Study 329 in the news

photo via Funny or Die

via Robinson Research Institute:

Study 329 Restored

via: Study329.org SCIENTIFIC INTEGRITY THROUGH DATA BASED MEDICINE:

BMJ Publishes Study Revealing How Flawed Drug Research Fails a Trusting Public

Band of Intrepid Researchers "Sets the Record Straight" on Ghostwritten Study

an excerpt:

"Toronto (September 16, 2015) — Today the BMJ published Restoring Study 329, a decade-long effort by researchers to uncover the truth about the safety of an antidepressant approved for use by adolescents. Restoring Study 329 is a reanalysis and rebuttal of the original Study 329 ..." more here

via Mad in America: 

Psychiatry’s Thalidomide Moment

By REDMOND O'HANLON

an excerpt: 

Study Details and Findings

"The authors of Study 329 began recruiting adolescents for a comparative study of Paxil, imipramine and placebo in 1994 and finished their investigations in 1997. They dropped a large number of their original cohort, so the randomness element in the study must be open to question. Late in 1998, SmithKline Beecham, (henceforth GSK) the marketers of Paxil, acknowledged in an internal document that the study had shown that Paxil didn’t work for adolescents in terms of the two primary and six secondary outcomes they had established at the start of the study. In a nutshell, Study 329 was negative for efficacy and positive for harm, contrary to their succinct upbeat conclusion. Adjudging, of course, that this lack of benefit and presence of risks could not be communicated to an innocent public, the team’s task was now to see how bad news could be transformed into good. They decided then that they would cherry-pick the few positives they might glean from their mass of data and publish these. This, however, required them to abandon nearly all of their original outcome measures and dredge up a few new ones, abandoning the symptoms in the Hamilton Rating Scale for Depression (HAM-D),which they originally invoked and which is the normal scale used in such studies.

"The article had first been rejected by JAMA..." read here

 

Dr. RICO Child Psychiatrist

updated April 25, 2014 first published May 20, 2012

Dr. RICO

Racketeer Influenced and Corrupt Organizations Act

I am disappointed by the lack of integrity that permeates the psychiatric profession. I see no evidence of any effort to be responsible or accountable for the harm done to patients. Bio-medical psychiatry has a foundation reliant on dishonesty. Psychiatrists who falsely reported of research results, fraudulently obtained FDA approval for drugs, and participated in illegally marketing of psychiatric drugs, help formulate public policy. It is plain that these psychiatrists are continuing to participate in what is a widespread ongoing criminal enterprise that continues to pick America's pocket and continues to harm thousands of patients. These doctors see nothing wrong with failing to warn other professionals away from corrupt 'evidence.' Psychiatrists don't petition medical boards to take away the medical licenses of the criminals among the APA and AACAP membership who have lied about 'the medicine;' not even those who have disabled and killed patients in drug trials and clinical practice. Doctors who buried the evidence of their wrongdoing, along with the bodies of their patients are considered 'Key Opinion Leaders.' Some are teaching in Institutions of Higher Learning using texts filled with their corrupt work. Discredited and fraudulent research remains in psychiatry's so-called 'Evidence-Base.' Coercive and manipulative social control strategies are standard clinical practices; this is social/political control by use of torture under color of law; if psychiatry is in fact an ethical medical specialty, I'm Mary Poppins...

At a Senate hearing that took place on December 1, 2011 Senator Tom Carper said the hearing was the culmination of the third investigation into the prolific use of psychiatric drugs particularly those prescribed off label then fraudulently billed to the Federal Medicaid program. What I want to know is WHY has there been no effort to prosecute obvious criminal activity, or better yet, STOP unethical pseudo-medical, i.e. fraudulent, standard practices? Psychiatrists adopting the bio-medical model by a political process have effectively functioned as social architects who willingly partnered with pharma and sold out their patients for financial and academic reward. Don't fool yourselves, psychiatrists are acting as eugenicists; psychiatrists have abused medical privilege, forgot ethical medical principles, lied about what is and is not known about psychiatric diagnoses---it is not the first time psychiatrists have done this. Psychiatrists have blatantly lied about the efficacy and the safety of prescribed drugs and their direct teratogenic mechanisms of action...Apparently lacking insight into the horrific human toll of their professional conduct, blinded to the iatrogenic harm inflicted on their patients, seemingly, absent any ability to truly empathize with or understand the meaning and the nature of their own tortured patients; psychiatrists determined by consensus that what they BELIEVE to be true about their patient is a fact, regardless of what their patient states. No need to ask the patient if they feel "effectively treated;" unless of course the patient is treatment compliant, i.e. successfully treated...

Somehow shared opinion is magically transformed it into scientific evidence by psychiatry. This 'evidence' is used by psychiatrists to 'practice medicine,' abusing their medical privilege to have noncompliant patients adjudicated as mentally ill in Courts of Law; while using subterfuge and coercion as 'medical instruments.' Psychiatrists are doctors treating 'brain diseases' but are not honest with their patients or the general public. Psychiatrists do not conform to ethical medical standards and violate the Human Rights of their patients as a matter of course. As a result, Human Experimentation has become the Gold Standard in clinical psychiatric care standards. The vast majority of psychiatric drugs are prescribed to people on Medicaid. When prescriptions are not FDA-approved, they are "off-label prescriptions;" e.g. prescribed experimentally. If the prescription is not supported by DRUGDEX, or another compendium of approved drugs recognized by Medicaid, both the prescriber and the pharmacist who cause a claim to be submitted for payment to Medicaid, are filing a fraudulent claim, it's a crime. This criminal activity continues unabated, and continues to cost billions; the human toll is inestimable.

The APA and AACAP professional associations are not regulatory bodies, both appear to be unable to accurately assess any ethical deficits in the "science" or the "medical practice" of psychiatry.  Albert Einstein said, “You cannot solve a problem from the same consciousness that created it. You must learn to see the world anew.” Psychiatry's ethical failure is the antithesis to medicine in the Hippocratic tradition, made more pronounced by it's consistent failure to recognize or respect the human rights of psychiatric patients. It is indeed criminal medical negligence for an individual, let alone almost an entire profession to abdicate any and all responsibility for the iatrogenic harm done to psychiatric patients; patients who are disabled and killed, without regard for the fact disability and death are consistent, if not desired outcomes. Willful blindness to obvious iatrogenic harm done by psychiatric drugs, including homicide is evidence of psychiatry's non-medical nature. Thomas Insel crowing about the need for using psychiatry's "evidence base" and recommending psychiatry implement even more reckless prescribing "standards" through "Translational Science;" is indicitive that Insel doesn't seem to realize there has to be actual 'ethical, medical science' to translate.

