiatric drugging of USA kids! Read how drug

companies are manipulating President Bush and state

officials to push drugs using " screening programs. "

 

Did you know President Bush is calling for screening

*every* child and even every *ADULT* in the USA with

the drug company screening programs exposed below?

 

Are you next?

 

SAY NO TO PSYCHIATRIC DRUG SCREENING NOW!

 

Join a peaceful protest by MindFreedom International

to say " no " in Washington, D.C. on Monday, 2 May 2005

at noon directly in front of the headquarters of the

Pharmaceutical Research and Manufacturers of America

(PhRMA). For a downloadable news release, poster, etc.

see Protest Info Center at http://www.MindFreedom.org.

 

*BELOW* is a full copy of the _Mother Jones_ article.

Please get this out far & wide on & off the Internet!

 

~~~~~~~~~~

 

_Mother Jones_ May/June 2005 Issue

 

Medicating Aliah

 

When state mental health officials fall under

the influence of Big Pharma, the burden falls

on captive patients. Like this 13-year-old girl.

 

by Rob Waters

 

ALIAH GLEASON IS A BIG, lively girl with a

round face, a quick wit, and a sharp tongue.

She's 13 and in eighth grade at Dessau Middle

School in Pflugerville, Texas, an Austin

suburb, but could pass for several years

older. She is the second of four daughters of

Calvin and Anaka Gleason, an African American

couple who run a struggling business taking

people on casino bus trips.

 

In the early part of seventh grade, Aliah was

a B and C student who " got in trouble for

running my mouth. " Sometimes her antics went

overboard -- like the time she barked at a

teacher she thought was ugly. " I was calling

this teacher a man because she had a

mustache, " Aliah recalled over breakfast with

her parents at an Austin restaurant.

 

School officials considered Aliah disruptive,

deemed her to have an " oppositional disorder, "

and placed her in a special education track.

Her parents viewed her as a spirited child

who was bright but had a tendency to argue

and clown. Then one day, psychologists from

the University of Texas (UT) visited the

school to conduct a mental health screening

for sixth- and seventh-grade girls, and

Aliah's life took a dramatic turn.

 

A few weeks later, the Gleasons got a " Dear

parents " form letter from the head of the

screening program. " You will be glad to know

your daughter did not report experiencing a

significant level of distress, " it said. Not

long after, they got a very different phone

call from a UT psychologist, who told them

Aliah had scored high on a suicide rating and

needed further evaluation. The Gleasons

reluctantly agreed to have Aliah see a UT

consulting psychiatrist. She concluded Aliah

was suicidal but did not hospitalize her,

referring her instead to an emergency clinic

for further evaluation. Six weeks later, in

January 2004, a child-protection worker went

to Aliah's school, interviewed her, then

summoned Calvin Gleason to the school and

told him to take Aliah to Austin State

Hospital, a state mental facility. He

refused, and after a heated conversation, she

placed Aliah in emergency custody and had a

police officer drive her to the hospital.

 

The Gleasons would not be allowed to see or

even speak to their daughter for the next

five months, and Aliah would spend a total of

nine months in a state psychiatric hospital

and residential treatment facilities. While

in the hospital, she was placed in restraints

more than 26 times and medicated -- against her

will and without her parents' consent -- with at

least 12 different psychiatric drugs, many of

them simultaneously.

 

On her second day at the state hospital,

Aliah says she was told to take a pill to

" help my mood swings. " She refused and hid

under her bed. She says staff members pulled

her out by her legs, then told her if she

took her medication, she'd be able to go home

sooner. She took it. On another occasion, she

" cheeked " a pill and later tossed it into the

garbage. She says that after staff members

found it, five of them came to her room, one

holding a needle. " I started struggling, and

they held my head down and shot me in the

butt, " she says. " Then they left and I lay in

my bed crying. "

 

What, if anything, was wrong with Aliah

remains cloudy. Court documents and medical

records indicate that she would say she was

suicidal or that her father beat her, and

then she would recant. (Her attorney

attributes such statements to the high

dosages of psychotropic drugs she was

forcibly put on.) Her clinical diagnosis was

just as changeable. During two months at

Austin State Hospital, Aliah was diagnosed

with " depressive disorder not otherwise

specified, " " mood disorder not otherwise

specified with psychotic features, " and

" major depression with psychotic features. "

 

In addition to the antidepressants Zoloft,

Celexa, Lexapro, and Desyrel, as well as

Ativan, an antianxiety drug, Aliah was given

two newer drugs known as " atypical

antipsychotics " -- Geodon and Abilify -- plus an

older antipsychotic, Haldol. She was also

given the anticonvulsants Trileptal and

Depakote -- though she was not suffering from a

