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Drug Industry Influence In Psychiatry

A very good interview, entitled appropriately enough, A Question of Ethics, on the dangers of the pharmaceutical kickbacks in the psychiatric field can be found on Medscape Today. The person being interviewed is a Dr. Amy Brodkey, adjunct associate professor of psychiatry at the University of Pennsylvania. Dr. Brodkey is also on the board of No Free Lunch, a nonprofit organization that encourages a greater distance between physicians and the drug industry.

Industry funds 60%-80% of all CME [Continued Medical Education] activities. CME is often put together by medical education and communication companies (MECC), most of which are for-profit companies that have as their explicit goal to increase industry profits. Many are credentialed to offer ACCME [Accreditation Council for Continuing Medical Education]-accredited programs.

As Dr. Brodkey points out, the drug industry has no business educating people as that’s a job for educators.

Crypto Creature ADHD Under The Magnifying Glass

My bullshit detector alarm is going off every time I do an internet search pertaining to matters psychiatric. Mental Health professionals now think they have the chimera Attention Deficit Hyperactivity Disorder, a disease that didn’t exist years ago, but which has been given its own illusory history, under wraps. Just Imagine–precision ADHD detecting!

This according to a Northwest Herald article, New technology makes ADHD diagnosis more precise, on the subject:

With new technology, diagnosing ADHD has become easier and more precise, said Dr. Robert Kohn, a neurologist and neuropsychiatrist with a private practice in McHenry [Illinois]. Doctors have been criticized for over-diagnosing the problem and over-prescribing powerful stimulants to treat it. New tests, such as the Quotient ADHD System, manufactured by BioBehavioral Diagnostics Co., and Neba, an EEG test by Lexicor, have “sharpened diagnosis and treatment,” Kohn said.

Apparently this diagnosis could give way to other diagnoses, and some of these diagnoses are much more ‘serious’, not to mention equally dubious, than the initial diagnosis. You’ve got an expanding population of the labeled mentally ill to bring in more mullah for those professionals who prey on them. That’s more business for shrinks and drug companies, folks. Whoopee!

While ADHD can be treated, it often is accompanied by other behavioral health issues. People with ADHD often have other psychiatric disorders. Depression, bipolar disorder, drug and alcohol abuse, and learning disorders are some examples, Kohn said.

It helps (I don’t know who, maybe mental health professionals?) to consider that according to this article children don’t outgrow it, and some undiagnosed adults have it.

The article ends on an even more curious note.

Not everyone with ADHD requires treatment. Some adults, especially those with mild cases, are able to manage, said [Dr. Sharyl] Balkin, who has worked with lawyers and doctors with ADHD.

“The more intelligent you are,” she said, “the more likely you are to get by without treatment.”

Hmmm, and nobody would see education as the answer? Stupid and gullible enough and you must have ADHD. Here’s a prescription of pills to feed it on.

Misdiagnosis In New York

While there are people who claim that there are all these people with mental illnesses who are afraid to come forward and be ‘treated’ due to the stigma against people with mental illnesses, there are also people who get thrown into the psych ward when there is absolutely nothing wrong with them. One case in point is that of Chris Muth, the Cat Man of New York City.

As relayed by The Brooklyn Paper in a story entitled Cat Man bares his claws in suit against hospital:

Chris Muth, aka “the Cat Man,” made headlines in July, 2008, when he got thrown into the psych ward of Long Island College Hospital for six days after his attempt to rescue Rumi, a friend’s feline who had fallen behind a wall in Muth’s Court Street apartment.

Chris is suing Long Island College Hospital and 11 of its workers to the tune of 260,000$.

Somebody apparently called the boys in blue, although these were perhaps not New York’s finest given the result, mistakes happen. Wait until you see what’s in the medical report…

A medical report compounded what Muth claims was a misdiagnosis, saying that Muth was suffering a “bizarre delusion [that he] was trying to ‘save’ a cat.”

Seeking a pen and paper with which to write a press release from the head nurse on duty at the hospital, Chris was promptly assaulted and injected with the powerful psychiatric drug Haldol.

Much of the difficulty in recovering from a diagnosis of serious mental illness, in my estimation, can actually involve recovering from the disruptive experience of institutionalization. These difficulties have given Chris Muth much reason to sue in his case.

Muth was eventually proven to be sane — regarding the cat at least. Rumi was indeed rescued by an animal control officer after 15 days. But by then, Cat Man had been declawed: His landlord kicked him out, he lost his job, and his girlfriend dumped him — though they are now back together.

Hopefully Chris Muth can manage to win his suit in this case involving rash decisions and such obvious lapses in good judgment on the part of law enforcement and mental health authorities. It’s not the only suit he is bringing forward, but it certainly shows that criminals are not the only people who make stupid mistakes.

The Parable Of The Thousand Different Holes

The octagonal peg will fit neither the square hole nor the round hole.

Of course, the octagonal peg must have a mental illness. On the other hand, maybe it is just octagonal rather than square or round.