In reality, any actual medical science is too often obscured with the APA's pseudo-democratic manner of gathering "evidence" to validate the APA consensus driven diagnostic and treatment standards. Consensus is no substitute for ethical medical research. The willful blindness to a wide variety of cognitive, neurological, and metabolic iatrogenic damage inflicted on psychiatric patients is compounded by the medical neglect of psychiatric patient's iatrogenic injuries. Society is paying for the mentally ill to be legally compelled to be "medically treated" with neuroleptic and other psychoactive drugs; sometimes in combinations known to be fatal. Psychiatrists recklessly abuse prescription privileges off label prescribing is NOT license to prescribe for no good reason, without any evidence.... Psychiatry's psychopharmacological pseudo-medical treatments with or without electro-shock are potentially fatal. The fact some people subjected to psychiatric treatment describe it as torture, should not be ignored. Far too many people "medically treated" in reality, have been tortured. One never hears of the APA or the AACAP validating survivors and victims of iatrogenic drug induced disabilities much less honoring the memory of victims of iatrogenic fatality.
 
Psychiatrists who willingly participated in research that effectively served as a marketing tool for pharma and published 'peer-reviewed' articles in support of marketing agendas are considered 'KOLs;' BMOC basically. The APA and the ACAAP membership fail to value ethical medical standards. As a whole, the profession has functioned without ethical integrity. Lead researchers have actively and passively participated in an ongoing criminal enterprise that is subverting science and defrauding the American people while using medical fraud as a standard clinical practice. It is little surprise that these geniuses who are so called KOLs are recommending that nothing in the practice of psychiatry change.

via AACAP The Academy of Child and Adolescent Psychiatry

FAQs on Child and Adolescent Depression

"What causes depression in children?

"Depression has no single cause. Both genetics and the environment play a role, and some children may be more likely to become depressed. Depression in children can be triggered by a medical illness, a stressful situation, or the loss of an important person. Children with behavior problems or anxiety also are more likely to get depressed. Sometimes, it can be hard to identify any triggering event."

The claim that depression is caused by a 'chemical imbalance' is no longer being made; paltry evidence of what should be a concerted effort to start providing factual information to the public. It is apparent to me that these professionals do not appear to concerned about regaining the public trust that has steadily eroded due to a serious lack of integrity in academic research, fraudulent marketing and abdication of ethical duty to patients. and . However, after reading this: "Are medications safe? Do they increase risk of suicide? When prescribed and monitored carefully, medications are both safe and effective ways to treat of depressed youth. Fluoxetine or Prozac, a selective serotonin reuptake inhibitor, is the medicine that so far has proved most safe and effective. There are times, however, when other medications can and should be used. While medications have been associated with a small increase in thoughts of suicide, there is no evidence that antidepressants actually increase the risk of suicide. For moderate to severe depression, the potential benefits from medication treatment seem to outweigh the potential risks. Click here for a complete discussion of the use of medication in childhood depression." I realized that no real changes are planned (to actually become ethical or evidenced-based medicine) Psychiatric drugs will continue to be recommended as a "First-Line" treatment for depression; and apparently, other drugs as well. I also realized (once again) that psychiatrists in positions of leadership at the ACAAP, seem to have no problem at all flat out lying about the drugs they are using.

The use of SSRI antidepressants on children and adolescents is based on the TADS Drug Trial. In the trial there were a total of 18 suicide attempts all but one was a kid who was on Fluoxetine, or Prozac, and there was an obvious attempt made by the researchers to present the data in a way that would misrepresent the suicide data in journal articles. Robert Whitaker reported, "The TADS study has been used to justify the prescribing of Prozac—and really, by extension—other SSRIs to children and adolescents. The TADS researchers reported that the drug treatment was effective and didn’t increase the risk for suicidal events, as compared to placebo. Adding CBT to medication “enhances the safety of medication,” the TADS researchers wrote.

"All the while, the real suicide data was being hidden. The TADS investigators weren’t disclosing the number of suicide attempts, and they weren’t reporting that all but one of the suicide attempts were in fluoxetine-treated youth. Instead, they made it appear that a similar number of suicidal events had been seen in the placebo group, and, at one point, even wrote that 15 in this group had attempted suicide." read here

Dr. David Healy reports, "The FDA became party to a myth that somehow Prozac was ok where other antidepressants given to children weren’t.

"Because FDA had licensed Prozac for depression before the 2004 suicide controversy blew up, they became party to a myth that somehow Prozac was ok where other antidepressants given to children weren’t. Prozac in fact shows no more efficacy than other antidepressants for children and has just as bad a suicidality profile, along with a range of other harms such as sexual dysfunction, inhibited growth, and other problems, as other antidepressants. emphasis mine

"This is not an argument against Prozac. Suicidality can be anticipated and forestalled by warning patients. I once thought that an appeal to patient safety would get doctors on board." here

In a large NIMH trial of 4,041 “real-world” outpatients, only 108 patients remitted and stayed well and in the trial during the one-year followup. Efficacy and Effectiveness of Antidepressants. Pigott, H. Psychotherapy and Psychosomatics, 79 (2010), 267-279.

Retract Study 329 from 1Boring Old Man

photo credit sciencephoto.com

Does the AACAP have an ethical, medical rationale for prescribing neuroleptics to kids? No, it does not.

It appears that prescribing neuroleptic drugs for children and youth with emotional and behavioral issues has proceeded without evidence the drugs even treat emotional and behavioral problems in the pediatric population. Worse than this, prescribing psychoactive drugs off label has become a "standard clinical practice" without any evidence the drugs are safe or effective for children and teen-agers. What is truly frightening: the wider medical community use these wholly unethical standards of "care." While off label prescriptions are not unusual in medicine, off label use of drugs requires sufficient evidence of safety and effectiveness to be considered an ethical standard of medical care! It is apparent that prescribing children and teen-aged youth neuroleptics and other psychotropic drugs has proceeded without even minimal evidence, forget definitive evidence, to support or validate the practice. Why are we using what are dangerous, teratogenic drugs to treat kids' emotional and behavioral symptoms?

Medical treatment in which drugs are used in ways that are not FDA approved, and not supported with definitive evidence of the drugs' effectiveness or safety is accurately described as "experimental use" of the drugs; not something that should be considered a "standard clinical practice!" Atypical antipsychotics or "Second Generation Antipsychotics," are neuroleptic drugs which alter many physiological processes. Although some of this class of psychotropic drugs have been FDA approved for pediatric use, for specific psychiatric diagnoses and/or behavioral symptoms, the approval was not based on what a reasonable person would consider to be robust data of safety or efficacy, much less effectiveness. The fact is, in real world practice, neuroleptics are prescribed to kids much more off label than they are prescribed for FDA approved conditions or symptoms. In effect, experimental use of teratogenic drugs on children and youth, i.e. human experimentation, is now a "standard practice" in psychiatry.

