By Dr. Mercola
A growing trend of drug misuse is alarming medical experts, policymakers, and patient advocates.
In recent years, there has been a massive increase in off-label use of a class of drugs called "atypical niacantipsychotics."
These drugs, which include Seroquel, Zyprexa, Risperdal and Abilify, are only approved to treat disabling mental illnesses, but they're being prescribed by psychiatrists and primary-care doctors to treat conditions they were never approved for, such as:
- Attention-deficit disorder
- Behavioral problems in toddlers, and
Atypical antipsychotics have carried a black-box warning – the strongest warning label possible for drugs – since 2005, cautioning that use in elderly patients with dementia increases risk of death.
According to the U.S. Food and Drug Administration, antipsychotic drugs are not indicated for the treatment of dementia-related psychosis.
Yet many doctors are still prescribing antipsychotics for dementia.
According to a recent article in the Washington Post:1
"Critics say the popularity of atypical antipsychotics reflects a combination of hype that the expensive medicines, which can cost $500 per month, are safer than the earlier generation of drugs; hope that they will work for a variety of ailments when other treatments have not; and aggressive marketing by drug companies to doctors and patients...
[S]erious side effects... include major, rapid weight gain... [t]ype 2 diabetes, breast development in boys, irreversible facial tics and, among the elderly, an increased risk of death."
Skyrocketing Misuse of Dangerous Antipsychotics in Children
Most of the atypical antipsychotics were approved in the 1990's, at which time they were reserved for a very small minority of serious mental illnesses; primarily schizophrenia and bipolar disorder – diseases afflicting an estimated three percent of Americans. More recently, some atypical antipsychotics have also been approved for the treatment of severe depression.
This class of drugs include:2
||Olanzapine/ Fluoxetine (Symbyax)
|Asenapine Maleate (Saphris)
Shockingly, as discussed in the featured Washington Post article, recent disclosures show that children in foster care receive a disproportionate amount of potent mind-altering drugs. Not only do American foster children receive more psychotropic drugs than other children in general; they receive more drugs than those with the most severe forms of mental illness! This is an absolute tragedy, as these children are being drugged not out of medical necessity, but primarily for the convenience of caretakers, and for the profit of those within "the system."
Can Severe Mental Illness Be Diagnosed in Toddlers?
Children as young as 18 months are now receiving antipsychotic drugs, despite the fact that the diseases they're designed to treat rarely develop before adolescence. So why are toddlers receiving these potent drugs? Sadly, one of the key reasons these drugs are used is because of their sedative effect. They're typically prescribed to control "disruptive" behavior – not to treat severe mental illness.
Granted, the dubious diagnosis of "pediatric bipolar disorder" is in large part responsible for the increased use of antipsychotic drugs in young children. It is absolutely incomprehensible that there has been such an astounding increase in the diagnosis of childhood mental illness. The only rational explanation is a manipulation of the definition to justify inappropriately drugging our children.
According to the featured article:
"Between 1994 and 2003, reported diagnoses increased 40-fold, from about 20,000 to approximately 800,000, according to Columbia University researchers. That diagnosis, popularized by several prominent child psychiatrists in Boston who claimed that extreme irritability, inattention and mood swings were actually pediatric bipolar disorder that can occur before age 2, has undergone a reevaluation in recent years.
The reasons include the highly publicized death of a 4-year-old girl in Massachusetts,3 who along with her two young siblings had been taking a cocktail of powerful drugs for several years to treat bipolar disorder; the revelation of more than $1 million in unreported drug company payments to the leading proponent of the diagnosis; and growing doubts about its validity."
"Inventors" of Pediatric Bipolar Diagnosis had Strong Drug Industry Ties
If you suspect foul play might have something to do with this dangerous trend, you're probably right. Last year, the Harvard psychiatrists who invented the pediatric bipolar diagnosis were disciplined for conflicts of interest4 after it came to light they'd all received millions of dollars in undeclared drug company monies. In a July 21, 2011 article, Vera Sherav for Alliance for Human Research Protection writes:
"An investigation, prompted by Sen. Charles Grassely, was conducted by Harvard University-affiliated Massachusetts General Hospital. It concluded that psychiatrist Joseph Biederman and two of his proteges, Thomas Spencer and Timothy Wilens - each of who failed to disclose millions of dollars they had each received from the makers of antipsychotics, the drugs they promoted for the treatment of bipolar in children – had indeed violated the University's/ and hospital's conflict of interest reporting standards. The three wrote a mea culpa letter stating "we want to offer our sincere apologies… 'acknowledging' our mistakes…"
However, no mention was made anywhere about the profound consequences of these psychiatrists' commercially-driven clinical recommendations. No mention about the corruption of the scientific literature, about clinical practice that deviated from the Hippocratic Oath, 'First, do no harm,' nor was any mention made about the harm suffered by children whose doctors were misled about the safety and efficacy of highly toxic drugs. Child psychiatrists and pediatricians throughout the US were guided by these exceedingly influential Harvard psychiatrists."
