Mixed Messages in Medicince: Medical Marijuana and Benzos

izquotes.com

via MedPage Today:

Rheumatology

Marijuana: Do Risks Outweigh Benefits in RA?

Published: Mar 3, 2014 | Updated: Mar 3, 2014

By Nancy Walsh, Staff Writer, MedPage Today

Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania

Medical Marijuana: Studies Find No Benefit for RA   Rheumatologists should not currently be recommending the use of medical marijuana to their patients for relief of chronic pain, researchers stated. Read more

"Among the reasons for this advice are acute and chronic risks, a lack of evidence for efficacy, and the absence of data on appropriate dosing, according to Mary-Ann Fitzcharles, MD, of McGill University in Montreal, and colleagues."

Pain Management

This Week in Medical News: Benzos, STDs, and IVF

Published: Mar 1, 2014

By MedPage Today Staff

"Although much has been written about the "opioid epidemic," less attention has been focused on the relatively common practice of prescribing benzodiazapines in combination with opioids, a practice that may increase the risk of fatal overdoses, reported John Fauber, Kristina Fiore, and Elbert Chu in "Killing Pain: Benzo 'Boost' Can Be Deadly." a three-part investigative series from the Milwaukee Journal Sentinel and MedPage Today.

 

The focus is NOT preventing iatrogenic addiction, iatrogenic disability& iatrogenic homicide.

I say it's quackery...

Medical standards of care originally were based on clinical research and clinical experience; ethical medical standards originally were diagnostic procedures and treatments for symptoms and medical illnesses with known risks and potential benefits discussed for informed consent for prescribed treatment. Standards of care protected patients from unsafe medical practices and unethical professionals. The standards being promulgated for use in standard psychiatric clinical practice and recommended for use in pediatric and general medical clinics currently are written to conform to what is, and has been standard practice in real world mental health clinical practice for decades.

In real world clinical practice, it not unusual for irresponsible off label prescribing of dangerous psychotropic drugs with little, if any empirical support; i.e. drugs are prescribed for no valid, ethical medical purpose. Incredibly, drugs are prescribed without empirical evidence of either the drug's safety or effectiveness for the patient, and/or the condition and/or syptom the drug is prescribed to treat, drugs are sometimes the only "treatment" available. Psychiatry's current standards of care protect psychiatrists and the other medical practitioners who are trained to practice "psychopharmacology," not evidence based medicine, social and political control of individuals based on consensus of professional opinions.  Psychiatric "standard treatment" endangers patients. Obviously, psychotropic drugs which have teratogenic effects and have inherent risks which include cognitive, neurological and physical disabilities and early/sudden death. Once drug impaired, psychiatric patients are limited in their capacity to complain of mistreatment and effectively advocate for themselves. Many will develop drug-induced cognitive, neurological, metabolic, and cardio-vascular impairments which are medically neglected by the doctors who inflict them.

Apparently, it's an article of faith for psychopharmacologically inclined psychiatrists to believe the subjective observations and opinions of psychiatrists can miraculously transubsantially transform agreed upon opinions and beliefs into "scientific evidence" through a quasi-democratic process of consensus. Imagine that! A consensus of the opinions of psychiatrists validates psychiatric diagnostic criteria. Psychiatrists agree teratogenic drugs are therapeutic and "necessary" by legal force if required. Seemingly, by ignoring the direct adverse effects of teratogens on their patients,  psychiatrists become willfully blinded to disabilities and infirmaties, the iatrogenic medical injuries that consensus based psychiatry inflicts upon humanity with seeming impunity.

In every other field of scientific inquiry, subjective observation and opinion is suitable only to support findings and conclusions derived from empirical data collected in research and real world practice. Educated subjective opinions and observations are no substitute for medical knowledge gained from ethical scientific research, and thoughtful consideration of all available data. Using medical terms,  relying on consensus without offering valid empirical evidence to support psychiatric standards of care is an egregious abuse of power, authority and medical  privilege---There is no substitute for empirical evidence, and no excuse for abdicating the use of sound medical judgement and ethical medical principles.