When children and youth are prescribed psychotropic drugs off label, particularly neuroleptics, what protection do they have from harm? In effect, they have little to none; using a "standard of care" is an affirmative defense against a malpractice claim for damages, whether it is an ethical standard or not...It is unconscionable that most of the prescriptions for neuroleptic drugs are for off label use; why is this ethically questionable standard of care casually accepted by the wider medical community? Drugs that have not been tested and clinically demonstrated to be safe and effective for children and youth, should not be widely prescribed in standard practice! Nonetheless, off label prescriptions for neuroleptic drugs continue to account for the largest percentage of prescriptions for neuroleptics in the pediatric population. Neuroleptic drugs cause a wide variety of adverse cognitive effects, i.e. brain damage, neurological impairments and metabolic dysfunction; they cause diseases---these are direct, adverse effects of neuroleptic drugs, it is how they "work." This "standard practice" has been investigated by the U.S. Senate at least three times in my memory, each investigation has quantified an increase in the numbers of children being prescribed teratogenic drugs and fraudulent Medicaid claims being paid. What is not quantified is the number of children who are disabled and killed. Using poor children on Medicaid who have behavioral and emotional problems as unwitting guinea pigs is now considered an ethical standard of care...

The standards of care, treatment algorithms, and practice parameters were developed by consensus, a quasi-democratic political process, not derived from clinical research data.  Psychiatric professionals who are members of the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association, then disseminated these unethical standards in their professional literature, in symposiums and continuing medical education programs.  Psychiatrists in the AACAP really would like the NIMH to fund research to hopefully gather the supporting evidence that will validate the standards of care in widespread use (thanks to the AACAP).  These are the standards of care that the AACAP is simultaneously vehemently defending as "necessary medical treatment;" implying it is ethical evidence-based treatment...

The AACAP is acknowledging that the evidence for the ethical medical prescription of teratogenic drugs off label to children and youth is STILL needed---decades after the AACAP started using neuroleptic and other psychotropic drugs off label to "treat" the emotional and behavioral problems children have---decades after it became a "standard prectice." The AACAP implemented a standard of care absent the evidence required to validate it as a standard. It is not ethically possible to implement the use of psychiatric drugs "off label," i.e. experimentally, as a standard treatment without definitive evidence of safety and effectiveness. Obviously, this standard was implemented  precipitously; without regard for patient safety. It is a standard of care that is not based on sound scientific principles, or actual evidence; it is absent the use of ethical medical judgement altogether...

Off label prescription drugs that are unsupported by evidence that the treatment is safe and effective, is experimental by definition. Medicaid, in theory, functions like insurance for the poor.  Why are fraudulent claims for non-covered, non-approved off label prescriptions drug costs paid? It is only psychiatric drugs that are ALWAYS paid for without question, by the Medicaid program.

Billions of taxpayer dollars have been defrauded from the American people since the vast majority of off label psychotropic drugs prescribed are written for poor children on Medicaid. We pay for it even though it is not ethical, even though it is fraudulent, even though it disables and kills children.

A few months ago, the AACAP applauded the AMA for seeking guidance from the NIMH about the off label use of neuroleptics for children and youth with emotional and behavioral problems.

via the AACAP:
The American Academy of Child and Adolescent Psychiatry (AACAP) applauds the American Medical Association (AMA) for adopting a report recommending the National Institute of Mental Health (NIMH) assist in developing guidance for physicians on the use of atypical antipsychotic medications in pediatric patients, and encouraging ongoing federally funded studies on long-term efficacy and safety.

AACAP delegate to the AMA and member of the AMA Council on Science and Public Health, Louis Kraus, M.D., testified that the report discusses the complex issues surrounding the clinical use of these drugs and evaluates the data currently available.

There has been an increased use in atypical antipsychotic medications which when used appropriately can be an effective part of a comprehensive treatment plan for children with schizophrenia and bipolar disorder. However, these medications are increasingly being used "off label" when treating children and adolescents with other psychiatric disorders.

"Physicians and parents need more information about both the safety and efficacy of these medications, especially when they are used over an extended period of time," testified David Fassler, M.D., AACAP alternate delegate to the AMA.

Most research on the use of atypical antipsychotic medications on the pediatric population focuses on short term use, yet in clinical practice an increasing number of pediatric patients take these medications for many months or years.

"AACAP is pleased that the AMA is encouraging NIMH to conduct additional studies on these medications. We need to better understand both the short term and long term effects on our patients," said AACAP President, Martin J. Drell, M.D.

The AMA report is supported by the American Psychiatric Association, American Academy of Psychiatry and the Law and the American Pediatric Association. here

Does the AACAP have an ethical, medical rationale 

for prescribing neuroleptics to kids off label?
No, it does not.  

via REPORT OF THE COUNCIL ON SCIENCE AND PUBLIC HEALTH CSAPH Report 1-I-12:
 a couple excerpts:

"The proportional use of atypical antipsychotics was 16% of treatment visits in 1995, but such use had surged to 93% of treatment visits by 2008. In two-thirds of these visits, the prescription was for an off-label use.5

"Antipsychotic treatment rates among privately insured youth ages 6 to 17 increased steadily from 1996 (0.21%) to 2006 (0.90%) with higher rates among those ages 13 to 17.7 The annualized rate of use in such patients ages 2 to 5 more than doubled between 1999 and 2007 to 0.16%, most commonly to help manage pervasive developmental disorder or mental retardation.8

"More than 4% of Medicaid youth ages 6 to 17 filled at least one prescription for an antipsychotic in 2004, with 75% of these being for off-label uses.7 A number of children under 6 years of age enrolled in Medicaid programs receive ongoing treatment with antipsychotic medications.9,10" (page 3)

Discussion
Although certain atypical antipsychotic drugs are FDA-approved for specific uses in pediatric patients, the majority of prescribing (70 to 75%) is off-label for these drugs. Head-to-head comparisons of atypical antipsychotic drugs for off-label uses are few, and evidence from placebo-controlled trials for off-label use suggests that efficacy differs between drugs. Accordingly, one cannot anticipate that a “class effect” exists for atypical antipsychotics with respect to any specific clinical use or indication.  here

from a letter from Citizens for Responsible Care & Research, Inc. to The Presidential Commission for the Study of Bioethical Issues Public Comment in Response to: Federal Register 76:41 (March 2, 2011) pp. 11482-11483:

a couple of excerpts:
"Part 1: Suggestions To Consider
As suggested in the Federal Register notice, in order assist the Commission in developing a thorough  understanding of the adequacy of current U.S. and international standards for protecting the health and well-being of human subjects in scientific studies supported by the federal government, we refer the Commission to the public comment of CIRCARE vice president Gerald Schatz, J.D., in which he describes international law, requirements of which the bioethics community is apparently oblivious. For your convenience we reproduce the relevant portion of his comment:
                “There is the International Covenant on Civil and Political Rights the United States
                ratified in 1992 and it makes informed consent an absolute requirement, no exceptions,
                not even in emergencies, subject to those normal legal fictions of consenting for the
                incapacitated patient to medical care and so forth. Additionally, the Geneva Conventions
                and Additional Protocols to the Geneva Conventions make research very, very difficult
                or prohibited altogether for those individuals who are caught up in the war and armed
                conflicts.” (2)

