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By Dr. Karen Effrem
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A May 3rd story in USA Today details the increasingly ugly record of prescribed psychiatric drug use in children. Coming on the heels of the recent Vanderbilt University data that 2.5 million (nearly doubling from five years ago) American children are on powerful antipsychotic drugs and the Oregon data that even PRESCHOOLERS in government programs are receiving these medications that are not even approved for children, the reporter found that 45 children have died in instances where these drugs were listed as the primary suspect.
This is highly disturbing for many reasons:
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The number of deaths and serious side effects is admitted to be only 1-10% of the total, so the 45 deaths that occurred in the 5 years reviewed represents the tip of the iceberg.
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Parents are not informed of the severe, sometimes fatal dangers of these drugs that include diabetes, heart attacks, metabolic dangers, and permanently disfiguring neurological problems called tardive dyskinesia.
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There are NO long-term studies on what these drugs do to the brains of developing children and plenty of evidence that they are neither effective nor safe in adults or children. Dr. John March (Duke University) acknowledges, "We have no evidence about the safety of these agents or their effectiveness in controlling aggression," he says. "Why are we doing this?"
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Psychiatric experts cannot even agree on how to accurately diagnose children. Dr. Barbara Geller, a proponent of labeling and drugging children for bipolar disorder, admitted, “The science is nowhere near where it is in other branches of medicine."
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The FDA is not concerned. When confronted with children's death toll, Thomas Laughren, director of FDA's division of psychiatry products, is quoted stating: "We haven't been alerted to any particular or unusual concern. The effects (in kids) are similar to what we're seeing in adults. We have not systematically looked at the data for children because the drugs aren't approved for them."
Unless we stop turning the problems of problems of childhood into diseases treated with pills; unless plans for widespread mental health screening of young children are stopped; and unless we demand that the FDA resume its role as a true watch dog of the public safety, instead of a lapdog of the pharmaceutical industry, expect the frequency of tragic stories like these to increase.
Myths and Facts Regarding Mental Health Screening Programs
and Psychiatric Drug Treatment for Children, Part IV
By Dr. Karen Effrem
Myth: Psychiatric drug treatments are effective in children.
Fact: Neither antidepressants like Prozac nor stimulants like Ritalin are effective inchildren, but pharmaceutical companies, with the approval of the FDA, only published positive studies despite having evidence for years of their ineffectiveness.
“More than two-thirds of studies of antidepressants given to depressed children, forinstance, found the medications were no better than sugar pills, but companies published only the positive trials” (Vedatam, Washington Post, 9/9/04, p. A02) “No antidepressants have demonstrated greater efficacy than placebo in alleviating depressive symptoms in children and adolescents”( Baker (1995) as quoted in Breggin, P.and Cohen, D. (1999) Your Drug May Be Your Problem: How and Why to Stop Taking, Psychiatric Medications, Perseus Books, Reading, MA)
“However, psychostimulants do not appear to achieve long-term changes in outcomes such as peer relationships, social or academic skills, or school achievement.” (Pelham, et.al. as quoted in Surgeon General, 1999)
Myth: Psychiatric drugs are safe for children.
Fact: Evidence of dangerous and sometimes deadly side effects of psychiatric medication has been covered up for years by the pharmaceutical manufacturers, sometimes with the help of the FDA.
“Dr. Robert Temple, director of the FDA's office of medical policy, said after anemotional public hearing here that analyses of 15 clinical trials, some of which were hidden for years from the public by the drug companies that sponsored them, showed a consistent link with suicidal behavior.” (Harris, New York Times, 9/14/04, p. A01) “TCAs [tricyclic antidepressants] have been linked to cardiac arrhythmias, and “sudden death.” (Wilens TE, et al, 1996. Cardiovascular effects of therapeutic doses of tricyclic antidepressants in children and adolescents. Journal of The Association Of American Child & Adolescent Psychiatry. 35: 1491-501)
“These drugs also impair flexible problem-solving and divergent thinking. James Swanson, a researcher for the U.S. Department of Education and leading Ritalin advocate, stated in a 1992 review of the medical literature that this type of ‘cognitive toxicity’ may occur at commonly prescribed clinical doses of stimulants, and in up to 40% of patients.” (Breggin, P., (2001) Talking Back to Ritalin, Cambridge, Massachusetts, Perseus, pp. 49-50) Zyprexa linked to Diabetes (Eli Lilly's Big Seller, Zyprexa, Can Help Schizophrenics; IsIt Linked to Diabetes? --- Warnings Abroad, Not in U.S. – Wall Street Journal, 4/11/03, http://www.ahrp.org/infomail/0403/11.php)
Myths and Facts Regarding Mental Health Screening Programs and Psychiatric Drug Treatment for Children, Part III
By Dr. Karen Effrem
Myth: Mental health screening instruments are scientifically validated and screening programs are effective at preventing suicide.
Fact: Screening instruments are not validated or effective and fail to prevent suicide.
