Neuroleptics for Children: Harvard’s Shame

In December 2012, Mark Olfson, MD, et al, published an article in the Archives of General Psychiatry.  The title is National Trends in the Office-Based Treatment of Children, Adolescents, and Adults with AntipsychoticsThe authors collected data from the National Ambulatory Medical Care Surveys for the period 1993-2009, and looked for trends in antipsychotic prescribing for children, adolescents, and adults in outpatient visits.  Here are the results:

Age Increase in no. of antipsychotic prescriptions per 100 population (1993-2009)
0-13 0.24-1.83 (almost 8-fold)
14-20 0.78-3.76 (almost 5-fold)
21+ 3.25-6.18 (almost 2-fold)

 

The authors provide a breakdown of the diagnoses assigned to the children and adolescents during the antipsychotic visits.

Diagnosis Visits %
Children
(0-13)
Adolescents
(14-20)
Schrizophrenia 6.0 8.1
Bipolar 12.2 28.8
Depression 11.2 20.9
Anxiety 15.9 14.4
Dev Disorders 13.1 5.0
Disruptive Behavior Disorders 63.0 33.7
Other Dx’s 18.0 16.8

 

Percentages do not total 100, because some individuals were assigned more than one diagnosis.

It is clear that disruptive behavior disorders are the most common diagnoses used in antipsychotic visits for both children and adolescents.

Thirty years ago, the prescription of neuroleptic drugs to children under 14 years of age was almost unheard of.  It was rare in adolescents, and even in adults was largely confined to individuals who had been given the label schizophrenic or bipolar.

By 1993, the first year of the Olfson et al study, about a quarter of 1% of the national childhood population were receiving antipsychotic prescriptions during office visits.  The percentage for adolescents was about three quarters of 1%.  By 2009, these figures had increased to 1.83% and 3.76% respectively.

The devastating effects of these neurotoxic drugs are well known, and it is natural to wonder what forces might be driving this trend.  The authors suggest that:

“Increasing clinical acceptance of antipsychotics for problematic aggression in disruptive behavior disorders may have increased the number of children and adolescents (especially male youths and ethnic/racial minorities) being prescribed antipsychotics.  The increase in the number of clinical diagnoses of bipolar disorder and autistic spectrum disorders among children and adolescents may have further increased antipsychotic use by youths, particularly by boys.”

They also note that:

“The trend in the prescribing of antipsychotics to youths occurred within the context of a dramatic increase in the clinical diagnoses of bipolar disorder among young people.”

The notion that the increase in the prescription of neuroleptics for children is driven by increased use of the bipolar diagnosis is supported by another study:  Most Frequent Conditions in U.S. Hospitals, 2010,  by Plunter et al, January 2013, published by the Agency for Healthcare Research and Quality (a division of the US Department of Health and Human Services).  This study, which analyzed hospital admission data from 1997 to 2010, found that mood disorder, which in 1997 had been in the fourth place (behind asthma, pneumonia, and appendicitis) was by 2010 the most common diagnosis for children aged 1-17.  In the 13-year period admissions for mood disorders had increased 80%, while admissions for asthma and pneumonia had decreased by 30% and 16% respectively.

Most of the increase in mood disorder frequency was for bipolar disorder.  In the period studied, admissions for children for depression rose 12%, but admissions for bipolar disorder rose 434% (from 1.5 per 100,000 population to 8.2).  For children in the age group 5-9, the increase was 696%! – a seven-fold increase.

So, over the last decade or two, we’ve seen a huge increase in the number of children being hospitalized for bipolar disorder and in the number of children being prescribed neuroleptics in office visits.

HOW DID THIS HAPPEN?

Neuroleptics are probably the most damaging drugs used in psychiatry.  The adverse effects, including permanent and extensive brain damage, are devastating, and occur in virtually all of cases where use is prolonged (Breggin, 2011, p 197).  In former decades, their use was confined mainly to adults who had been labeled schizophrenic or bipolar.  It was routinely claimed by psychiatrists that their benefits outweighed the risks, though this contention is not standing up to the increasing scrutiny that has occurred in the past decade or so.

The increase in the prescription of neuroleptic drugs for children is a direct consequence of the increased use of the bipolar label in that population.  And most of the responsibility for that increase can, in my view, be laid at the door of one person:  Joseph Biederman, MD, of Harvard Medical School and Massachusetts General Hospital.  Dr. Biederman will go down in history as the inventor of pediatric bipolar disorder.

DSM-III-R was published in 1987.  It makes no reference to the existence of childhood bipolar disorder.  The total entry under Prevalence is:

“It is estimated that 0.4% to 1.2% of the adult population have had bipolar disorder.” [emphasis added]

DSM-IV, published in 1994, greatly expanded the concept of bipolar disorder, essentially by removing the requirement of a manic episode or a mixed (manic-depressive) episode.  References to age are vague – e.g.:

“Approximately 10%-15% of adolescents with recurrent Major Depressive Episodes will go on to develop Bipolar I disorder.”