Over the past several years the International Compilation of Human Subjects Protections posted on the OHRP website has been significantly strengthened by additions of the International Covenant on Civil and Political Rights, the Geneva Conventions and Additional Protocols to the Geneva Conventions. (3) A persistent problem, however, has been a lack of OHRP guidance on the significance and applicability of this law. An additional difficulty seems to be that not only is there failure to acknowledge this law and its applicability inside and outside the U.S., it is almost surely the case that neither OHRP nor FDA are adequately resourced to implementation of this law.(sic) Consequently we urge the Commission to recommend information about this law be distributed to appropriate U.S. agencies, research partner governments, research institutions, commercial research sponsors, and appropriate NGOs. Links to the Michigan State University faculty response as drafted by Gerald Schatz to the 2005 OHRP request for comment on equivalent protections as described above, two legal articles, and electronic versions of the law in question are provided in the references at the end of this document. (3)"

"CIRCARE holds FDA and OHRP in high regard and commends staff for their accomplishments. Practically speaking, our post hoc system means that failures of protections occasion the bulk of regulatory oversight of institutions or individuals. The opening paragraph of a typical FDA warning letter refers to an inspection conducted many months earlier and addresses objectionable conduct in one or more clinical investigations which ended years previously. (4) The definition of the verb “to protect” is “to cover or shield from exposure, injury, damage, or destruction; (to) defend.” (5) We challenge the Commission to consider if is it reasonable to believe post hoc action provides meaningful protection of human subjects in research."

"A typical FDA warning letter offers two challenging paradoxes the Commission should to consider. Prior to 2007 boiler-plate language informed warning letter recipients that FDA inspections are conducted under a program, one aspect of which is to ensure the integrity of data submitted in drug or medical device marketing applications, the other aspect of which is to ensure that human subjects are protected from undue hazard or risk in clinical investigations. More recently this language has been revised to state that inspections are conducted pursuant to FDA’s Bioresearch Monitoring Program to evaluate the conduct, i.e. data integrity, and to ensure that the rights, safety, and welfare of human subjects have been protected. (op sit, p.1) The past tense of the copulative verb “have been” illustrates the paradox of a post hoc system in which the regulator proposes to protect the welfare of human subjects by inspection and enforcement after the fact." here

photo credit
4-16-2013

Is the primary ethical duty of a physician unknown to mainstream psychiatry?

"I am sure that we will recognize that there are some things in our society, 

some things in our world, to which we should never be adjusted." 

Martin Luther King Jr.

"I am sure that to be silent about psychiatric abuse and oppression is to be complicit."
MadMother

Although definitive evidence in support of the hypothesis that schizophrenia is a brain disease remains elusive, psychiatrists who firmly believe in the correctness of it, used their belief in this hypothetical explanation for the etiology of schizophrenia to justify the "Standard Practice" of prescribing neurotoxic teratogenic drugs as a necessary medical treatment. Calling it a "Standard Practice" is misleading; it is not an ethical medical standard, since it is a "standard" only because it was designated as such by consensus; i.e. a quasi-democratic political process, evidence only of an agreement of the meaning to be attached to behaviors. Psychiatry relies upon consensus, a quasi-democratic process in the absence of evidence gathered by using ethical scientific principles.  It is a standard that does not rely upon the use of sound ethical medical judgement; it is contradictory to the ethical standards of medical science. The standard clinical practices used by psychiatry to "medically treat" psychiatric diagnoses are validated by a political process; as a result, they are not ethical medical standards. In other medical specialties, the standards used in clinical practice are derived from and supported by the data collected in research, and includes documented "anecdotal" evidence from experienced clinicians;  i.e. the "evidence base." Theoretically, to be ethical medical care, care is offered with the primary purpose of serving the best interests of the patient; in the Hippocratic tradition to, "First, do no harm..."

In effect, the AACAP and the APA have determined by a quasi-democratic process, that psychiatric diagnoses are biological, neurodevelopmental brain diseases, or chemical imbalances that require "medical treatment." It is a determination that is not based on research, but on a political process; it is based on a vote. This is also how diagnoses and diagnostic criteria is standardized as well. So psychiatry recommends "treating" behaviors as if they are symptoms of disease; and this recommendation is not based upon the scientific method, or the ethical principles of medicine; which begs the question, why is it called, "medical treatment?"

The devotees of psychiatry's disease model have been frantically searching for proof of an elusive  hypothetical disease that causes psychiatric symptoms; and have yet to find definitive evidence despite decades of diligent searching for it. The fact that they have standards of practice that are based on the belief in an unidentified disease is despicable really, when one considers the loss of liberty, and life that has resulted from ego-maniacal hubris masquerading as "professional medical judgement." Belief in a hypothetical explanation for symptoms is not an ethical basis for any medical decision; it is a juvenile justification for bullying. Psychiatry is, in effect bullying psychiatric patients by using coercion, biased information, Police Powers, and Court Orders; none of which can ever magically transform what is being done into a valid or ethical medical treatment. Stating authoritatively, that a disease exists which requires medical treatment in order to compel or coerce "treatment compliance," is nothing but a fraud.

Do NOT misunderstand what I am saying--distress, social difficulties, emotional, behavioral and cognitive symptoms are all very real; but none have been proven to be the result of a neuro-biological disease, chemical imbalance or a genetic defect. This fact is acknowledged; by the APA, and AACAP and the NIMH. Yet all three of these entities disseminate educational materials for the general public that imply and literally state the exact opposite. At the same time, through NAMI, and other so-called patient advocacy groups, and in "peer-reviewed" professional journals the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry, disseminate information that authoritatively states, in effect, that psychiatric diagnoses are medical illnesses (like diabetes!) that can be treated "safely and effectively." The claim is more of a hopeful exaggeration; and strictly speaking, is not a truthful claim. The new psychiatry, or "psychopharmacology," purports to be "treating diseases" whose etiology and/or pathology have never been defined, validated, much less understood well enough to ethically support the claim made that their symptoms can be effectively treated.