“[TeenScreen has] reasonable specificity identifying students at risk for suicide. A second-stage evaluation would be needed to reduce the burden of low specificity.... As with other suicide risk instruments, the CSS has the potential of having high (0.88) sensitivity at the expense of specificity [false positives]…” (Journal of the American Academy of Child & Adolescent Psychiatry, 2004, v. 42, 71-79) “USPSTF found no evidence that screening for suicide risk reduces suicide attempts or mortality. There is limited evidence on the accuracy of screening tools to identify suicide risk in the primary care setting, including tools to identify those at high risk.”(US Preventative Services Task Force http://www.ahrq.gov/clinic/3rduspstf/suicide/suiciderr.htm#clinical)
Myth: Children are not adequately treated for mental illness.
Fact: Children are over diagnosed and over treated with psychiatric medications and bothproblems will increase with wide spread screening programs.
300% increase in psychotropic drug use in 2-4 year old children between 1991-1995 300% increase in psychotropic drug use in children between 1987 and 1996
More spent on psychiatric medications for children than on antibiotics or asthma medication in 2003
Myth: The decision to treat a child with psychotropic medications is always between a parent and their physician.
Fact: Parent all over the country have been coerced with threats of child abuse or to place their children on or continue psychiatric medications prompting over 20 state legislatures and the US Congress to introduce or pass legislation prohibiting coercion.
Both Matthew Smith and Shaina Dunkle died of medication toxicity after their parentswere coerced to place their children on drugs by the schools. (http://ritalindeath.com/homepage.htm) Paul Johnston was institutionalized with drug-induced psychosis after his parents were coerced to put him on 16 different psychiatric medications over seven years. (http://www.eagleforum.org/educate/2002/june02/drug-induced.shtml)
Myths and Facts Regarding Mental Health Screening Programs
and Psychiatric Drug Treatment for Children, Part II
By Dr. Karen Effrem
Myth: Psychiatric diagnostic criteria are scientificially validated and non-controversial among experts in the field.
Fact: Mental health diagnostic criteria are very vague and subjective. The very studies andreports cited by proponents of universal screening are full of contradictions. These experts admit the lack of science underlying psychiatric labels.
“In other words, what it means to be mentally healthy is subject to many different interpretations that are rooted in value judgments that may vary across cultures.” (Surgeon General Report on Mental Health. 1999. p. 1-5 http://www.surgeongeneral.gov/library/mentalhealth/pdfs/c1.pdf)
“The diagnosis of mental disorders is often believed to be more difficult than diagnosis of somatic or general medical disorders since there is no definitive lesion, laboratory test or abnormality in brain tissue that can identify the illness.” (Surgeon General, p. 2-18, http://www.surgeongeneral.gov/library/mentalhealth/pdfs/c2.pdf) “No consistent structural, functional, or chemical neurological marker is found in children with the ADHD diagnosis as currently formulated.” (Attention Deficit Hyperactivity Disorder State of the Science - Best Practices, Peter S. Jensen and James R. Cooper, Eds, Civic Research Institute, Kingston, N.J. 2000, p. 3-7) “DSM-IV criteria remain a consensus without clear empirical data supporting the number of items required for the diagnosis . . . Furthermore, the behavioral characteristics specified in DSM-IV, despite efforts to standardize them, remain subjective . . . ” (American Psychiatric Association Committee on the Diagnostic and Statistical Manual (DSM IV- 1994), pp.1162-1163)
Myth: It is possible to accurately diagnose mental illness in young children, even infants. “Even before their first birthday, babies can suffer from clinical depression, traumatic stress disorder, and a variety of other mental health problems.” (Florida Strategic Plan for Infant Mental Health)
Fact: Due to rapid developmental changes, it is very difficult to accurately diagnose young children.
“Childhood and adolescence being developmental phases, it is difficult to draw clear boundaries between phenomena that are part of normal development and others that are abnormal.” (World Health Organization, World Health Report, 2001) “The science is challenging because of the ongoing process of development. The normally developing child hardly stays the same long enough to make stable measurements. Adult criteria for illness can be difficult to apply to children and adolescents, when the signs and symptoms of mental disorders are often also the characteristics of normal development.” (Surgeon General, 1999)
Myth: Children would never be labeled potentially violent or mentally based on their worldview or politics.
Fact: Federally funded school violence prevention programs do label children based on their beliefs. A federally funded study held that people of a particular political philosophy had hallmarks of mental illness.
A school violence prevention program funded by the federal government called Early Warning, Timely Response lists “intolerance for others and prejudicial attitudes” as an early warning sign for violence and mental instability, saying, “All children have likes and dislikes. However, an intense prejudice toward others based on racial, ethnic, religious, language, gender, sexual orientation, ability, and physical appearance when coupled with other factors may lead to violent assaults against those who are perceived to be different.”(U.S. Department of Education - Early Warning, Timely Response Action Guide http://www.ed.gov/admins/lead/safety/actguide/action_guide.txt) “In August 2003, the National Institute of Mental Health and the National Science Foundation announced the results of their $1.2 million taxpayer-funded study. It stated, essentially, that traditionalists are mentally disturbed. Scholars from the Universities of Maryland, California at Berkeley, and Stanford had determined that social conservatives, in particular, suffer from ‘mental rigidity,’ ‘dogmatism,’ and ‘uncertainty avoidance,’ together with associated indicators for mental illness.” (Eakman, Chronicles, 10/04. See full study at http://facultygsb.stanford.edu/Jost/_private/Political_Conservatism_as_Motivated_Social_
Cognition.pdf)
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