It is not clear whether this “development” might occur in late adolescence or in adulthood. There is no suggestion that bipolar disorder can occur in a pre-adolescent child.

By 1996, however, Dr. Biederman and his colleagues at Harvard were promoting childhood bipolar disorder as an accepted psychiatric diagnosis that needed to be treated with pharmaceutical products, including neuroleptics.  This was accomplished primarily by selling the notion that childhood temper tantrums could legitimately be regarded as symptoms of mania.  This blatant distortion of the traditional concept of mania was facilitated by the “not otherwise specified” (NOS) qualifier which has been a component of almost all diagnostic categories since DSM-III.  The purpose of the NOS diagnoses is to enable psychiatrists to assign the diagnosis in question to an individual even though he doesn’t actually meet the criteria.  The fact that this renders the criteria somewhat pointless is generally lost on psychiatrists, but that’s a different story.

What the Bipolar Disorder NOS diagnosis enabled Dr. Biederman and his colleagues to say was essentially this:

We know that temper tantrums aren’t really an integral component of bipolar disorder as it is traditionally conceived.  But we believe that that’s how bipolar disorder presents itself in young children, and so that’s what we’re going to call it.

This is on a par with dermatologists deciding that pattern baldness is a symptom of psoriasis!  In real medicine, this isn’t how it’s done, but in psychiatry it’s the norm.  The “diagnoses” are fictitious.  They can be created, modified, and eliminated with strokes of a pen.  This is what Dr. Biederman and his Harvard colleagues did, and American psychiatry followed.  The neuroleptics-for-children spigot was opened, and is running freely to this day.

The creation and promotion of pediatric bipolar disorder has been described and critiqued by several writers.  Joanna Moncrieff, a British psychiatrist, provides an excellent account in her book The Bitterest Pills (2013 , p 200-205).  Here are some quotes:

“Although it is the adult market that accounts for the bulk of sales of atypical antipsychotics, it is the use of these drugs in children alongside the emergence of the diagnosis of paediatric bipolar disorder that best illustrated the way in which a severe mental disorder can be morphed into a label for common or garden difficulties, as well as the role that money plays in this process.”

“Moreover, by locating the problem in the brain of the child, it seemingly detaches it from the situation within the family.”

“Academic psychiatry fuelled this craze, with added financial incentive from the pharmaceutical industry…”

“In the 1990s, a group led by child psychiatrist Joseph Biederman, who was based at Massachusetts General Hospital and the prestigious Harvard Medical School, started to suggest that children could manifest ‘mania’ or bipolar disorder, but that it was frequently missed because it was often co-existent with other childhood problems like ADHD and ‘antisocial’ behaviour…  In a paper published in 1996 the group suggested that 21% of children attending their clinics with ADHD also exhibited ‘mania’, which was diagnosed on the basis of symptoms such as over-activity, irritability and sleep difficulties…  A year later the group were referring to bipolar disorder in children as if it were a regular, undisputed condition, and emphasized the need for ‘an aggressive medication regime’ for children with the diagnosis…”

“Neither Harvard nor Massachusetts General Hospital nor any other psychiatric or medical institution has commented on the fact that prominent academics were found to be enriching themselves to the tune of millions of dollars through researching and promoting the use of dangerous and unlicensed drugs in children and young people.  Although some individual psychiatrists have expressed misgivings…academic papers continue to discuss the diagnosis, treatment and outcome of bipolar disorder in children as if no controversy existed, with more than 100 papers on the subject published in Medline-listed journals between 2010 and 2012.  Notwithstanding…the disgrace of Joseph Biederman, the practice of diagnosing children with bipolar disorder and treating them with antipsychotics remains alive and kicking.”

The spurious creation of childhood bipolar disorder has been critiqued also by Mickey Nardo, MD, a retired psychiatrist who blogs under the name 1 Boring Old Man (which, incidentally, he isn’t).  On July 2, 2011, he published a post called bipolar kids: an all too familiar lingo…  Here are some quotes:

“What happened in that second half of the 1990s is that they created a new diagnosis – Pediatric Bipolar Disorder. Looking at these articles…or at the COBY Study [started right around this time], Bipolar Disorder in children was becoming a common diagnostic term, but the diagnostic criteria bore little resemblance to the familiar symptom complexes from the Manic Depressive Illness of old. It was something new masquerading as something old [or vice versa]. These kids weren’t euphoric, they were irritable.”

“…the Biederman-led movement to broaden the category to call all kinds of difficult and disruptive children Bipolar had little to no scientific basis. It felt like a rationalization to use the new atypical antipsychotics to control difficult behavior-disordered kids – a trick.”