The diagnoses in the Diagnostic and Statistical Manual are based upon the most unreliable scientific data, subjective observation/opinion. The disease hypothesis is supposedly derived from the mechanism of action of the drugs, but the disease hypothesis predates the use of drugs. In the field of medicine, a phenomenon is studied, and a hypothesis is formulated and tested. In medicine, a disease or defect is studied, defined and validated through testing of the hypothesis, once understood, somatic treatments to reverse, prevent or inhibit the progression of the disease can be developed and tested... Psychotropic drugs can cause disease in major organs and alter the function of physiological processes; in effect, the drugs cause iatrogenic illnesses and impairments; and can cause sudden death. Psychopharmacology has a devotion to the bio-disease paradigm; but it is due to a hopeful belief, an illusion, not sucessful use of the drugs. Psychiatry; i.e. psychopharmacology, does not consistently use scientific standards; and worse yet, it is not grounded in, or even seem to value, ethical medical principles.

Psychiatry does not keep track of how many actually die, develop obesity, diabetes, akathisia, tardive dyskinesia, tachycardia, or any iatrogenic illness from the drugs which will shorten their patient's lives. This is indicative of how important the collection of relevant data necessary for an accurate risk vs. benefit assessment in real world practice is to psychiatry. Why would a belief in a particular etiology for psychiatric symptoms become a justification for adopting a clinical standard of practice unsupported by evidence, or for using force to compel the treatment Under Color of Law? How can it be ethically or morally justifiable to compel treatment with significant and fatal risks by Court Order?

Sudden fatality, the development of chronic conditions that are disabling, i..e. the rate of iatrogenesis, is  needed information for a meaningful risk vs. benefit analysis in real world clinical practice; yet this information is purposely not being collected. Those who are disabled, and the fatal outcomes are considered "anecdotal evidence." Ironically, unlike  the anecdotal evidence used to recommend prescribing the drugs to a patient, this outcome data, is "anecdotal evidence" that is ignored---it is not considered relevant when making treatment decisions.  This is in no small measure why children are being drugged in the manner that they are... Rarely, are iatrogenic, drug-induced deaths, recorded in the FDA AER database, as such. Based upon my own casual observation, child fatalities are commonly reported by a parent or an attorney; not a medical professional.

The twisted logic seems to be, if psychiatric diagnoses are "diseases" and psychiatrists are "doctors" who diagnose the diseases; that what they are do is provide necessary "medical treatment."  Whether a person gives consent or not, is not important. Psychiatry does not treat individuals so much as apply a label to the individual; then implement a treatment protocol.  Since Practice Parameters are based upon consensus, outcomes or overall improvement in the patients was not ever considered important enough to be quantified in any meaningful way, nor was the data considered important enough to collect. The patients' perspective,  physical health and general well being, doesn't appear to be given thoughtful consideration. The effect of treatment on the patient is certainly never as important as the patient never questioning the bio-disease model. A patient must always remain treatment compliant regardless of the actual effects of psychiatric treatment.

Without insisting on the absolute utility of the "treatments" of psychotropic drugs, how would psychiatry "practice medicine?" It would have to return to the "treatment" used prior to the drugs: lobotomy and insulin shock. Choosing to stop the using coercion to control, having respect and showing compassion for patients, considering patients to be worthy of kindness, and treating patients as equals would be an indication that the psychiatric profession may be worthy of trust. Choosing to use methods of control to main authority while continuing to deny the the plight of patients who are harmed, is evidence that psychiatry is not a profession that can be  trusted.

Psychiatry continues to defend the use of coercion, while wielding Police Powers; continues to mislead and lie to patients and the general public, continues to lie about patients and lie about the nature of the diagnoses that are applied to people in distress, with impunity. All of psychiatry's standard practices are anathema to ethical medical principles and the scientific understanding of disease. The manner in which psychiatry is practiced makes it impossible to earn the trust and respect of patients who have critical thinking skills; without mutual respect it is impossible to develop a therapeutic relationship.

It becomes obvious why Informed Consent is not really an important part of psychiatry's "standard clinical practices;" whether it is accidental oversight, careless disregard, or lack of appropriate training, doesn't really matter.  In the end, it is the real world outcomes of the patients themselves that matter; doing what is in a patient's best interest is supposed to be the primary focus in providing medical care.

The refusal to collect accurate data and to base treatment decisions upon ethical scientific methods and sound ethical medical principles, in effect, encourages psychiatrists to be wilfully blind to the countless, uncounted and discounted psychiatric patients they treat who are not "effectively treated;" but are instead grievously harmed. Psychiatry is blind to the plight of patients who are experiencing profound iatrogenic impairments and effectively dismisses the patients, and doesn't collect the data quantifying the harm done to them.

Psychiatric survivors are denigrated by mainstream advocates 'for the mentally ill' and by psychiatrists in "professional" journals. Patients who are liberated from psychiatric incarceration who have reclaimed their voices; refuse to be silent. Psychiatric survivors are the ONLY advocates who speak of and remember the lives that are lost forever. The psychiatric patients who are (de)voiced, who can no longer speak about what happened to them, whether they are alive or dead, are people worthy of respect. They are people who matter, and their real world outcomes are not "anecdotal evidence."

It is a choice to abdicate the primary ethical duty of a physician to, "First, do no harm..."

photo credit bipolarbears11 photobucket

AACAP Policy the irony of the pot calling the kettle black

“ . . . No one is really paying attention to what’s going on. . . The issue is how many Medicaid kids are being drugged to death, not how many kids in fostercare are being over medicated." 

Grace E. Jackson, M.D., Author: Rethinking Psychiatric Drugs: A Guide for Informed Consent 

and Drug-Induced Dementia: A Perfect Crime

A Bill of Rights 

For Children with Mental Health Disorders and their Families 

These basic rights should be afforded all children with mental disorders and their families, regardless of socioeconomic, gender, cultural, or racial status.  These rights apply to families and children with neurodevelopmental, neuropsychiatric, and psychological disorders.

1. Treatment must be family driven and child focused.  Families and youth, (when appropriate), must    have a primary decision making role in their treatment. 

2.  Children should receive care in home and community based settings as close to home as possible. 

3.  Mental health services are an integral part of a child’s overall health care.  Insurance companies 

must not discriminate against children with mental illnesses by imposing financial burdens and barriers to treatment, such as differential deductibles, co-pays, annual or lifetime caps, or arbitrary limits on access to medically necessary inpatient and/or outpatient services. 

4. Children should receive care from highly qualified professionals who are acting in the best interest of the child and family, with appropriate informed consent. 

5.  Parents and children are entitled to as much information as possible about the risks and benefits of all treatment options, including anticipated outcomes. 

6.  Children receiving medications for mental disorders should be monitored appropriately to optimize the benefit and reduce any risks or potential side effects which may be associated with such treatments. 

7.  Children and their families should have access to a comprehensive continuum of care, based on 

their needs, including a full range of psychosocial, behavioral, pharmacological, and educational services, regardless of the cost. 

8.  Children should receive treatment within a coordinated system of care where all agencies (e.g., health, mental health, child welfare, juvenile justice, and schools, etc.) delivering services work 

together to support recovery and optimize treatment outcome. 