We could give the octagonal peg drugs, but no amount of drugging will cure the octagonal peg of being an octagonal peg. Nevertheless, perhaps the drugs will help the octagonal peg better adjust to being octagonal.

Maybe we should just forget the drugs.

What does the octagonal peg need then?

The octagonal peg needs a board with octagonal holes in it rather than just round holes or square holes; otherwise the octagonal peg won’t be able to fit in with the other pegs.

It’s ok to be octagonal. Octagonal, after all, is a little more multidimensional than round or square. There’s refinement there. Perhaps even genius.

A world of only round pegs and square pegs is a boring world.

As long as we’re going to have octagonal pegs, we need to make boards with octagonal holes in them if we want these pegs to fit in.

A world without boards with octagonal holes is absurd to an octagonal peg, although it may seem to make perfect sense to a round peg or a square peg. Not only is it absurd, but it’s unfair.

Oh, no! Now the five pointed star peg is complaining!

Good night, boys and girls.

Corruption In A Government Agency

Who is going to reign in the FDA (Food and Drug Administration)!? This totally irresponsible government agency has abandoned its regulatory capacity again and again and again. The agencies strings are being pulled by rich and powerful drug companies. If this were not the case, why would this agency be approving psychiatric drugs for uses beyond the uses for which they were originally designed and intended? Why would this agency be approving drugs for use by children and adolescents as safe that have lost numerous lawsuits due to the damage they’ve done to the health of people using them? Obviously such drugs are by no means safe for anyone, let alone children.

Among the recent decisions of the FDA was the approval of Seroquel XR, or an extended release form of Astra Zenica’s Seroquel, as an add-on drug for treating depression. We know that drug cocktails are one of the worst treatment courses of action you can take for treating people suffering from mental distress, and here Seroquel has been approved as another chemical compound in just such a drug cocktail. Seroquel has also been approved for treating schizophrenia in teenagers and for treating bipolar disorder in children and adolescents. Additionally the FDA approved Eli Lilly’s Zyprexa for the treatment of teenagers with schizophrenia and for the treatment of teenagers with bipolar disorder. Metabolic changes associated with these drugs that have contributed to the average age at death being 25 years younger for mental health consumers than that of the rest of population speak to the reasons why these drugs should have never gotten approved for all these usages.

There is an effort underway to get the ECT (electro-convulsive therapy) device reclassified from a class III device with the highest risk associated with it to a class II device that is relatively low risk. This approval would take place without any thorough going investigation taking place as to whether ECT is actually dangerous or safe. There is a good chance that after many years of forestalled efforts to reclassify shock devices, next year the FDA will approve this reclassification. Lacking an investigation into the actual risks involved with shock treatments, this kind of approval could only be based upon a lie. Shock devices should go through the same kind of rigorous examination that any other device would go through before approval. Why is the FDA being encouraged to circumvent studies into the safety or danger of shock treatments? Frankly because the proponents and manufacturers of these devices know the devices would never receive reclassification if any such investigation were allowed.

You have perhaps heard about drug companies being fined for the off label advertising of their drugs. This is when a company recommends a drug for some use the FDA hasn’t approved it for. So we know the FDA cares about procedural matters, and the maintaining of its power and control. The story you perhaps haven’t gotten is the story of all these drugs that have gained FDA approval for uses that they should have never been approved for in the first place. Obviously questions arise here as to how independent this agency is of the corporations it would be policing.

You were wondering about the alarming rise in mental illness on campus

Mental illness is beginning to be seen as cool and trendy. You can’t be with it if you aren’t diseased. Why it’s like vampirism in the movie Twilight! Anyway, it would be the trend, if it weren’t for stigma.

As an article, Groups work to destigmatize mental illness, from The Minnesota Daily News relates:

When University of Minnesota junior Nellie Brau was in high school, she suspected she might be suffering from depression and anxiety. But she didn’t feel comfortable discussing her feelings with friends or family.

“I internalized the issue,” said Brau, who is majoring in global studies and French. “I was afraid to reach out, and I thought I would be judged or called crazy,” she said. Eventually she spoke out about how she was feeling and was diagnosed with clinical depression and anxiety.

I like ‘crazy’ myself; ‘mental illness’ is a little too medical model for me. ‘Madness’ is college football and soccer.

After her diagnosis, Brau started an advocacy group at her high school aiming to destigmatize mental illnesses, and during her sophomore year at the University she joined a student group called Active Minds that has a similar goal. She is now president of the group.

Now the question remains, with mental illness seen as such a trendy disability, how will we ever destigmatize mental health recovery!?