“And even without knowing what we know today about what happened, at the turn of the last century there was plenty of reason to smell a rat [named pharma]. The articles had all the tell-tale phrases – “urgent public health problem” “emerging new treatments” “need for more research” – an all too familiar lingo that pointed down a well-traveled yellow brick road. And this time it didn’t lead to Oz, it lead to Harvard University. And the guy behind the curtain was Joseph Biederman …”

Ultimately Dr. Biederman was disgraced – not for the spurious expansion of a diagnostic category.  Diagnostic expansion has been psychiatry’s primary agenda for the past 60 years.  A small minority of psychiatrists might have had reservations concerning Dr. Biederman’s work, but the mainstream psychiatry-pharma alliance embraced the new development with their customary zeal and self-serving enthusiasm.

Nor was Dr. Biederman disgraced because he had deliberately encouraged the exposure of thousands of children to neurotoxic chemicals.  Again, that’s just business as usual.  And in fact, he received awards and accolades for drawing attention to the plight of these tragically “underserved” children.  Here are some of the awards and honors he has received since his ground-breaking work on childhood bipolar disorder:

  • NAMI Exemplary Psychiatrist Award
  • NARSAD Senior Investigator Award
  • ADHD Chair of World Psychiatric Association
  • Outstanding Psychiatrist Award, Massachusetts Psychiatric Society
  • Excellence in Research Award, New England Council of Child and Adolescent Psychiatry
  • Mentorship Award, Psychiatry Department, Massachusetts General Hospital
  • William A. Schonfeld Award for outstanding achievement and dedication
  • Distinguished Service Award, MGH/McLean Child and Adolescent Psychiatry Residency

He was disgraced for under-reporting to his employers at MGH and Harvard the amount of money he was receiving from the pharmaceutical industry for conducting research that was used to promote their products.  Here again, there was nothing particularly unusual in this.  The so-called Key Opinion Leaders (KOL’s) in psychiatry have been awash in pharma money for decades.  But Dr. Biederman’s take ($1.6 million) was on the high side, and came to light at a time when the corrupt psychiatry-pharma alliance was being exposed nationally, largely through the efforts of Iowa Senator Charles Grassley.

Dr. Biederman was also criticized for promising Johnson & Johnson a positive result for their neuroleptic drug risperidone in pre-school children before he had actually conducted the research.  Obviously this makes a mockery of the research, but psychiatric research was hijacked by pharma marketing decades ago.  It has long since ceased to be a source of genuine scientific information, and much of it instead is little more than marketing material bought and paid for by the pharmaceutical industry.  Dr. Biederman’s error in this area was that he committed his promises to writing (in the form of slides that he presented to Johnson & Johnson executives), and these slides and other correspondence came to light during lawsuits against Johnson & Johnson for fraudulent marketing of their products.  These are the same lawsuits that Johnson & Johnson recently settled for $2.2 billion.

The great irony with regard to Dr. Biederman’s premature promise of a positive result for Johnson & Johnson is that he was absolutely correct!  If you give a neuroleptic drug to a misbehaved child, the incidence of misbehavior will indeed decrease.  If you give him enough, he’ll go to sleep and won’t misbehave at all!  That’s why these drugs used to be called major tranquilizers.  Dr. Biederman could accurately predict this result in advance because that’s what major tranquilizers do.  If you conduct a study to see if alcohol will make people drunk you’ll get a positive result.  If you conduct a study to see if major tranquilizers subdue childhood temper tantrums, you’ll get a positive result.  Dr. Biederman couldn’t use this defense, however, because he, like psychiatrists in general, has to play along with the big fiction:  that childhood temper tantrums are a symptom of an illness, and that the drugs are medicines targeting specific faults in neural circuitry or chemical imbalances or whatever.  Dr. Biederman’s proposed study would have produced a positive results for Risperdal in the same way that most industry-sponsored studies obtain positive results:  by limiting outcome criteria to the known effects of the drug, by keeping follow-up times short, and by ignoring adverse effects.

Dr. Biederman’s ethical lapses were thoroughly investigated (for three years) by his bosses at MGH and Harvard, and in 2011 they gave him and two of his colleagues (Thomas Spencer – total take:  $1.0 M, and Timothy Wilens – total take:  $1.6 M) very, very severe slaps on the wrists.  The Boston Globe covered this story.  Here’s a quote:

“The three psychiatrists apologized in their letter for the ‘unfavorable attention that this matter has brought to these two institutions.’  They called their mistakes ‘honest ones’ but said they ‘now recognize that we should have devoted more time and attention to the detailed requirements of these policies and to their underlying objectives.’

They said the institutions imposed remedial actions, requiring them to refrain from all paid industry-sponsored outside activities for one year, with an additional two-year monitoring period during which they must obtain approval before engaging in paid activities. They were also required to undergo unspecified additional training and suffer ‘a delay of consideration for promotion or advancement.'”

The notion that the ethical lapses of these three psychiatrists were “honest mistakes” is a little hard to credit, given that the total dollar amount was more than $4 M!