9.  Children and families are entitled to an increased investment in high quality research on the origin, diagnosis, and treatment of childhood disorders. 

10.  Children and families need and deserve access to mental health professionals with appropriate 

training and experience.  Primary care professionals providing mental health services must have 

access to consultation and referral resources from qualified mental health professionals. 

March 12, 2008 

The final paragraph of the American Academy of Child and Adolescent Psychiatry's 

Code of Ethics:

Principle X Legal Considerations

"In order to practice medicine in optimal fashion, the child and adolescent psychiatrist must have awareness of the laws governing medical practice of those states in which the physician performs professional work, as well as local and federal laws that may apply. While bearing in mind that laws may vary subtly or substan- tively between states, the child and adolescent psychiatrist must consider, in particular, those laws concerning reports of child abuse and/or neglect, custodial arrangements and guardian responsibilities, warnings to others concerning patients’ potential self- or other-directed threatening behaviors, assent and consent, release of information, documentation of care, and medical responsibilities and negligence.  These legal considerations cannot minimize or supercede the ethical principles of this code.   Rather, knowledge and
consideration of pertinent laws is an important component of ethically responsible practice."

via the American Academy of Child and Adolescent Psychiatry:

Enhancing Transparency in Research

Statement from Thomas F. Anders, M.D., President of the American Academy of Child and Adolescent Psychiatry

"Washington, D.C., February 6, 2007 – The American Academy of Child and Adolescent Psychiatry (AACAP), along with other professional organizations, academic institutions, professional journals and the pharmaceutical industry, all are working toward protecting the integrity of clinical research and ensuring that accurate and complete data are disseminated following each clinical study. The commitment made by the pharmaceutical industry to register all clinical trials in public databases, like ClinicalTrials.gov, and to publish accurate results of these trials is necessary.

"The commitment to registration is critical to protecting the child and adolescent subjects in these trials, as well as all children who are treated subsequent to the trials. Child and adolescent psychiatrists, like all physicians, need access to all relevant data in order to make optimal treatment decisions for their patients.

"The AACAP supports these and other actions designed to enhance the transparency of clinical research.

"The American Academy of Child and Adolescent Psychiatry's (AACAP) mission is to actively promote mentally healthy children, adolescents and families through research, training, advocacy, prevention, comprehensive diagnosis and treatment, peer support, and collaboration. Representing over 7,500 child and adolescent psychiatrists, the American Academy of Child and Adolescent Psychiatry is the leading authority on children’s mental health. To learn more about the AACAP, please visit www.aacap.org."

Some Questions that need answers:

What evidence supports the AACAP's continued defense of using SSRIs for children and youth when it is well established that the FDA approval for the these drugs for use in children and adolescents was based on data that was incomplete, biased or altered; i.e. fraudulent?

On what basis does the Academy continue to defend the off label use of neuroleptic drugs? Here again, the FDA approval for the drugs was based on scant evidence of efficacy or effectiveness. The drugs are teratogenic so they cannot be called 'safe.' The FDA approval for neuroleptic drugs in children appears to have been driven by the pharmaceutical industry's marketing expansion agenda; and psychiatry's interest in legitimizing at least some of the widespread indiscriminate use of the drugs on children.

The drugs are, for the most part, being prescribed to poor children who are on Medicaid which means the cost for the off label drugs is billed to the Federal Medicaid program fraudulently.  In effect, and in fact, this makes the Academy itself willing accomplices participating in an ongoing criminal enterprise.  The American people are being defrauded to pay for the drugs children are being given, often to their detriment.  Neuroleptics cause a wide variety of iatrogenic diseases and neurological impairments because the drugs alter the function of the entire parasympathetic nervous system.  The fact that the the drugs cause impairments, means they drive up the costs of medical care for children on Medicaid due to the iatrogenic, or physician caused, diseases and impairments.  The impairments can be disabling and this causes many of them to need federal disability programs increasing the cost of those programs.

The AACAP uses consensus based practice parameters, and treatment guidelines. Study 329 has not been retracted from the Journal of the Academy of Child and Adolescent Psychiatry, which is the #1 "professional" journal in the world, according to it's editor.  The same editor that continues to deny requests from around the world for Study 329 be retracted.

The final report and the raw data from the TEOSS drug trials is still not available and it's been five years since the study was concluded. That this is important I've no doubt. There has been a total of three Senate investigations into the off label drugging of foster children each one has painted a grimmer picture and quantified and increasing number of children and adolescents are being given neuroleptic drugs, when are the America people going to wake up to the fact WE ALL have a responsibility to the children in foster care. We are paying for them to be harmed.  It is a situation that demands action on the behalf of foster children, and remaining silent is to be passively complicit.

All of these facts belie the above statement made by Thomas F. Anders, M.D, that the AACAP, in collaboration with other stakeholders is, "ensuring that accurate and complete data are disseminated following each clinical study." 

the irony of the pot calling the kettle black

Leading Psychiatric Medical Associations Speak Out On 

New Antidepressant Clinical Trials Study

"Leading Psychiatric Medical Associations Speak Out On New Antidepressant Clinical Trials Study Arlington, Va., January 16, 2008 -- The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) today renewed their call for a mandatory public registry for clinical trials in light of a study that shows medical research is published selectively, effectively suppressing and misrepresenting studies deemed negative." here

Both the APA and the AACAP require members to practice in compliance with the principles contained in their Code of Ethics.  Both the APA and the AACAP fail to hold their members accountable for ethical failures. Analogous to a chain only being as strong as it's weakest link, a profession is perceived to have the ethical integrity of it's most unethical members. In psychiatry unethical professionals become Key Opinion Leaders, are elected President of their organization, and advisers to patient advocacy groups, the ones funded by pharmaceutical companies---such as the groups featured on the Bill of Rights above.

Excerpts from the Excerpts the AACAP Code of Ethics Related to Transparency 

(These values were not evident to me at Child Study and Treatment Center) 

• Child and adolescent psychiatrists’ primary concern is the welfare, functioning, and optimum development of children and adolescents. 

• The child and adolescent psychiatrist’s primary responsibility is to act on behalf of children, adolescents, and their families. 

• Child and adolescent psychiatrists put the health and welfare of children above any other competing interest.  

• As third parties raise possibilities of conflicts of interest, child and adolescent psychiatrists must keep the interests of children and adolescents paramount. 

• Examples of third party influence could include gifts, dinners, educational opportunities, recreational outings, medication samples, financial support, or investments. 

• The first priority of researchers is the welfare of research participants and their families. 

• All aspects of a research study must defer to the safety and well-being of the participant.  

• Child and adolescent psychiatrists who conduct research must ensure that their investigative processes are conducted ethically and are compliant with all federal, state, local, and institutional regulations.  Institutional Review Boards must approve all research protocols before research 

studies are implemented. 