On The Importance Of Being Literate

Let’s look at definitions. Specifically let’s look at the definition of one of the words most frequently being bandied about in connection with the labeling of serious mental illnesses. Let’s look at stigma.

stig•ma
n. pl. stig•ma•ta or stig•mas
1. A mark or token of infamy, disgrace, or reproach: “Party affiliation has never been more casual . . . The stigmata of decay are everywhere” (Arthur M. Schlesinger, Jr.) See Synonyms at stain.
2. A small mark; a scar or birthmark.
3. Medicine A mark or characteristic indicative of a history of a disease or abnormality.
4. Psychology A mark or spot on the skin that bleeds as a symptom of hysteria.
5. stigmata Bodily marks, sores, or sensations of pain corresponding in location to the crucifixion wounds of Jesus, usually occurring during states of religious ecstasy or hysteria.
6. Biology A small mark, spot, or pore, such as the respiratory spiracle of an insect or an eyespot in certain algae.
7. Botany The receptive apex of the pistil of a flower, on which pollen is deposited at pollination.
8. Archaic A mark burned into the skin of a criminal or slave; a brand.

The Free Dictionary stigma

Putting a social before the word stigma doesn’t make it something you can just wash off with soap and water.

Some people have argued that stigma is a religious term, and that perhaps another term would be better used in these cases. Who, after all, has an eternity to endure the Mark of Cain or the Sign of the Cross in. I think the above definition bears out the truth of this view.

(No, I don’t think there are all these uncaught whack jobs out there that are not coming forward to receive their treatment or, *cough* ‘help’, on account of some ‘stigma’ pertaining to whack jobs.)

There are, in my opinion, better words to use. Words that even a politician might understand. Words like prejudice.

prej•u•dice
n.
1.
          a. An adverse judgment or opinion formed beforehand or without knowledge or examination of the facts.
          b. A preconceived preference or idea.
2. The act or state of holding unreasonable preconceived judgments or convictions. See Synonyms at predilection.
3. Irrational suspicion or hatred of a particular group, race, or religion.
4. Detriment or injury caused to a person by the preconceived, unfavorable conviction of another or others.
tr.v. prej•u•diced, prej•u•dic•ing, prej•u•dic•es
1. To cause (someone) to judge prematurely and irrationally. See Synonyms at bias.
2. To affect injuriously or detrimentally by a judgment or an act.

The Free Dictionary prejudice

The ex-patient movement has had its share of Rosa Parks. Do we speak of stigma when we speak about the adversity faced by women and African Americans? No. People are prejudiced against certain people on account of their skin color, gender, or what have you, and they discriminate against those people who are perceived as being somehow different from themselves.

dis•crim•i•nate
v. dis•crim•i•nat•ed, dis•crim•i•nat•ing, dis•crim•i•nates
v.intr.
1.
          a. To make a clear distinction; distinguish: discriminate among the options available.
          b. To make sensible decisions; judge wisely.
2. To make distinctions on the basis of class or category without regard to individual merit; show preference or prejudice: was accused of discriminating against women; discriminated in favor of his cronies.
v.tr.
1. To perceive the distinguishing features of; recognize as distinct: discriminate right from wrong.
2. To distinguish by noting differences; differentiate: unable to discriminate colors.
3. To make or constitute a distinction in or between: methods that discriminate science from pseudoscience

The Free Dictionary discriminate

We are in this instance referring specifically to definition 2.

2. To make distinctions on the basis of class or category without regard to individual merit; show preference or prejudice: was accused of discriminating against women; discriminated in favor of his cronies.

This is important. Some people don’t ‘get it’. The English language need not be your lack of understanding of that language.

I’ve also heard the view expressed that mental illness doesn’t discriminate, or that it is indiscriminate, and that anybody can be stricken with it. What I say when I hear such a view expressed is, “What evidence do you have to support your hypothesis?” Facts and figures are what count. Prove it! We know people discriminate, if your illness discriminates, too, we shouldn’t ignore that discrimination. Merely saying it, in other words, doesn’t make it so.

The Lily Foundation And Cemetery Reclamation

Some people you are probably better off not making your partner.

The Lily Foundation, for example, established by the same family behind the company that brought you Zyprexa, is donating $2,500 to the Toledo State Hospital Cemetery Reclamation Project in honor of labeled schizophrenic artist Larry Wanucha.

Problem: These newer drugs, including Zyprexa, have been credited with having much to do with why people in the mental health system are dying off at an age on average 25 years younger than the rest of the population.

The patients buried at the old cemetery were buried before the development of atypical psychiatric drugs, and so that is not so much of an issue with that one. No, they only had shock treatments, sterilization, lobotomies and other abuses of power to help put them under the sod earlier than the rest of the population.

Burials at the newer cemetery stopped in 1973, well after the 1950s when the initial drugs had been developed. The effects of those older drugs led to the development of these newer atypical psychiatric drugs in the 1990s, of which Zyprexa is but one example. These older drugs could contribute to a premature demise as well, only maybe a tad less premature.

This is rather like having a major tobacco company donating money for the upkeep of a cemetery for cancer victims, and think, it’s a multi-billion dollar company shedding peanuts on this cemetery reclamation project.

I know it might be able to carve a granite legend or two with this pittance, but if I were the Toledo State Hospital Cemetery Reclamation Project I would send this $2,500 straight back to the Lily Foundation with a prompt thank you kindly, but we don’t need your blood money. We can and will go much further with people who truly care about people than we will with people who are throwing away chump change to placate their very real guilt.

Just think, buried before the development of Zyprexa, the lucky bastards!