seizure disorder -- and Cogentin, an

anti-Parkinson's drug also used to control

the side effects of antipsychotic drugs. At

the time of her transfer to a residential

facility, she was on five different

medications, and once there, she was put on

still another atypical -- Risperdal.

 

The case of Aliah Gleason raises

troubling -- and long-standing -- questions about

the coercive uses of psychiatric medications

in Texas and elsewhere. But especially

because Aliah lives in Texas, and because her

commitment was involuntary, she became

vulnerable to an even further hazard:

aggressive drug regimens that feature new and

controversial drugs -- regimens that are promoted

by drug companies, mandated by state

governments, and imposed on captive patient

populations with no say over what's

prescribed to them.

 

In the past, drug companies sold their new

products to doctors through ads and articles

in medical journals or, in recent years, by

wooing consumers directly through television

and magazine advertising. Starting in the

mid-1990s, though, the companies also began

to focus on a powerful market force: the

handful of state officials who govern

prescribing for large public systems like

state mental hospitals, prisons, and

government-funded clinics.

 

One way drug companies have worked to

influence prescribing practices of these

public institutions is by funding the

implementation of guidelines, or algorithms,

that spell out which drugs should be used for

different psychiatric conditions, much as

other algorithms guide the treatment of

diabetes or heart disease. The effort began

in the mid-1990s with the creation of

TMAP -- the Texas Medication Algorithm Project.

 

Put simply, the algorithm called for the

newest, most expensive medications to be used

first in the treatment of schizophrenia,

bipolar disorder, and major depression in

adults. Subsequently, the state began

developing CMAP, a children's algorithm that

is not yet codified by the state legislature.

At least nine states have since adopted

guidelines similar to TMAP. One such state,

Pennsylvania, has been sued by two of its own

investigators who claim they were fired after

exposing industry's undue influence over

state prescribing practices and the resulting

inappropriate medicating of patients,

particularly children.

 

Thanks in part to such marketing strategies,

sales of the new atypical antipsychotics have

soared. Unlike antidepressants -- which have been

marketed to huge audiences almost as lifestyle

drugs -- antipsychotics are aimed at a small but

growing market: schizophrenics and people

with bipolar disorder. Atypicals are

profitable because they are as much as 10

times more expensive than the old

antipsychotics, such as Haldol. In 2004,

atypical antipsychotics were the

fourth-highest-grossing class of drugs in the

United States, with sales totaling $8.8

billion -- $2.4 billion of which was paid for by

state Medicaid funds.

 

At a time when ethical questions are dogging

the pharmaceutical industry and algorithm

programs in Texas and Pennsylvania, President

Bush's New Freedom Commission on Mental Health

has lauded TMAP as a " model program " and

called for the expanded use of screening

programs like the one at Aliah Gleason's

middle school. The question now is whose

interests do these programs really serve --

 

THE TEXAS MEDICATION ALGORITHM PROJECT got

under way in the mid-1990s just as the new

generation of antipsychotic drugs was coming

on the market. For some 40 years before,

medications like Thorazine, Haldol, and

Mellaril were given to patients with

schizophrenia or psychosis to silence their

voices and calm their agitation. But they

caused terrible side effects, including

sedation, social withdrawal, and tardive

dyskinesia, which causes muscle and facial

tics and strange jerking movements like those

in people with Parkinson's disease. Many

patients would refuse to take them -- when they

had a choice. Some sued drug companies and

doctors for failing to warn them about the

side effects and won large awards.

 

Into that environment, drug companies brought

out the new atypical antipsychotics and began

describing them in almost miraculous terms.

The drugs -- including Janssen Pharmaceutica's

Risperdal, Eli Lilly's Zyprexa, Pfizer's

Geodon, AstraZeneca's Seroquel, and

Bristol-Myers Squibb's Abilify, as well as a

slightly older drug, Clozapine by Sandoz -- were

said to be more effective than the

first-generation antipsychotics and less

likely to cause motor problems and other side

effects. " A potential breakthrough of

tremendous magnitude, " Stanford University

psychiatrist Alan Schatzberg gushed to the

New York Times. Laurie Flynn, executive

director of the National Alliance for the

Mentally Ill, added that now " the long-term

disability of schizophrenia can come to an

end. "

 

Despite the hoopla, not all doctors

immediately embraced the new drugs, and many

patients bounced haphazardly between the old

and new antipsychotics. " They complained that

whenever they got new doctors, their whole

medication regimen usually changed, " says Dr.