• Child and adolescent psychiatrists conducting research must report all potential conflicts of interest with the research study participants before the research begins. 

• All potential risks and benefits of the research should be clearly described to the study’s participants and their guardians. 

• Study results must be made public in a timely manner after a research project is completed, regardless its findings. 

link to the Code of Ethics link the the Excerpts related to transparency in research

This is one of the efforts that resulted from the latest investigation into the off label drugging of foster children. For an example of how the AACAP plans on "educating" professionals who work at child serving agencies about psychiatric drugs (unethical) read:    

When anecdotal evidence is sufficient adverse events are merely anecdotal at my other blog, Systems of Care Yakima

Psychiatry: focused on defending unethical research and clinical care standards instead of real world outcomes

"Currently, there are no pharmacological or psychosocial therapies with enough evidence in youth samples to meet the standards for empirically-supported treatments as defined by Chambless & Hollon (1998; Brown et al., 2008; McClellan & Werry, 2001)." here

via NYTimes:
Use of Antipsychotics in Children Is Criticized
By GARDINER HARRIS

Published: November 18, 2008

a few excerpts:

"From 1993 through the first three months of 2008, 1,207 children given Risperdal suffered serious problems, including 31 who died. Among the deaths was a 9-year-old with attention deficit problems who suffered a fatal stroke 12 days after starting therapy with Risperdal."

"At least 11 of the deaths were children whose treatment with Risperdal was unapproved by the F.D.A. Once the agency approves a medicine for a particular condition, doctors are free to prescribe it for other problems."

"Panel members said they had for years been concerned about the effects of Risperdal and similar medicines, but F.D.A. officials said no studies had been done to test the drugs’ long-term safety."

"Dr. Dure said he was concerned that doctors often failed to recognize the movement disorders, including tardive dyskinesia and dystonia, that can result from using these medicines."

“I have a bias that extra-pyramidal side effects are being under-recognized with these agents,” Dr. Dure said.

"Dr. Laughren of the F.D.A. said the agency could do little to fix the problem. Instead, he said, medical specialty societies must do a better job educating doctors about the drugs’ side effects." here

via Archives of General Psychiatry:

Original Article | June 2006

National Trends in the Outpatient Treatment of Children and Adolescents With Antipsychotic Drugs

Mark Olfson, MD, MPH; Carlos Blanco, MD, PhD; Linxu Liu, PhD; Carmen Moreno, MD; Gonzalo Laje, MD

an excerpt:

Child and adolescent mental health visits that include antipsychotic treatment occur disproportionately among publicly rather than privately insured patients. After adjusting for patient diagnosis and other background characteristics, mental health visits by publicly insured children and adolescents were significantly more likely to include prescription of an antipsychotic medication. This finding is in line with higher youth antipsychotic prescription utilization among populations covered by Medicaid^2 - 3 compared with commercially insured populations.⁴ The basis of this is unknown but may relate to differences in public and private payer reimbursement schedules for pharmacologic or psychological interventions, insurance-related variations in parent or child acceptance of antipsychotic treatment, or selection of patients in different insurance plans by physicians for treatment. Because Medicaid covers children and adolescents with Social Security Income and young people who are medically needy or in foster care, illness severity may account for differences in antipsychotic medication use across insurance groups.²⁹ Additional study is needed to understand the factors that contribute to insurance-related differences in child and adolescent antipsychotic treatment.

Approximately one third of the child and adolescent visits with prescription of antipsychotic medications were by young people with mood disorders. In addition, approximately one third of antipsychotic visits included coprescription of an antidepressant medication and one third included coprescription of a mood stabilizer. At present, there is a dearth of empirical evidence to support these prescribing patterns. 

In office-based practice, almost all of the antipsychotic treatment among children and adolescents is provided by psychiatrists. Although the NAMCS data suggest that primary care physicians and other nonpsychiatrist physicians provide care in approximately half of the youth mental health visits, they seldom prescribe antipsychotic medications. (emphasis mine) here

via American Journal of Psychiatry:

November 01, 2008 

Double-Blind Comparison of First- and Second-Generation Antipsychotics in Early-Onset Schizophrenia and Schizo-affective Disorder: Findings From the Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) Study

Linmarie Sikich; Jean A. Frazier; Jon McClellan; Robert L. Findling; Benedetto Vitiello; Louise Ritz; Denisse Ambler; Madeline Puglia; Ann E. Maloney; Emily Michael; Sandra De Jong; Karen Slifka; Nancy Noyes; Stefanie Hlastala; Leslie Pierson; Nora K. McNamara; Denise Delporto-Bedoya; Robert Anderson; Robert M. Hamer; Jeffrey A. Lieberman

Am J Psychiatry 2008;165:1420-1431. doi: 10.1176/appi.ajp.2008.08050756

a couple of excerpts:
Finally, different choices could have been made with regard to the specific medications studied. At the time the trial was initiated, olanzapine was widely used in the pediatric population, whereas quetiapine had a small market share. Ziprasidone and aripiprazole, both of which may have fewer metabolic side effects, were introduced subsequent to the initiation of the study. Efforts to introduce them partway through the study were not supported by the FDA or NIMH. We also considered utilizing a placebo for comparison, as opposed to a first-generation antipsychotic. We expected that this would increase the demonstrated efficacy of the second-generation antipsychotics, but it would not address the fundamental comparative questions. Distributing the sample among four treatment conditions rather than three would also have reduced statistical power. We also considered requiring a drug-free baseline to minimize the likelihood of finding no apparent benefit of substituting one partially effective treatment for another. However, concerns about the long-term consequences of delaying effective treatment and associated recruitment difficulties argued against including a placebo treatment group or a drug-free baseline. At the time the study was initiated, there were significant ethical concerns about utilizing any first-generation antipsychotic in comparison with second-generation antipsychotics, because second-generation antipsychotic treatment was the standard of care for early-onset schizophrenia and schizoaffective disorder. We felt any traditional medication selected as a comparator would have to provide a strong potential advantage to maintain therapeutic equipoise. Molindone was chosen as the best option among first-generation antipsychotics based on its low propensity for both weight gain and extrapyramidal side effects. Despite this advantage, molindone is not commonly used in clinical practice. A more frequently used medication, such as perphenazine or haloperidol, might have facilitated comparison with adult studies and acceptance in the community. Failure to require a drug-free baseline may have reduced response rates and led to earlier treatment discontinuation.

Another potential limitation of the study is the 8-week duration of treatment. Different patterns of response or risk of side effects might have emerged over a longer trial. Some young people may require more extended therapy to adequately respond, and it is likely that some aspects of the illness, such as negative symptoms, neurocognitive function, and associated anxiety, may require longer periods to recover (44, 45). However, published standards of care for early-onset schizophrenia and schizoaffective disorder recommend the use of 6- to 8-week trials (1). A longer acute phase trial would have increased the risk of exposing subjects to prolonged ineffective treatment. Furthermore, antipsychotic medication trials in adults with schizophrenia suggest that nonresponse as early as 2–4 weeks after initiating treatment predicts nonresponse up to 12 weeks later (46–49).