The investigation also unearthed evidence of commercially-driven corruption of the research produced by these psychiatrists. A New York Times article5 revealed that court documents showed Dr. Biederman promised Johnson & Johnson that the results of a planned study in preschool children would "support the safety and effectiveness of Risperdal in this age group."
One Drug... A Cornucopia of Side Effects...
According to a study published last year, off-label prescriptions for antipsychotic drugs doubled between 1995 and 2008, from 4.4 million to a staggering 9 million prescriptions. In 2008, an estimated $6 billion was spent on off-label antipsychotics in the US, of which $5.4 billion was for uses based on uncertain evidence!
Taking an antipsychotic drug to treat, say, insomnia, is really like using a bazooka to rid yourself of a mosquito. It's overkill of the highest order, or as Dr. Adriane Fugh-Berman is quoted as saying in the featured article, "It's a total outrage."
Unfortunately, relentless advertising has helped "normalize" these drugs, so people don't think much of taking one. Take Abilify (aripiprazole), for example. It is licensed for the treatment of bipolar disorder, schizophrenia, autism, as well as major depression when taken with antidepressants. I.e. it is used to augment the effects of the antidepressants. This is because, of course, antidepressants don't work as advertised either. Numerous studies have demonstrated that antidepressants are no more effective than a sugar pill...
Abilify is a perfect example of how dangerous polypharmacy is spreading and increasing.
The word 'polypharmacy' means "many drugs," and essentially refers to instances where an individual is taking too many drugs – either because more drugs are prescribed than clinically indicated, or when the sheer number of pills simply becomes a burden for the patient. This situation used to be primarily a concern for the elderly, who generally take more medicines than younger folk. But over the past several years, even children as young as three are increasingly being prescribed four or more drugs! This is a significant problem, as the more drugs you mix together, the greater the chances of serious side effects.
People (of all ages) taking psychiatric drugs appear to be particularly prone to polypharmacy, which is particularly disturbing since each and every one of these drugs are quite potent and potentially dangerous when taken all by itself. Abilify, for example, has a staggering 75 different side effects6 associated with it, including:
|Low thyroid (hypothyroidism) or high thyroid (hyperthyroidism)
||Gastroesophageal reflux disease (GERD)
||Irritable bowel syndrome (IBS)
||Gallstones and kidney stones
||Carpal tunnel syndrome
Antipsychotics: Overused, Overpriced, Oversold
According to Sandra B. Goodman, author of the featured article:
"'Antipsychotics are overused, overpriced and oversold,' said Allen Frances, former chair of psychiatry at Duke University School of Medicine, who headed the task force that wrote the DSM-IV, psychiatry's diagnostic bible. While judicious off-label use may be appropriate for those who have not responded to other treatments for, say, severe obsessive-compulsive disorder, Frances said the drugs, which are designed to calm patients and to moderate the hallucinations and delusions of psychosis, are being used 'promiscuously, recklessly,' often to control behavior and with little regard for their serious side effects.
Doctors are allowed to prescribe drugs for unapproved uses, but companies are forbidden to promote them for such purposes.
In the past few years major drugmakers have paid more than $2 billion to settle lawsuits brought by states and the federal government alleging illegal marketing; some cases are still being litigated, as are thousands of claims by patients. In 2009 Eli Lilly and Co. paid the federal government a record $1.4 billion7 to settle charges that it illegally marketed Zyprexa through, among other things, a '5 at 5 campaign' that urged nursing homes to administer 5 milligrams of the drug at 5 p.m. to induce sleep."
Who Decides What Mental Illness is?
Modern psychiatry has expanded its reach to the point that even the most normal of emotions and mental states now fall under one labeled "disorder" or another. They have been able to cleverly define mental illness with the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This book is created by members of the American Psychiatric Association.
You would think that diseases are put in this book after evaluating carefully executed scientific trials, but nothing could be further from the truth. Additions and changes to this manual are determined by votes by its members. This categorization is NOT based on science at all!
It is well documented that psychiatric drugs in general and atypical antipsychotics specifically, are misused across the board.
The over-use and mis-use of these drugs exact a very steep price – your health. If you fall into the category of having been mis-prescribed a psychiatric drug – which today is more the norm than the exception – please understand that there are far better, safer options. And for those of you who are taking a properly prescribed drug, based on appropriate diagnosis of a mental illness, just be aware of what the potential side effects are, so that you can avoid more serious illness. By making key lifestyle changes you may be able to counteract some of the most devastating side effects, allowing you to maintain better health…
Normal Life Challenges are Now Medical Conditions
According to the featured Washington Post article:
"Wayne Blackmon, a psychiatrist and lawyer who teaches at George Washington University Law School, said he commonly sees patients taking more than one antipsychotic, which raises the risk of side effects. Blackmon regards them as the 'drugs du jour,' too often prescribed for 'problems of living.' Somehow doctors have gotten it into their heads that this is an acceptable use. Physicians, he said, have a financial incentive to prescribe drugs, widely regarded as a much quicker fix than a time-intensive evaluation and nondrug treatments such as behavior therapy, which might not be covered by insurance."