Steven Shon, the medical director for

behavioral health for the Texas Department of

State Health Services (DSHS).

 

In 1995, Shon began talking with researchers

at the UT-Southwestern Medical Center in

Dallas about the use of algorithms to address

these random prescribing practices. From the

start, the process of creating the algorithms

reflected the extensive ties between academic

psychiatrists and the pharmaceutical

industry. UT-Southwestern was a major

research center stocked with investigators

conducting drug trials paid for by

pharmaceutical companies.

 

One of Shon's key collaborators was Dr. John

Rush, a nationally known psychopharmacologist

who has extensive ties to industry. Rush

declined to speak for this article, but

according to a disclosure statement appended

to one of his published articles, he has

received grant and research support from 14

pharmaceutical companies, has served as a

consultant to 11, and has been a member of 10

drug company speakers' bureaus.

 

Together, Shon, Rush, and the then-chair of

UT-Southwestern's psychiatry department

convened panels of experts who drew up

" consensus guidelines " for schizophrenia,

bipolar disorder, and major

depression -- blueprints on which drugs to give

patients in what order and combination. Of

the 46 members of the three panels, 27 have

conducted research on behalf of

pharmaceutical companies, served on drug

company speakers' bureaus, or served as

consultants to a drug company, according to a

review conducted for Mother Jones by the

Center for Science in the Public Interest, a

watchdog group that maintains a database on

the financial links of researchers.

 

For the drug companies, TMAP represented an

opportunity. Their products were given a high

priority in the algorithm, and if the

algorithm was widely followed, it could mean

thousands of prescriptions and millions of

dollars in revenue. The industry didn't miss

the chance. " We went to the pharmaceutical

companies or, actually, they approached us

because they are always dropping by, " Shon

told Mother Jones. " Once we created the

algorithms, they said, 'Could you use any

financial help for any materials?' And we

said, 'Yeah,' because we have to publish

manuals. We have to create training

videotapes. "

 

Shon says the initial creation of the TMAP

guidelines was underwritten by state funds,

along with $3 million in grants from

foundations, including $2.4 million from the

Robert Wood Johnson Foundation, a charity set

up by the estate of a former chief executive

of Johnson & Johnson, the parent of Janssen.

Shon insists that no industry money went into

the creation of the guidelines, though a 1999

paper he coauthored outlining the

" development and implementation " of TMAP

acknowledged grant support from seven

pharmaceutical companies.

 

Shon also told Mother Jones that his

department received only $285,000 from drug

companies for TMAP's training materials in

the program's " feasibility testing stage. "

But Nanci Wilson, an investigative reporter

for KEYE-TV in Austin, reviewed the DSHS

accounts, and her analysis indicates that

gifts from pharmaceutical companies totaled

$1.3 million from 1997 to July 2004, at least

$834,000 of which was earmarked for TMAP. For

example:

 

*** Janssen Pharmaceutica, the maker of

Risperdal, gave $191,183 " to help support

further developmental activities of TMAP " or

in general support of TMAP.

 

*** Eli Lilly, the maker of Prozac and

Zyprexa, gave $47,000 to " help fund the

collaborative effort to develop medication

best practices for the treatment of major

depression, schizophrenia and bipolar

disorders. " All together Lilly contributed

$103,000 to support TMAP.

 

*** Pfizer, the maker of the antidepressant

Zoloft and the new antipsychotic Geodon,

contributed at least $146,500 for TMAP.

 

While not refuting Shon's statement, DSHS

spokesman Doug McBride says he is " aware "

that industry donated $1.3 million.

Representatives of pharmaceutical companies

contacted by Mother Jones denied that their

contributions were intended to shape TMAP.

" We didn't participate in the development or

influence the content, " said Janssen

spokesman Doug Arbesfeld. " It was an

arm's-length contribution. " Heather Lusk, an

Eli Lilly representative, said contributions

to TMAP were " educational " grants made by a

company grants office that " is completely

independent of any kind of sales and

marketing function. "

 

Pfizer's Jack Cox pointed out that nonprofit

mental health advocacy groups also raise and

spend money to influence policy. " There's an

assumption that our money is dirty and

corrupt, " he said. " I beg to differ. "

 

AS THE TMAP PANEL MEMBERS worked on the

protocols, drug companies aggressively

promoted the new antipsychotics across the

psychiatric landscape. Their key selling

point: that they were more effective and

caused fewer serious side effects than the

older antipsychotics, especially Haldol, the

most widely used. Though it did approve six

atypicals, the FDA was dubious of some of

these claims. " We would consider any

advertisement or promotional labeling for

Risperdal false, misleading or lacking fair

