Mad in America

I work as a behaviour clinician, primarily with children with intellectual disabilities. I have noticed that a great number of children who display challenging behaviours are being prescribed antipsychotics, especially if they are autistic.

This research highlights a significant concern for long term use of antipsychotics in children and it will be very interesting to follow where this goes.

I would hate to think that the medication which is trying to help the children overcome their behaviour difficulties was actually doing physical damage to their brain.

I would hope that anyone trying to address behaviour would be looking at non-drug therapies and less invasive techniques than medication.

See also another story on the same thing:

http://www.medpagetoday.com/Psychiatry/Schizophrenia/24763?utm_content=G...

Ski Dude

It's a bit like saying- open heart surgery leaves a scar.

What do think unmedicated Schizophrenia does to the brain?

Maybe one day a medicine will come along that's perfect. Until then, this is the best they have, and they're damn lucky to have it.

Hi Robert, interestingly part of autism, or certain subtypes, are known for having a hyperactive brain and increased grey/white matter. That would be expected during a stress response, a lowering of latent inhibition, a better scanning of the environment and a higher attunement for "dangers"... but it gets excessive. So, yes, while not the perfect solution, solutions that "dampen" brain activity can show "improvement", which is why the next generation of drugs are looking toward Glutamate suppression or oxidative stress reduction.

Another point to make, and it's an important point and fine line... is that while reduce grey matter can signify issues, such as in lead toxicology studies, in animal studies smaller brains are also associated with greater domestication. And "disorders" such as ADHD may walk that fine line of being a highly creative type, or predestined explorers under stress... so a complete suppression to "domestication"... may NOT be what the doctor ordered. This may be a fine line of distinction that doctors SHOULD be aware of before medicating. Sometimes inappropriate environments (lack of nutrition), social stress (abuse, overly competitive environment, lack of physical exercise), inappropriate work/school enviornments (inapporp expectations) can create the problem... so drugs themselves wouldn't alsways be the only answer.

This frustrates me, too, that people say, oh, if the brain is shrinking you shoudlnt be allowed to prescribe them. My son was given a small amount of risperdone when teachers were screaming for some adhd meds, since he was on the spectrum and had tics. But the risperdone allowed him to make freinds for the first time. Instead of screaming that everyone was doing everything to him on purpose (even when they didnt do ANYTHING), he was just a little weird and akward. He also was no longer suicidal . . .at age 9. The liklihood that an autistic, bipolar man with tourettes will be self-supporting is so slight, but the liklihood that a childhood of horrible experiences due to paranoia beyond his control will lead to suicide in his teens or 20s is high. I'll take the brain shrinkage.

Good summary of the situation. By Andreasen's own admission (in the NY Times interview mentioned, "A Conversation With Nancy C. Andreasen: Using Imaging to Look at Changes in the Brain") she and her team have sat on these findings for years, partly through fear that people would stop taking antipsychotics which doesn't seem a particularly neutral scientific method.

See also "A systematic review of the effects of antipsychotic drugs on brain volume" (2010) which addresses a point made above about about unmedicated vs medicated sufferers.

To Anonymous who says "I'll take the brain shrinkage" in regard to son - there must be a risk-benefit line that is crossed somewhere for mass prescribing though.

The British goverment recently finally decided that prescribing of these drugs to the elderly in care homes must be severely limited (down to about 1/3 of current numbers within a year, and at lower doses) because of clear evidence of them causing early death in at least 180,000 elderly people and a wide range of other adverse effects, not to mention quality of life issues when they are routinely prescribed "because of their strong sedative effects'. See BBC Doctors told to cut anti-psychotic drugs for dementia.

180,000 a year that is

I have many patients who are court-ordered to engage in psychiatric treatment, but I have none who are ordered to take antipsychotics. In fact, it would be a violation of the court's duty (not to mention the practice of medicine without a license) to order a client to take an antipsychotic, or any other medication for that matter. That decision is up to the physician, in conjunction with the patient.

That said, courts can and do order medication in cases of grave disability or when the patient cannot provide his/her informed consent, usually in the context of a psychiatric hospitalization.

Also, in your fourth question, be careful not to confuse the issue. There is no evidence in Andreasen's study that the loss in brain volume was associated with poor cognitive function, even though in cases of dementia (a very different disease process) cognitive decline does mirror the loss of brain tissue.

"Also, in your fourth question, be careful not to confuse the issue. There is no evidence in Andreasen's study that the loss in brain volume was associated with poor cognitive function, even though in cases of dementia (a very different disease process) cognitive decline does mirror the loss of brain tissue."

Steve MD, she was talking about people who have never taken meds. As a result, I don't think you can make the assumption that this is true with folks who have taken anti psychotics.

As one who successfully slowly tapered off of a psych med cocktail after 15 years, I have definitely lost some cognitive function that I don't think is strictly age related.

I think these meds greatly worsen cognitive function over time and it seems many of your colleagues don't want to acknowledge this. That needs to be the focus.

Regarding court ordered psychiatric treatment, you are unique if you don't prescribe meds. Most psychiatrists do.

in this comment thread are still under the delusion of the mental illness myth. So much so they will even have their own children targeted by this pesudoscience and profiteering.
This to me is of same ilk of falling for the war propaganda. Where 'loving' parents will gladly wave their children off to wars which are NOT about (which I wouldn't sacrifice my loved ones for either) what they are even supposed to be about, but are for corporate profits and power.

If ONLY you people still caught up in your gullibility about the mental illness myth could look at the BIGGER picture and/or context it subsists in, you may get an inkling of what I am meaning here!

Robert,

Another excellent post. Keep it up.