Alas, you cannot push a drug unless people believe they might have a disease. At the heart of the problem is the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), and its slew of newly created diseases that are dubbed in need of medical treatment (i.e. drugs). The central dilemma is that many of the "disorders" could apply to nearly any one of us at one time or another, hence any one of us, or ALL of us, can at some point justify taking a potent drug. The practice of systematically inventing disease or exaggerating minor ones in order to sell more products actually has a name. It's called disease-mongering, and it's a well established tool used among drug companies.
And as irrational as it may seem, any one of the following "disorders" can be "treated" with a drug:
- Are you sometimes shy? Then you may have "Social Phobia."
- Are you wondering about deeper things, such as the meaning of life? Then you've got a "Religious or Spiritual Problem."
- Do you argue with your brother or sister? Then it's a "Sibling Relational Problem."
- Does your child argue with adults, lose his temper, or annoy people? Then he has "Oppositional Defiant Disorder."
- If you or your teenager is uncertain about what path to take in life, what your values or career goals are, you've likely got an "Identity Problem."
The Drugging of Our Children
It is bad enough to prescribe dangerous psychotropic drugs to adults, but some of the most targeted people are just barely out of diapers. In 2007 alone, half a million children and teenagers were given at least one prescription for an antipsychotic, including 20,500 under the age of 6. American children are the most medicated children in the world. For example, they get three times more prescriptions for antidepressants and stimulants, and up to double the amount of antipsychotic drugs than kids from Germany and the Netherlands.
How can we, as a society, continue to allow corporate profits to come before lives, and even before children's lives? And why is it that so few people are willing to step up and really expose the corruption once and for all?
If you or your child is suffering from an emotional or mental challenge, please seek help, but do so from someone who does not regard psychotropic drugs as a first line of defense. It will be very helpful if you first optimize your or your child's diet and lifestyle as this will significantly improve the likelihood of any successful natural intervention. A good starting point would be my comprehensive health plan that is free to view. There are also many wonderful tools out there to address your emotional challenges. One of my favorite ones is the Emotional Freedom Technique (EFT).
Could a Vitamin Actually Help Psychosis?
I will be interviewing Dr. Andrew Saul later this year about his new book, Niacin: The Real Story: Learn about the Wonderful Healing Properties of Niacin.8 He co-wrote the book with Abram Hoffer M.D., Ph.D., who published over 600 reports and articles as well as 30 books. His early work led to the use of niacin for schizophrenia and as an cholesterol treatment. Dr. Hoffer died in 2009 at the age of 91, but he successfully treated many thousands of patients with high dose niacin for psychotic disorders.
He presented some very compelling evidence to support treating most psychotic disorders as a vitamin B3 deficiency.
Considering it is very inexpensive and has virtually no dangerous side effects it would certainly be worth a consideration for anyone who has a family member with this mental health challenge. I would also highly recommend picking up this $12 book at Amazon and learning more about its use.
Is there Hope for Change?
Fortunately, there are glimmers of hope that sensibility will return and that much-needed changes will be made to prevent most of the unnecessary drugging. According to Boodman:9
- Texas has announced it will not allow a child younger than 3 to receive antipsychotics without authorization from the state10
- Arkansas now requires parents to give informed consent before a child receives an anti-psychotic drug
- The federal Centers for Medicare and Medicaid Services announced it is summoning state officials to a meeting this summer to address the use of antipsychotics in foster care
- Senators Herb Kohl (D-Wis.) and Charles E. Grassley (R-Iowa) have introduced legislation that would require doctors who prescribe antipsychotics off-label to nursing home patients to complete forms certifying that they are appropriate, and
- Medco is asking doctors to document that they have performed diabetes tests in patients taking the drugs
"Our intention here is to get doctors to reexamine prescriptions," [Psychiatrist David J.] Muzina [a national practice leader at pharmacy benefits manager Medco] said. "In the short term, I don't see a change in this trend unless external forces intervene."
I believe one of the first steps toward change is education and awareness - in this case, people need to be re-educated about drugs and disease, so they won't fall for the lure of "the magic pill." Doctors must also become more sensitized to the grave harm inflicted on their patients by unnecessary drugs, and focus on normalizing their patient's biochemistry by eliminating sugars and processed foods, and considering addressing hidden vitamin deficiencies like niacin.