balance if there is a presentation of data

that conveys the impression that [Risperdal]

is superior to [Haldol] or any other marketed

antipsychotic drug product with regard to

safety or effectiveness, " an FDA official

wrote in a 1993 letter to Janssen

Pharmaceutica. But the letter was only made

public 53years later, when journalist Robert

Whitaker quoted it in his 2002 book, Mad in

America. Most prescribing doctors were left

in the dark. (For more on how drug companies

manipulated clinical trials for atypicals see

motherjones.com/spinningdoctors.)

 

The largest study to date, a review of 52

clinical trials including more than 12,000

patients published in the British Medical

Journal in 2000, found " no clear evidence

that atypical antipsychotics are more

effective or better tolerated than

conventional antipsychotics. " A 2003 study

comparing Zyprexa, the top-selling atypical

antipsychotic, and Haldol, published in the

Journal of the American Medical Association,

found the new drug " does not demonstrate

advantages compared with [Haldol] in

compliance, symptoms or overall quality of

life. "

 

The new drugs now appear to be associated

with higher suicide rates and to cause

tardive dyskinesia, too, though perhaps at

lower rates than the first-generation drugs.

They can cause rapid weight gain and thus an

increased risk of diabetes. In September

2003, the FDA required the makers of all

atypicals to add to their labels a warning

that the drugs can cause hyperglycemia,

diabetes, and even death. Janssen was also

made to send doctors a letter conceding it

had misled them when it said that Risperdal

does not increase the risk of diabetes. In

fact, the company had to admit, it probably

does.

 

When TMAP's schizophrenia algorithm was

finalized in 1997, however, it did exactly

what industry representatives must have hoped

for: It called for the newest, most expensive

drugs -- five atypicals -- to be used first. If a

patient does not respond well to one of those

drugs, a second member of this group should be

tried. If that drug also fails, a third drug

should be tried, this time either another

atypical or an older antipsychotic. The

guidelines for major depression and bipolar

disorder similarly favor new drugs.

 

" When [the drug companies] saw the newer

medications were there, they liked that, of

course, " says Shon. " I know that has raised

questions in people's minds: 'Why are the

newest, most expensive first?' Well, the

newest, most expensive are either the most

efficacious and/or the safest. "

 

But that assertion is increasingly disputed.

" When atypicals came out, they looked a

little better in effectiveness and a lot

better in terms of side effects, " says Mike

Hogan, Ohio's mental health director and

former chairman of President Bush's New

Freedom Commission on Mental Health. " These

days, they look perhaps a tiny bit better in

terms of effectiveness, but increasingly it's

not clear whether the side-effect profile is

better or just different. "

 

Ohio adopted a TMAP-like algorithm in 2001

but with a critical difference. According to

Hogan, it's merely a guideline for

prescribing doctors to consider. But in

Texas, state officials put far more pressure

on its physicians to follow the protocols.

Under regulations codified by the legislature

in 1999, doctors in state-owned and

state-funded mental health entities must

follow the algorithm, or justify a different

course with a note in a patient's file -- a

hurdle that sends the message that such

deviation should be the rare exception.

 

As the TMAP guidelines began to be adopted in

1997, Texas Medicaid spending on the five

atypical antipsychotics skyrocketed from $28

million to $177 million in 2004.

 

MANY DOSES OF THESE DRUGS went to patients

like Aliah Gleason. She was one of 19,404

Texas teenagers prescribed an antipsychotic

in July or August of 2004 through a publicly

funded program, according to ACS-Heritage, a

medical consulting firm hired by Texas to

investigate the use of psychotropic drugs on

children. Nearly 98 percent were atypical

antipsychotics -- unapproved for children and

prescribed " off-label, " a controversial

practice in which doctors legally prescribe

FDA-cleared drugs to patients, such as

children, or for conditions, such as

depression, for which they are not approved.

The report found that more than half of the

doses for antipsychotics appeared

inappropriately high, that almost half did

not appear to have valid diagnoses warranting

their use, and that one-third of child

patients were on two or more medications.

 

When she was transferred from Austin State

Hospital to a residential facility on March

18, 2004, Aliah was on five different

medications, putting her on the extreme end

of a growing practice known as polypharmacy

that worries many doctors. " This is a

complicated regimen using powerful

psychotropic medications in a barely

adolescent girl, so I would be quite

concerned about it, " says Dr. Joseph

Woolston, a Yale University professor and

chief of child psychiatry at Yale-New Haven

Hospital. " It isn't grossly, acutely