Today Dr. Biederman is fully rehabilitated and is back in business. He’s receiving research funding from ElMindA, Janssen, McNeil, and Shire, and is once again churning out research papers on topics such as ADHD and, guess what? – pediatric bipolar disorder.

THE BIG QUESTIONS

The two big questions in all of this are:

1.  Why do Harvard and Massachusetts General Hospital stand for this kind of blatant corruption and deception in the upper echelons of their psychiatry department?

2.  Why does the APA not take a stand against the medicalization and drugging of childhood temper tantrums – a problem that parents of previous generations simply took in their stride as an integral part of normal childrearing?

With regards to the APA, it’s really not much of a question.  Their agenda has always been: more psychiatric drugs for more people, and the neuroleptics-for-children development is really just business as usual.  They have dulled their ethical sensibilities through decades of prescribing benzodiazepines, SSRI’s, methylphenidate, and various other neurotoxins for an ever-widening range of human problems, and prescribing a neuroleptic to a 1½ year old for temper tantrums is a short step.

The APA, however, did express some mild concern about the spurious extension of the bipolar label to children.  In DSM 5 (p 132) they state:

“In individuals with severe irritability, particularly children and adolescents, care must be taken to apply the diagnosis of bipolar disorder only to those who have had a clear episode of mania or hypomania – that is, a distinct time period, of the required duration, during which the irritability was clearly different from the individual’s baseline and was accompanied by the onset of Criterion B symptoms.”

But rather than risk losing the pediatric business, hard-won by Harvard’s psychiatrists, they created a new diagnosis:

“When a child’s irritability is persistent and particularly severe, the diagnosis of disruptive mood dysregulation disorder would be more appropriate.”

The effect of all this is that psychiatrists can go on prescribing drugs for childhood temper tantrums, but instead of calling them bipolar disorder, they should use the new label:  disruptive mood dysregulation disorder – but they can continue to use the bipolar diagnosis also, with a few caveats, couched in the APA’s characteristically vague language.

Harvard’s stance on the scandals is a little harder to fathom.  After all, Harvard is hallowed ground – America’s Oxbridge.  It has acquired an image as a center of learning where educational and research standards eclipse all other considerations.

And in fact, there are legal and medical ethicists at Harvard who clearly recognize the implications of the psychiatric scandals.

Earlier this year, the Journal of Law, Medicine & Ethics (Vol 41, Issue 3) published a symposium of 17 papers written by members of Harvard’s Edmond J. Safra Center for Ethics.  Here are some of the titles:

Here are some quotes:

“The pharmaceutical industry has corrupted the practice of medicine through its influence over what drugs are developed, how they are tested, and how medical knowledge is created.” (Light et al)

“In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests.” (Cosgrove and Wheeler)

“Pharmaceutical and medical device companies apply social psychology to influence physicians’ prescribing behavior and decision-making.” (Sah and Fugh-Berman)

Clearly these papers are addressing important and relevant topics.  But what’s particularly noteworthy, from the present perspective, is that they originated in Harvard – the same institution in which senior psychiatry faculty members were hand-in-glove with pharma in the production of fraudulent research and advertizing.  How are we to understand this contradiction?  How are we to understand the minimal response from Harvard’s management, and incidentally from the other academic departments, given that such a wealth of ethical resources was there on their own campus, presumably available and willing to be consulted on these kinds of matters.

BUSINESS ETHICS VS UNIVERSITY ETHICS

In America, it is becoming increasingly recognized, and even accepted, that big businesses are frequently amoral.  Considerations of right and wrong are routinely subordinated to bottom line accounting.  Many big pharmaceutical companies are perceived in this light.  Indeed, the recent $2.2 B  penalty levied against Johnson & Johnson was discussed in some media outlets quite simply as a “cost of doing business.”  The question of whether it is a good thing to promote the use of neuroleptics for children doesn’t even come on the radar.  The perverse calculus is reduced to the difference between the projected profits from the drugs sales, and the fines and lawsuit settlements that might ensue.

Has Harvard’s Psychiatry Department, in concert with their pharmaceutical allies, crossed this line?  Have they now, implicitly or explicitly, adopted the ethical standards of the business world?  Have they subordinated their sense of decency and shame to considerations of prestige and revenue?

And what of the MGH/Harvard leadership?  Do they actually believe that the sanctions imposed on Dr. Biederman and his colleagues are adequate?  Or do they reckon that the years of past and future pharma revenue are worth the cost?  Have they crossed the line into the shady realm of business ethics?

And as we ponder these thorny questions, let’s not forget that the Johnson & Johnson lawsuit listed psychiatric researchers at other renowned universities, including Johns Hopkins, Stanford, UCLA, University of Illinois at Chicago, University of Texas at Austin, Georgia Regents, University of Toronto, and Dalhousie University.

Meanwhile the destructive prescribing continues, and Dr. Biederman is still at MGH, where he is Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, and at Harvard, where he is a full Professor of Psychiatry, a position, which, by his own account, ranks just below God!