The results question the nearly exclusive use of second-generation antipsychotics to treat early-onset schizophrenia and schizoaffective disorder. The safety findings related to weight gain and metabolic problems raise important public health concerns, given the widespread use of second-generation antipsychotics in youth for nonpsychotic disorders. here

Let's be real, using neuroleptic drugs for any psychiatric diagnosis is not supported by any definitive evidence; calling the drugs "effective treatment" is more than stretching the truth---Indeed, the evidence clearly demonstrates neuroleptic drugs are minimally effective for a small minority of children and adults experiencing symptoms of psychosis; and have significant disabling and fatal risks particularly for  children and the elderly.  The standards used in clinical practice are not supported by or derived from empirical data from clinical trials, or data collected from the decades long use of neuroleptic drugs off label in clinical practice---begging the question, how did prescribing these drugs to children "off label" become a "standard practice?"  This experimental use is a standard of care only because it was discussed, and adopted as a "standard" by psychiatrists. It is not because the prescription of neuroleptics is supported by, or derived from any empirical data of the safety or efficacy for the symtoms the drugs are being prescribed to children and youth to treat. In psychiatry, there are standards of care that are without support from any ethical scientific psychiatric research.  Since they are not derived from or supported by the evidence base, these so-called "standard practices" are not ethical medical standards. The drugs are used off label as a "standard" treatment due to the hubris of psychiatric professionals who have determined that consensus will suffice in place of the objective evidence that theoretically is required for a particular practice to become a clinical care "standard." 

I have been reading 'peer-reviewed' psychiatric journal articles for over ten years and I am still amazed at the lack of critical thinking exhibited by the psychiatrists who do the research and write the articles.  The utter lack of of ethical integrity of "RESEARCH PSYCHIATRISTS" is truly stunning.  The commonality is that all of them continue to repetitively state more evidence is needed to support psychiatric standards of care that are the standards psychiatrists disseminate to other professionals for clinical use; and teach to students and other medical professionals! When reporting trial results that don't support the standards used, which are the recommended 'first line treatments' that comprise the Standard of Care---does it not occur to any of these geniuses that the standards are not ethical medical standards!?  Apparently, psychiatric research and clinical practice requires no critical thought...

For example, in the TEOSS drug trials, 12% of patients enrolled were "effectively treated."  97 out of the either 116 or 119 enrolled experienced a serious adverse event; the Olanzapine arm was stopped due to the number of adverse events---At the time, Olanzpine was the most widely prescribed neuroleptic drug in the pediatrics population!  BUT there were no warnings for professionals to stop prescribing the drug to children...Exactly how many more children need to be subjected to what are harmful teratogenic neurotoxic drugs which may in fact disable and kill them, before "external forces" put a stop to these dorktors conducting research in their attempt to validate unethical standards of care? 

As a society we need to recognize that Human Experimentation on people given a psychiatric diagnosis is not an ethical standard of care; nor is it a benificent act. 

The BEST INTERESTS of the patient must come first---even if the patient is unpleasant, and even if we have been taught that the some psychiatric diagnoses mean that a patient's Human Rights can be ignored or revoked--in the interests of society... It is immoral, and it is unconstitutional.  It is also the same ignorant reasoning used to implement Eugenics laws in this country that brutalized tens of thousands, and unlike the Germans in WWII, we didn't keep track of those we killed.  America's program wasn't as 'successful' as Germany's, but it has left a stain.  Worse than that, the fundamental social control strategies and bigotry that propelled eugenics as public policy remain embedded in our publicly funded social service and mental health programs.  Sadly, the lessons learned have not remained in the general public's collective conscience...  

I believe the fact that medical care is supposed to be in the best interests of the patient, has been lost in the debate about how to help 'the seriously mentally ill' altogether.  Patients are being used as research fodder and Human Experimentation is standard psychiatric clinical practice.  In Medicine, a "standard practice" is theoretically supposed be derived from and well-supported by empirical evidence that is ethically gathered and reported in an unbiased manner.  In psychiatry, standards are discussed in committees and "validated" by a vote; these are not scientific methods, so the "standards" are unethical.  Without empirical evidence to support a particular "standard practice" or treatment protocol it is not a "standard of care," it is nothing more than an affirmative defense for psychiatric fraud and medical malpractice.  

The academic elite, Key Opinion Leaders who are members of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry are unethical psychiatrists who are desperately defending what are obviously gross departures from ethical scientific methods and ethical medical practice, inexcusable errors in judgement, and blatant abuse of power and authority.  Ironically, these medical professionals are doing this while claiming it is not their ethical medical duty to treat the iatrogenic neurological impairments brain damage and physical diseases psychiatrists inflict upon their patients.  It is medical neglect; it is criminal.  Psychiatrists are doctors, doctors should treat the illnesses they cause instead of spending so much time defending their so-called "professional integrity."  Perhaps treating the iatrogenic illnesses and injuries they are causing will remove the scales of prejudice from their eyes...

It is certain that continuing to deny the iatrogenic harm psychiatrists are causing patients while simultaneously medically neglecting the victims and frantically tryiing to validate unethical clinical care standards with federally funded seeding trials, are desperate, dishonest acts that serve only to further undermine the integrity of psychiatry as a profession.  It's sheer hubris to vehemently defend unethical "standards of care" and "professional integrity," (which is sorely lacking) while maligning psychiatric survivors; adding insult to iatrogenic injury.  It's not possible to regain trust  with the same dishonest, unethical behavior that destroyed it. 

via Vitals NBCNews.com:
Docs: Antipsychotics often prescribed for 'problems of living'
by Sandra G. Boodman Kaiser Health News  March 18, 2012

"Adriane Fugh-Berman was stunned by the question: Two graduate students who had no symptoms of mental illness wondered if she thought they should take a powerful schizophrenia drug each had been prescribed to treat insomnia."

"In 2010 antipsychotic drugs racked up more than $16 billion in sales, according to IMS Health, a firm that tracks drug trends for the health-care industry. For the past three years they have ranked near or at the top of the best-selling classes of drugs, outstripping antidepressants and sometimes cholesterol medicines. A study published last year found that off-label antipsychotic prescriptions doubled between 1995 and 2008, from 4.4 million to 9 million. And a recent report by pharmacy benefits manager Medco estimated that the prevalence of the drugs' use among adults ballooned more than 169 percent between 2001 and 2010."

"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."

"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," Muzina said."

"In the short term, I don't see a change in this trend unless external forces intervene." here