dangerous, but it is sedating and would make

it difficult for a child to experience the

world in a normal way. If you or I were on

that regimen we would have a lot of trouble

attending to work or school. We don't have

any idea what that combination of medications

does to a developing child. It may have a

number of long-term side effects. " He also

suspects that the drugs may have been used as

much to control the angry reactions of a girl

who was hospitalized against her will

as to treat any mental and emotional

problems.

 

Dr. Clifford Moy, clinical director of Austin

State Hospital, says that while the hospital's

philosophy is to avoid using more than one

member of any particular class of psychiatric

medication, using multiple drugs from

different classes is often the best way to

treat a patient with multiple symptoms. While

declining, for privacy reasons, to discuss

Aliah's treatment, he said medication and

restraint would never be used for punitive

purposes or merely to promote compliance with

hospital rules, but only in the case of a

" significant emergency behavioral situation. "

He added that forced injection of an

antipsychotic -- which happened to Aliah several

times -- might be used " if there were a legal

consent for an oral antipsychotic medication,

which the patient refused. " Such consent was

apparently provided, in Aliah's case, by the

Department of Protective and Regulatory

Services.

 

The 46-bed child and adolescent wing where

Aliah stayed was not, like the rest of Austin

State Hospital, obligated to follow TMAP. Its

treatment regimens were influenced more by

CMAP, the children's algorithm not yet

mandated by the legislature. CMAP steers

clear of providing protocols for

schizophrenia and bipolar disorder -- the

disorders that atypicals were designed to

address -- in part, says DSHS's Doug McBride,

because there's " little scientific evidence "

as to what the appropriate regimen for kids

would be. CMAP does, however, call for

combining atypicals with antidepressants for

children diagnosed -- as Aliah was -- as suffering

from depression " with psychotic features. "

McBride defends such off-label use of

prescription drugs, saying that the FDA

approval process " is not the end of clinical

and other scientific evidence on the use of

that medication. "

 

Beyond their technical dictates, the

algorithms established a culture that

affected which medications were prescribed.

Steven Shon, who, along with his colleagues,

had led training sessions for the staff of

Austin State Hospital, argues that the

algorithms were designed to prevent

irrational and excessive medication. Yale's

Woolston agrees with the goal, though not

necessarily the reality. " Algorithms are

supposed to cut down on people using

medications inappropriately and to take into

account medication interaction, " he says.

" Where they become a problem is when people

use them as a mandate, forget their own

clinical judgment, and believe that when

you're in doubt, you're supposed to move

forward in the algorithm and add more

medication. "

 

Medications can be invaluable, and some

patients say their lives have been

transformed by atypicals. But algorithms

reinforce the perception in both psychiatry

and popular culture that mental problems

always require drug treatment. " An algorithm

may put blinders on a psychiatrist and create

the presumption that the only clinical

approach to problems is to use medications, "

Woolston says. If a patient doesn't respond

to a particular medication, a doctor relying

on an algorithm may think they need to use or

add a different medication, he says. " But

sometimes, the best approach is to say,

'Medication isn't working; let's try

something else.' "

 

ONCE THE DEVELOPMENT of the algorithms was

largely complete, Shon began hitting the

road, making about one trip a month -- often at

the expense of drug companies -- to spread the

TMAP gospel to officials in other states.

This close relationship between TMAP and the

pharmaceutical industry raises disturbing

questions about whether the drug companies

were wielding undue influence or profiting at

the expense of patients. But no one raised

these questions until 2002, when Allen Jones,

an investigator for the state of

Pennsylvania's Office of Inspector General

(OIG) began to look into a complaint that

mental health officials had set up an

unorthodox bank account to collect money from

drug companies.

 

Jones, a lanky, 50-year-old chain-smoker, had

spent several years with the OIG in the late

'80s and early '90s, but left to pursue real

estate investing to pay for his daughters'

college tuition. He had only just rejoined

the agency in the summer of 2002 when he

began investigating this case. Over several

months, he interviewed state officials,

traveled to New York and New Jersey to

question pharmaceutical company executives,

and learned all he could about TMAP. He soon

felt that something inappropriate, and

possibly illegal, was going on. " It just did

not pass the smell test, " he says.

 

Jones learned that in early 2000, Dr. Steven

Karp, who was then medical director of the