Psychiatry’s primary agenda for the past 60 years has been the expansion of their diagnostic net to embrace an increasing range of ordinary human problems, and the unscrupulous prescribing of more and more psycho-pharmaceutical products to more and more people.  In the final analysis, Dr. Biederman’s problem was that he was particularly good at this job.  He was, in effect, a Model Psychiatrist – the perfect embodiment of everything that the APA stands for.

CLARIFICATION OF TERMINOLOGY

My frequent use of the term bipolar disorder in this article should not be interpreted as an endorsement on my part of the ontological validity of this expression, much less its status as an illness or disease.  I use the term bipolar disorder (and the various other so-called diagnoses) for the sake of readability and linguistic convenience.  What I mean by “bipolar disorder” is:  the vaguely defined and loosely clustered behaviors, thoughts, and feelings that psychiatrists call bipolar disorder.

  • Nick Stuart

    Deliberately, and permanently, damaging the brains of children with toxic chemicals to make them ‘behave’. Child cruelty does not get any worse than that. How have we, as a society, allowed this to happen? How? We have quite rightly banned smacking but can ‘promote’ this obnoxious abuse? Dr. Biederman is Dr. Mengele in disguise and yet is applauded for his work. I despair. I really do.

  • Phil_Hickey

    Neuroleptics for Children: a clarification

    On December 4, I published the above post: Neuroleptics for Children: Harvard’s Shame

    I noticed this afternoon that the article has been reproduced in full, showing me as the author, on the site Turmeric Curcumin Gold. This is a commercial site that sells Turmeric Curcumin Gold. Turmeric is one of the main ingredients in curry powder, and Turmeric Curcumin Gold is evidently sold as a dietary supplement.

    The purpose of this comment is to clarify that I have no connection with Turmeric Curcumin Gold, and that I derive no income or other considerations from the sale of these products.

  • Nanu Grewal

    Hello Phil
    Another excellent posting. The Tumeric disclaimer made me chuckle as it happens to be on my shopping list this morning!
    Here in Australia there have been case reports of children under the age of 10 who have been on 2 or 3 psychotropics for up to 7 years for socalled “behavioural” issues and have had harrowing emergency department attendances with florid psychotic episodes whose a priori aetiology is primarily the prescribed medications.
    Due to the permanence of the internet your blog will be the uncovered prophesy of the disaster we are heading towards in a decade or so.(sorry to sound like the “End Is Nigh”guy at the metro station)

  • Phil_Hickey

    Nick,

    Yes, indeed – but the tide is turning! Don’t despair. Just keep telling the truth.

  • elsiep

    Thank you for this Phil. It seems to me that the big problem with psychiatry as an academic discipline is that it has failed, for decades, to apply the scientific method to its implicit assumptions.

  • cannotsay

    The answer to your two questions boils down to the following fact:
    just because somebody is uber smart and highly trained at the best
    universities, it doesn’t mean that he/she is automatically ethical. My
    personal experience, for what it is worth, is that intelligence and
    ethics are completely orthogonal. We would love that not to be the case,
    ie, that smart people are the cure to all problems in society, but
    unfortunately, societies that are ruled by “the best and brightest” are
    not necessarily the most ethical. Worst yet, among the highly educated,
    those who tend to rise at the top tend also to be the less ethical
    because they use their smarts not to the benefit of society but to
    advance their own careers. A high IQ unethical person can inflict more
    damage than a legion of less smart, equally bad people.

    William F. Buckley, Jr. put it best “I’d rather entrust the
    government of the United States to the first 400 people listed in the
    Boston telephone directory than to the faculty of Harvard University.”

    It bets however the question of why the situation is so much worse in
    psychiatry than in other areas of medicine or research. And the answer
    is also obvious: because psychiatry is not a scientific discipline. You
    can claim all you want that something travels faster than the speed of
    light, but unless you design a falsifiable experiment that proves it,
    that claim will not advance your career. Psychiatry deals with
    subjective labels, not with objective realities, so clearly all bets are
    off. All clinical data in psychiatry can be cooked to show whatever you
    want it to show, which is why meta-analyses, which average out
    manipulations, consistently show that even using psychiatry’s own
    measures of efficacy, there is no real benefit in psychopharmacology.

  • Phil_Hickey

    Nanu,

    Thanks for coming in. I’ve been reading about the neuroleptic emergency room “epidemic.” Psychiatry will go to any depths to sell their products and promote their turf. It reminds me of the thalidomide tragedy back in the late 50’s and early 60’s. But there’s one big difference: the thalidomide was an accident. Nobody can say that they don’t know the adverse effects of these drugs. And as far as psychiatry is concerned, it’s still full speed ahead – drugs for everyone.

    Best wishes.

  • Phil_Hickey

    elsiep,

    Thanks for coming in. I agree.