An additional disturbing feature of this whole business is the fact that the bio-psychiatric-pharma bloc has over the years successfully promoted and sustained the notion that these individuals must “stay on their meds.” There is enormous resistance to these products within the client population, and with good reason. To counteract this, the drug pushers maintain constant pressure on these individuals to go on taking the products. This pressure has been successfully transmitted into wider circles (judges, police, prosecutors, Social Service personnel, etc.) to the extent that “coming off one’s meds” is widely perceived as a great harbinger of doom.

This kind of thinking has even infiltrated the popular imagination. If a person is acting silly or prankish, he will often be asked jokingly if maybe he should “get back on the meds.”

The bio-psychiatric pharma bloc will be running rear-guard action on the Andreasen finding. We can expect to hear and read lots of arguments as to how the benefits of these drugs outweigh the risks and, of course, we will be assured that the psychiatrists only use these products when absolutely necessary.

Philip Hickey, PhD
http://behaviorismandmentalhealth.com/

The religion of pharmacological psychiatry & their followers can't be objective in this discussion because they are hell bent on defending their faith with hypothetical and theoretical prepositions they naively except as indisputable and unquestionable scientific fact.

The brain shrinkage issue is just another in a very long line of evidenced alarming issues concerning using these medications in kids.

I have found by reading the blogs of many parents trumpeting the drugging bandwagon, it's not the kids that need intervention treatment or are primarily troubled; but the ignorant & misguided parents that blindly follow those that professionally profiteer at the expense of these pharmacological abused children.

I have also found the majority of these parents embrace wholeheartedly their own psychiatric labels and their psychological addiction to these drugs.

YES! it really is child abuse plain and simple...In no other segment of our society would we place children at such risk without substancial and long term effency data supporting such diabolical/serious risk concerning our childhood population.

It's no secret that by any admission that the drugs are in fact dangerous and inappropriate for use in children, this would also come along with personally bearing the responsibility & admission that they as parents and/or medical professionals now solely carry the burden of the damage they have with forethought and malice inflicted upon these children.

Take that one to your next CABF/NAMI/DBSA chat and chew on it for a while please.

Robert,

I think the time has come to take up the issue of banning psychiatric drugs for children.

Children have no say in their "treatment," which can cause lasting harm.

The drugmakers have not earned the trust necessary to allow them to expand their markets with our most vulnerable - children.

I'm for free markets, but in this case, unfortunately the states must step in, and regulate... to protect children - especially those in Medicaid and foster care.

Thank you for the post.

My best,

Duane Sherry, M.S.
http://discoverandrecover.wordpress.com/warning/

*This Comment is on Pharmagossip's blog

http://pharmagossip.blogspot.com/2011/02/should-prescribing-of-antipsych...

Here it is in full:

"Hi Robert,I'm a big fan, having read everything you publish (sometimes several times, in order to understand the nature of the damage). You've brought up some great questions here, related to Andreason's study. And clearly, you predicted this revelation yourself quite a few years ago when you first published Mad in America. I think the bigger question is whether the manufacturers will be held liable? They've had the same information for at least as long as you have. What happens when the corporate whistleblowers start coming forward, showing evidence of Big Pharma board meetings at which brain shrinkage among juveniles was discussed and discarded? How big will the bill be under the False Claims Act? Fines of $11,000 per incident and triple damages can add up quick.

*Andy Prough is a Certified Fraud Examiner who has been investigating fraud and abuse in healthcare settings.
http://www.austinacfe.com/andy.htm

1 boring old man blog just wrote an excellent 12 part series on AstraZeneca's Seroquel...deception, fraud, hiding the facts, ghost writing, and using outright lies. AstraZeneca cooked/manipulated the study data to get this drug to market....

Read it, learn, & weep for all the victims past, present, and future.

http://1boringoldman.com/

The burden of proof is on doctors, researchers, and pharmaceutical companies to show that antipsychotics and other psychiatric drugs have beneficial long-term effects. This should have been done BEFORE any psychiatric drugs were ever prescribed to children. Children have the most to lose if these drugs cause long-term harm. We should ban prescribing all psychiatric drugs to children. Individual drugs can be approved only after studies show long-term benefit in children (long-term = 5 or more years).

Elizabeth H,

This is a forum on the psychiatric drugging of kids, not an opportunity to bash the military.

You say that our troops are "murdering" children in those countries.

It's one thing to say that your against the war(s), but to use that kind of rhetoric is uncalled for, in fact it's disgraceful!

Many young women and men are serving who believe in the causes, who see it as a global war on terror, with the countries you mentioned as part of that larger picture. Many are kind and loving souls, many have children of their own, whom they haven't seen for months (tours) at a time.

If you think they have been misguided, fine. But how dare you call them "murderers!" Many have given their lives to protect innocent life, who don't want to see women in Burkas and our own nation under Sharia Law.

Robert, I apologize for the rant, but I've had enough of people who like to sneak in a little America bashing whenever they have the opportunity.

Shame on you, Ms. Al Jazeera!

Recovery Resources for Military Service Members and Veterans -

http://discoverandrecover.wordpress.com/2011/03/12/recovery-resources-mi...

Elizabeth H,

If you respond, I'm not responding back...
This is not the forum.
You said what it is you wanted to say, and I said what needed to be said.

Enough!

Duane Sherry, M.S.
discoverandrecover.wordpress.com

what can we do to stop this blasphemous "treatment?" We are destroying brilliant minds! Such as mine! I made the dean's list taking a vigorous course load in the business school at a prestigeous university, had a "mental breakdown," went on drugs when i should have just waited it out, and now I'm dumb. simply put, dumb. My recall is terrible and memory is fading, I think about my old self and its like i feel like im looking back on someone that no longer exists. F*** YOU, YOU JOKES FOR "DOCTORS!" Honestly.