state's Office of Mental Health, had become

interested in implementing a Pennsylvania

version of TMAP. Karp discussed his interest

with executives of Janssen Pharmaceutica,

Jones found, and the company paid for Shon to

come to Pennsylvania in late 2000 to meet with

Karp and Steven Fiorello, the state's chief

pharmacist. Shon returned in March 2001 to

train state medical personnel, according to

records Jones obtained and provided to Mother

Jones. To cover Shon's travel expenses,

Janssen made an " educational grant " of

$1,765.75. A Janssen funding request form

notes that the grant was to support the " TMAP

initiative to expand atypical usage and drive

Steve Shon's expenses. " A box marked

" Risperdal " is checked on the form. Janssen's

check was sent to Fiorello and placed in the

account where other donations from

pharmaceutical companies were deposited.

 

Two months later, Janssen provided $4,000 for

Fiorello and a state psychiatrist to travel to

New Orleans for meetings with Dr. Madhukar

Trivedi, a UT-Southwestern psychiatrist and

TMAP project team director. The funding

request form for this payment listed the

" deliverable " as the " successful

implementation of PennMAP. " A Janssen

representative also attended and paid for

$80-per-person dinners for the Pennsylvania

and Texas officials. Fiorello and the

psychiatrist made another trip to New Orleans

later that year, also paid for by Janssen,

according to Jones. Such perks, while of no

great consequence to a company the size of

Janssen, did forge a friendly relationship

with Pennsylvania officials whose decisions

carried enormous financial stakes for the

company.

 

Fiorello told Jones he was the state's " point

man " for selecting drugs for the state

formulary -- those used in state hospitals -- and

that industry representatives visit him often

" to ensure access of their drugs to the state

system, " Jones wrote in a file memo as he

pursued his investigation. In April 2002,

Fiorello and Dr. Frederick Maue, clinical

director for the state's Department of

Corrections, spoke at a Janssen-sponsored

symposium for prison doctors and nurses on

treating mentally ill offenders. They were

paid $2,000 by Comprehensive NeuroScience, a

marketing firm working for Janssen that

helped shape their presentation. Another

marketing company hired by Janssen appointed

Karp to its advisory board, flying him to

meetings in Seattle and Tampa. Pfizer put

Fiorello on an advisory council and twice

paid his expenses to come to New York.

 

Jones became convinced that, as he puts it,

" the pharmaceutical companies were buying

influence with key decision makers in state

government, trying to turn their drugs into

blockbusters. " But as he brought these

findings to his boss, Daniel Sattele, he was

told to stop pushing so hard. After he was

barred from investigating whether state

officials had received inappropriate payments

from drug companies, Jones sued in federal

court, alleging that " major public corruption

investigations were being delayed, obstructed,

or otherwise hindered by officials in the

OIG. " Sattele subsequently conceded in a

deposition taken in 2003 that he asked Jones

if he were " a salmon, " telling him, " go with

the flow, don't swim against the current. "

Sattele also said that after Jones came to

him with his concerns for the fourth or fifth

time, he reminded Jones of the industry's

power and influence. " I said, 'Allen,

pharmaceutical companies are very aggressive

in their marketing. They probably donate to

both sides of the aisle,' " he recalled in the

deposition.

 

When Jones continued to pursue the case he

was removed as lead investigator, then pulled

off altogether, he says. Nonetheless, over the

coming months, he quietly copied documents

and, on his own time, gathered more

information.

 

In February 2004, Jones laid out his charges

for the New York Times and the British

Medical Journal. In April he was suspended.

In May he again sued in federal court,

charging that his superiors were harassing

him to " cover up, discourage, and limit any

investigations or oversight into the corrupt

practices of large drug companies and corrupt

public officials who have acted with them. " He

was then fired. He is now working as a

bricklayer; both his actions are pending.

 

A spokeswoman for the Pennsylvania Office of

Inspector General declined to comment on

Jones' allegations or his termination. A

representative of the Department of

Corrections told Mother Jones that Maue

donated the honorarium he was given by

Comprehensive NeuroScience to the state's

general fund. And Stacey Ward, a spokeswoman

for the Department of Public Welfare, said

that the state " did not receive contributions

of any kind from any pharmaceutical company to

study or support the implementation of

PennMAP. " [Ed note: After the print edition

of this story went to press, the Pennsylvania

State Ethics Commission fined Steven Fiorello,

the state's chief pharmacist, $27,000 for

using his position to earn extra income from

sources that included Pfizer.]

 

Meanwhile, another Pennsylvania official was

becoming increasingly alarmed with how drugs