  • Phil_Hickey

    cannotsay,

    Thanks for your comment. It reminded me of Starship Enterprise’s warp drive. If you want to write stories about intergalactic space travel, alien races, and what not, then you have to invent something to get around the universal speed limit. Otherwise the shows will be very boring. Star Trek invented warp drive.

    If you want to legitimize the prescription and sale of drugs for virtually all and every human problem, then you have to invent “mental illnesses.” ADHD, childhood bipolar, disruptive mood dysregulation disorder, etc., are all exactly on a par with warp drive.

    The difference, of course, is that warp drive doesn’t actually harm people.

  • cannotsay

    The more I think about it, and this is particularly true when I discuss the matter with Steven Novella “pseudo skeptic” types, the more I am convinced that the reason psychiatry has the backing of so many elites, despite its more than obvious lack of scientific foundations, is because the DSM is the secular version of the Inquisition rulings. The DSM allows a group of self selected and self appointed mind guardians to dictate behavioral orthodoxy via voting. Many people, especially those at the Harvards or Yales of the world, find the idea of voting in/out behavioral orthodoxy in a book without having to invoke divine inspiration very appealing. CS Lewis famously wrote,

    “I live in the Managerial Age, in a world of “Admin.” The greatest evil is not now done in those sordid “dens of crime” that Dickens loved to paint. It is not done even in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered (moved, seconded, carried, and minuted) in clean, carpeted, warmed and well-lighted offices, by quiet men with white collars and cut fingernails and smooth-shaven cheeks who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the office of a
    thoroughly nasty business concern.”

    While he probably didn’t have psychiatry in mind, that quote applies to the current practice of psychiatry 100%.

  • Phil_Hickey

    cannotsay,

    It surely does!

  • Nick Stuart

    Not sure the tide is turning. I have been censored on MiA for leaving the same comment as above. Oh well.

  • Nick Stuart

    http://www.tandfonline.com/doi/full/10.1080/13674676.2012.762574#.UqMlveK4Ef4

    ‘The diagnostic and statistical manual: sacred text for a secular community?’ by Elizabeth Ann Maynard.

  • cannotsay

    Ok Nick,

    So this idea of mine is not even original! Yes, I totally agree, the DSM is the secular version not of the bible, but of the regulations issued in the past by religious tribunals to impose behavioral orthodoxy.

  • Phil_Hickey

    Nick,

    The “Mengele in disguise” reference probably raised some eyebrows. I don’t censor material on this site unless it’s extremely obnoxious and defamatory – and even there I have fairly liberal standards.

    However, I use the Disqus program to support the discussion
    section of my site, and if a comment attracts five “flags” (condemnations), Disqus automatically deletes it. Or so I
    understand. I don’t think it’s ever happened on my site – but something like that may have happened on MIA.

  • Phil_Hickey

    Nick,

    The “Mengele in disguise” reference probably raised some eyebrows. I don’t censor material on this site unless it’s extremely obnoxious and defamatory – and even there I have fairly liberal standards.

    However, I use the Disqus program to support the discussion
    section of my site, and if a comment attracts five “flags” (condemnations), Disqus automatically deletes it. Or so I
    understand. I don’t think it’s ever happened on my site – but something like that may have happened on MIA. Or they may have software that automatically responds censorially to certain words. “Mengele” would probably be on such a list, and in fairness, it is a bit extreme, analogies notwithstanding. As you know, I’m extremely critical of what Dr. Biederman and other psychiatrists have done over the past 20 years, but I would not go so far as calling them Mengeles in disguise.

  • cannotsay

    Phil,

    I joined Nick in a private discussion with the MIA moderators on the topic. Yes, it raised their eyebrows, yes I admit that some people, especially academic types who strongly believe in Godwin’s Law, might find it excessive, but no, I do not think that the comparison is excessive.

    Biederman has been rehabilitated at Harvard. Martin Keller is living the high life as a retiree with a “scholar” journal that refuses to retract his most infamous demonstrably fraudulent paper. Charles Nemeroff is back receiving NIH money. Now, it is estimated that several million people died in Nazi extermination camps. The actual number is a matter of contention among historians, but it is certainly in the single digit range. How many children have been chemically abused by the drugs promoted by these three worldwide? How many have taken their own lives while on Risperdal, Paxil or Ritalin?

    We are under the same scenario denounced by CS Lewis. In Mengele’s case, the world saw the actual result and condemned it. In the case of these three pals, the number of children worldwide that have been victimized by their prescriptions in the last 20 years is certainly in the tens of millions range. While difficult to estimate, I bet that the number of suicides or other kinds of deaths associated to their prescriptions is at least in the thousands range worldwide, probably in the tens of thousands range. Yet, these white collar men have their reputations intact and we are supposed to say “yes sir, you have a valid point of view, I cannot call you a Mengele type of individual”. You tell me which one is more evil.