being pushed by the pharmaceutical industry

were actually affecting patients. Dr. Stefan

Kruszewski, a Harvard-trained psychiatrist

working for the state's Department of Public

Welfare, was charged with reviewing

psychiatric care provided by state-funded

agencies to identify cases of waste, fraud,

and abuse. In the summer of 2001, he began

documenting examples of what he calls " insane

polypharmacy " and widespread use of drugs for

reasons not approved by the FDA. Most

shocking to him were the cases of children

placed in state-funded residential treatment

facilities, sometimes for years, and heavily

drugged on the new antipsychotics and

anticonvulsants, including some of the same

medications given, off-label, to Aliah

Gleason.

 

" These kids were on multiple medications

without the clinical diagnoses to support the

medications, " Kruszewski says. One drug,

Neurontin, approved for controlling seizures,

" was being massively prescribed for anxiety,

social phobia, PTSD, social anxiety, mood

instability, sleep, oppositional defiant

behavior, attention deficit disorder. Yet

there's almost no evidence to support these

uses in adults and no evidence for kids

whatsoever. "

 

Last year a Pfizer subsidiary pleaded guilty

to criminal fraud and agreed to pay $430

million in fines for promoting off-label

prescribing of Neurontin, which racked up

$2.8 billion in U.S. sales in 2004. Officials

estimate that off-label uses account for some

90 percent of its sales. New York attorney

Andrew Finkelstein says he's been enlisted by

the relatives of 425 people who committed

suicide while on Neurontin, and thus far has

filed 46 lawsuits against Pfizer.

 

Kruszewski sent memos to his bosses about

dangerous off-label uses of these medications

but says they were ignored. He also looked

into the deaths of four children in

residential programs and submitted a report

on an Oklahoma facility, where Pennsylvania

children were sometimes sent. He found that

many of the kids " were severely

overmedicated " with atypical antipsychotics,

antidepressants, and anticonvulsants, and he

theorized that the death of at least one

child could be attributed to a culture that

combined polypharmacy and neglect.

 

His report earned him no plaudits. The day

after submitting it, he says, he was yelled

at for " trying to dig up dirt. " The next day

he was fired and escorted to the street. He

has since filed suit in federal court against

the state officials who fired him, along with

several drug companies that, he charges, have

" distorted statistics, violated regulations

and misrepresented the effects of the use of

their psychotropic drugs simply to make

money. " (The Pennsylvania Department of

Public Welfare declined to comment on

Kruszewski's charges because of his pending

lawsuit.) Months after he was fired,

Kruszewski alternates between anger and

sorrow as he thumbs through documents piled

in the dining room of his Harrisburg home. " I

get very emotional about these reports, " he

says. " The people who were paid to protect

consumers did exactly the wrong thing. "

 

UNLIKE SOME OTHER HEAVILY medicated children,

Aliah Gleason survived. In June 2004, more

than five months after she was taken from

school, Calvin and Anaka Gleason saw their

daughter for the first time -- in a courtroom.

" I was so excited, " Aliah recalls. " I hid

under the table so I could surprise them. I

started crying when I saw them. I thought I

would never see them again. "

 

It would take another four months of legal

wrangling with the state before a district

court judge ordered Aliah released into her

parents' custody. Finally, the Gleasons were

allowed to choose the people who would treat

their daughter. They selected Austin

psychologist John Breeding, a well-known

critic of the overuse of psychiatric

medications, and soon the whole family began

meeting with him.

 

The first priority, Breeding said, " was to

get her off the medication. " Working with the

family's doctor, he helped design a program

for tapering her off her final drugs,

Risperdal and Depakote, a process that was

completed by the end of last year. He says

the goal now is to help her recover from the

emotional wounds she suffered as a result of

her time under the state's care. She also

needs to lose all the weight she gained while

on the atypicals.

 

The good news, he says, is that " the family

is reunited, she's doing well in school, and

is even participating in extracurricular

activities. " Like her sisters, Aliah plays in

the school band and also takes part in a drill

team. " She's coming back, starting to get that

gleam in her eye, " Breeding says.

 

Aliah found herself at the intersection of a

capricious child-protection system and a

health care system that's all too ready to

medicate. As doctors dispense ever-greater

quantities of potent psychiatric drugs, and

the industry spends ever-greater amounts of

money promoting them, how can consumers be

confident that decisions about their care are

truly informed and in their interest? Whatever

the stakes for the drug companies, the stakes

for patients are infinitely higher.

 

~~~~~~~~~~

 

Rob Waters has written extensively on the use

of psychiatric medication by children. Last

year he revealed in the San Francisco

Chronicle that the FDA suppressed an internal

report linking antidepressants to an increased

risk of suicide among children, a story that

led to congressional hearings and warnings

being issued for the drugs.

 

- end -

 

~~~~~~~~~~

 

For a photo of Aliah see the above article on

the _Mother Jones_ web site at:

 

http://www.motherjones.com/news/feature/2005/05/medicating_aliah.html

 

To write a letter to the _Mother Jones_ editor

e-mail to: backtalk. They need

to hear that readers applaud this excellent job.

 

~~~~~~~~~~

 

MINDFREEDOM INTERNATIONAL has helped

break the silence about how President Bush is

pushing for psychiatric screening of every youth

and even every *ADULT* in the USA using programs

described by _Mother Jones_ above.

 

Protest the screening of every American citizen!

Protest PhRMA's front groups and lies!

 

Join us on Monday, 2 May 2005, at noon, when

MindFreedom is holds a peaceful protest in

front of PhRMA headquarters in Washington, D.C.

 

For complete information on the protest see

http://www.MindFreedom.org. You may also

discover there about how President Bush

is pushing for the screening of every USA

citizen, child and adult. Read about how about

the USA right wing & left wing finally may be

uniting on something: saying " no " to screening

programs that push psychiatric drugs into kids!

 

For more information and to join MindFreedom

go to http://www.MindFreedom.org or phone

541-345-9106 or e-mail office.

 

~~~~~~~~~~~~~

 

MindFreedom International is a non-profit

coalition uniting 100 grassroots groups

campaigning for human rights and alternatives

in the mental health system. Our coalition is

the only group of its kind to be accredited

by the United Nations as a Non Governmental

Organization with Consultative Roster Status.

 

MindFreedom is 100 percent independent with

no funding from government, mental health

systems, drug companies or religions. In

May 2005 the coalition will be 15 years old.

 

Open to the public, a majority of MindFreedom

members, board and staff have personally

experienced human rights violations in the

mental health system. MindFreedom emerged from

this psychiatric survivors movement that is

35 years old this year, 2005. We didn't forget.

 

You are reading an alert issued by the

MindFreedom-News alert system that is free

and open to the public.

 

The first few words of the MindFreedom

mission statement sum up our principles:

" In a spirit of mutual cooperation... " Do

you feel enough passion for human rights

to do one of the most powerful things: UNITE?

 

MindFreedom is one of the very few independent

organizations in the entire mental health field

because of membership support. Please join today

and get your copy of _MindFreedom Journal_:

 

http://www.mindfreedom.org/join.shtml

 

PLEASE FORWARD & POST to all appropriate

places on and off the Internet TODAY!

 

 

 

David Oaks, Director

MindFreedom International

454 Willamette, Suite 216 - POB 11284

Eugene, OR 97440-3484 USA

 

http://www.mindfreedom.org

email: oaks fax: (541) 345-3737

phone: (541) 345-9106 toll free in USA: 1-877-MAD-PRIDE

 

MIND YOUR FREEDOM: United Action for Human Rights.

 

join here: http://www.mindfreedom.org/join.shtml

 

MindFreedom Support Coalition International is an

independent non-profit uniting 100 sponsor groups

to win human rights & alternatives in mental health.

Accredited by the United Nations as a

Non-Governmental Organization (NGO) with

Consultative Roster Status.

 

" Human salvation lies in the hands of the

creatively maladjusted. " - Martin Luther King, Jr.

 

_____________

 

If you are not on the MindFreedom-News alert list already, sign up for

this free non-profit public service here:

http://www.intenex.net/lists/listinfo/mindfreedom-news

 

~~~~~~