  • Nick Stuart

    Ha! I did not mean to steal your thunder! I just wanted to let you know that there are others that agree with and back up your ideas and you may be interested. Hope all good with you… cheers! (I like the C.S Lewis quote btw. It reminds me Hannah Arendt’s concept of the banality of evil.)

  • Phil_Hickey

    cannotsay,

    I don’t dispute the factual material that you outline. In fact, if it were researched and developed, it would make a great book: psychiatry’s toll – something along the lines of William Shirer’s work on the Third Reich.

    You wrote:

    “In the case of these three pals, the number of children worldwide that have been victimized by their prescriptions in the last 20 years is certainly in the tens of millions range. While difficult to estimate, I bet that the number of suicides or other kinds of deaths associated to their prescriptions is at least in the thousands range worldwide, probably in the tens of thousands range.”

    In my view, these two sentences are infinitely more powerful than calling the three individuals Mengeles or Hitlers or Nazis or any other detractory names. Many years ago, I wrote a short piece for, I think, the National Psychologist. In the article I made the point that the condition known as ADHD is not an illness – that it is something a child does rather than something a child has. In the following issue there was a response from an outraged reader who denounced me as an anti-science Nazi. My response to him was:

    firstly, don’t call me names, counter my arguments if you can;

    secondly, name-calling detracts from your position.

    Like yourself, I also feel a great sense of revulsion at what psychiatry has done and continues to do. I think it’s important that we are clear and outspoken in our condemnation of psychiatry and of its corrupt ties to the pharmaceutical industry. But we should leave the name-calling to them. Our job is to expose their spurious concepts, their fraudulent research, and their trail of destruction. The record speaks for itself.

  • cannotsay

    Perhaps you are right that calling these three pals “Mengeles” might distract from valid criticism for those Godwin’s Law believers. However, it is clear in my mind, and it seems to be clear in yours, that the actual destruction caused by these three is comparable both in magnitude and quality to the destruction caused by the real Mengele, probably even worse because society still has not repudiated any of them.

    After I accepted “my destiny”, namely, that my own story of abuse is here with me to stay and that there is no way the consequences both legal and social can be removed (they can be minimized but not removed), I have also been thinking that in a way, I have also been very lucky that when this thing happened to me I was already in my thirties. I cannot possibly imagine what my life would have been if I had been “taken to a psychiatrist” in my teens or my twenties by my parents. In addition to a severely impacted life, I might be dead by now because the psychiatric drugs that I took for around 1 year had damaged severely both my kidneys and liver. The damage got reversed only after stopping the drugs.

    All this to say, that yes, I find psychiatry repulsive in all levels: on the intellectual level (because it is no different from astrology), on the social level (because they stigmatize people gratuitously) and the criminal level (because if the same criminal standards that are applied to illegal drug dealers were to be applied to psychiatrists, most of them would be convicted of trafficking with dangerous substances or for murder).

    We just need to keep exposing the fraud, and that’s what I plan to continue doing, all through entirely peaceful and legal means. But indeed, to me the words psychiatry and psychiatrists have become synonymous with hell and the devil.

  • Nick Stuart

    It is a funny old world. The fact that I compared Biederman to Mengele on an internet chat forum, (and it was figuratively speaking since no other doctor sprang to mind), seems to have offended more people than the actual actions Biederman has committed ‘in reality’ to the brains of thousands of children. He still rakes in his millions whilst I get ‘moderated’. Only if I would apologise to him then I would be forgiven. Phew!! I still despair. ….

  • Phil_Hickey

    cannotsay,

    Thanks for coming back.

    “I cannot possibly imagine what my life would have been if I had been ‘taken to a psychiatrist’ in my teens or my twenties by my parents.”

    How about at age 2? or 3? or 4? What chance do these children have? As you say, we need to keep exposing the fraud and the damage.

    Best wishes.

  • Phil_Hickey

    Nick,

    I don’t think you’ve offended more people than Dr. Biederman has. That would take some doing!

    Don’t despair – just keep writing; keep spreading the word.

  • cannotsay

    I’d like to think that I am not as evil as to even imagine anybody doing that to 2,3,4 year olds. Giving neuroleptics to said children should be a crime punishable with jail, as far as I am concerned.

    Thanks for your great work at exposing this quackery.

  • Francesca Allan

    cannotsay, I love this: “You can claim all you want that something travels faster than the speed of light, but unless you design a falsifiable experiment that proves it, that claim will not advance your career.”

    Reminds me of my ongoing debate with my psychiatrist (who is not at all a bad guy). I claim that antidepressants (applied to a situational depression) made me manic which of course led to my bipolar diagnosis. My evidence is that it happened several times and that between psychiatric nightmares, I had an intervening 12 years without treatment and without symptoms.

    My shrink, on the other hand, claims that antidepressants merely “triggered” my underlying bipolar disorder, i.e. that I was bipolar all along. This has always struck me as a perfectly unfalsifiable theory but the doctor, being the designated sane one, disagrees.

    Isn’t this what Occam’s Razor is all about? The theory with the fewest assumptions is most likely to be correct? IMO, I won the face off but my “hostility and belligerence” are just seen to be further proof of my disease.

  • Guest

    It is sad to hear that the pharmaceutical industry’s personal interests goes that far….. We’re talking about children here. Not rats! Even if it probably took years to reach that point, and that even doctors are probably not conscious about that themselves, I can’t but feel ashamed about human vices’ limits when reading this…

  • t is sad to hear that the pharmaceutical industry’s personal interests go that far….. We’re talking about children here. Not rats! Even if it probably took years to reach that point, and that even doctors are probably not conscious about that themselves, I can’t but feel ashamed about human vices’ limits when reading this…

  • Phil_Hickey

    Lawrence,

    Thanks for coming in. Psychiatry does indeed plumb the depths!

  • jameskatt

    Child antispsychotic options:

    Disruptive behaviors are the most common reasons to prescribe antipsychotics to children.

    These include:

    1. aggressive-violent behaviors that are uncontrollable

    2. destruction of property – lighting fires, vandalism, holes in the wall of the home – placing the family at risk of eviction.

    3. fighting in school – leading to expulsions – risking the loss of a parent’s job since they now have to stay home to care for the child

    4. frequent and uncontrollable anger outbursts and agitation

    5. self-injurious behavior – hitting head on wall, cutting, burning, etc.

    6. refusal to go to school – placing the parent at risk of going to jail.

    These behaviors cause distress and illness to parents and siblings, loss of job for parent, pose a danger to others, and seriously disrupts the education of other students in school.

    What is a parent, foster parent or school to do?

    1. Talking to the child does absolutely no good with these conditions.

    2. Behavioral interventions – rewards, withdrawal, time outs – do nothing. The children learn quickly they can completely ignore them. They have the absolute power to say “No!”.

    3. In the past we beat our children into submission. This is now illegal.

    4. The police are helpless. They may talk to the child and admonish them. But the child learns to ignore them.

    If antipsychotics are not used, some possible solutions:

    1. EXPEL the child – the standard school intervention. The buck is passed to the next school – good luck with that. Children are often then placed in a continuation school – a dumping ground for unwanted children where education of the child is laughably ignored. The emphasis is to house them for the day

    2. JAIL the child. This is often the best solution. But it is hard to do without a crime. In juvenile hall, the children can be locked in isolation and strapped or chained to chairs for discipline among other things that would be illegal for a parent to do. The legal system often loathes to house a child in jail since it costs $80,000 a year to jail a child. This comes out of the county budget. If too young, even Juvenile Hall refuses to take the child.

    3. GIVE THE CHILD AWAY – very hard to do since nobody wants them and society frounds on this. Parents generally don’t want to give their child away anyway, despite how it may be in their best interest since they don’t have the skills to parent the child anyway.

    4. GROUP HOME PLACEMENT – possibly may be used, but often the child is evicted for continued behavioral problems. The supervisor of the group home will ask for antipsychotic treatment.

    5. OUT OF STATE PLACEMENT: Place the child in a group home in some other state – but someone has to pay the $60,000+ yearly bill

    6. BOARDING SCHOOL: If rich, send the child away to a boarding school or military school so someone else can deal with the kid. Boarding schools are orphanages for the wealthy who don’t want to deal with their children.

    7. FOSTER PARENTS can get rid of the problem child so the child may be given to another and another and another foster parent or group home – causing psychological damage to the child that is life long

  • Phil_Hickey

    Jameskatt,

    Thanks for coming in.

    You are raising profound questions. It may be that society will eventually condone the drugging of children as a way of “managing” misbehavior. But for that to happen, the matter would have to be debated publicly and voted on in various legislative bodies. And the implementation of such a policy would be shrouded in legal safeguards, etc… And there would be enormous pressure to explore alternatives, provide training and support to parents, etc…

    But that’s not even close to what’s happening today. What we’re dealing with today is the psychiatric lie that these children are ill and that the drugs are medications. There is no public discussion, no voting, and no regulatory safeguards. Just a psychiatrist’s pharma-directed say so.

    In addition, because the psychiatric fiction is accepted and implemented without question, no attention is paid to the fundamental question: Why are children behaving in these disruptive and dangerous ways? The glib (and false) psychiatric answer – “because they’re sick” – is accepted, and the crucial issues are never raised. The child is drugged with neurotoxic chemicals, and in many cases, is damaged for life.

    Again, thanks for coming in, and best wishes.

  • Wendy Ann Keenan

    I agree with you I think giving children these harsh toxic drugs is child abuse !!! They should be banned for under 18 year olds as they definitely can cause brain damage All kids rebel and misbehave and have mood swings Its called childhood and is quite normal They just need patience guidance and love The pharmaceutical companies must BACK OFF and leave kids alone