Psychiatry's consensus-based diagnostic manual, the DSM, and consensus-based treatment algorithms such as TMAP and , are not ethically, medically or scientifically valid. TMAP and T-MAY, are consensus-based treatment protocols developed to market drugs and/or unethically "validate" off label prescription of dangerous FDA approved drugs; i.e. off label prescribing becomes psychiatry's "standard of care"absent empirical support or contrary to available evidence of either  drug safety or effectiveness for patient or symptom or condition...

How did off label use of dangerous drugs become so common, more importantly, how can it be considered ethical or even a "standard medical practice?" Psychotropic drugs are teratogens; yet they are prescribed without evidence of effectiveness, even though they have inherent, disabling, even fatal risks.

Abuse of prescription privileges. 

Psychiatry: a consensus-based standard of care. 

Psychiatry's so-called standards of care are commonly used to "validate" the prolific off label prescribing of neuroleptic, or so-called "antipsychotic" and other psychotropic drugs to children, the elderly and traumatized veterans. Treatment algorithms are based on consensus and "validated" by a quasi-democratic process. In reality, what are obviously political decisions are the justification, not exactly the needed evidence base, for so called standards of care. These "standards" which primarily serve to protect practritioners who use them by providing a pre-emptive affirmative defense against medical malpractice for iatrogenic injuries. Standards of care shield psychiatrists against malpractice claims for drug-induced iatrogenic injuries, permanent disabilities weven  fatalities inflicted with impunity. Most victims are mostly poor and/or reliant on Federal Medical programs. Marginalized by poverty, stigmatized with a diagnostic label, patients can be systematically dis-empowered a direct effect of legislating bigotry. Grass roots advocates who proclaim themselves to be "The Nation's Voice on Mental Illness" do not acknowledge psychiatric survivors/victims, much less advocate justice for victims of iatrogenic harm, educate the public about drug-induced disease, disability and death. The Nation's Voice does not speak for those who are killed as a direct result of psychiatric treatment.

via 1 Boring Old Man:

a mess, [still] deserving close attention…

a couple of excerpts:

"Childhood Psychosis is an uncommon finding, but can be associated with significant impairment, and the article mentioned by Dr. Purssey purports to be discussing childhood psychosis. But we all know that the extensive use of Atypical Antipsychotics in children [Medicaid children] isn’t about childhood psychosis at all. It’s off-label uses. The drugs are being prescribed for behavior control. That’s where the costs come from. That’s where the dangers are. That’s where the risk/benefit equation has been massively perverted. That’s the reason for the alarm. These are the kids that were inappropriately labeled Bipolar, justifying the use of these medications.

"There can be little question that the incidence of behavioral problems among the children on Medicaid is quite high. In fact, it would be surprising if that weren’t the case. Many of them are foster children or otherwise born into families in difficult circumstances. And for all its glitches, our foster-care system beats the orphanages of a former time hands down. These medications can be somewhat effective in situations when these children inevitably present with behavior problems, but at a very high price. Foremost, this is not a situation best approached by symptom control. Childhood is not something to be gotten through. It’s the period of complex development that shapes directions for a lifetime. This is a self-evident truth. It’s impossible to imagine that the important work of childhood can proceed through the fog of Antipsychotics – so the side effects such as the metabolic syndromes are an additional burden to children already swimming up-stream. Rampant medication in these situations is a clearly inappropriate and dangerous medical solution to a psycho-social problem. This is not simply something to decry. It needs to be stopped." read here

Here is the latest treatment algorithm to ensure kids will be drugged: 

via The Reach Instittute

T-MAY: Treatment of Maladaptive Aggression in Youth

Psychotropic agents are increasingly prescribed to aggressive youth on an outpatient basis,^5–7 despite limited efficacy and safety data.⁶ For example, sixfold increases in outpatient antipsychotic prescriptions were found between 1993 and 2002,⁸ followed by further increases between 2002 and 2006,⁹ largely with aggressive, nonpsychotic youth. These practices fall largely outside of indications approved by the Food and Drug Administration, raising concerns about efficacy, safety, role of alternative therapies, polypharmacy, and appropriate parent engagement and education.⁹Furthermore, a significant portion of antipsychotic prescribing takes place by primary care physicians, including pediatricians. For example, an estimated 32.2% of antipsychotic prescriptions for children ages 2 to 18 during 1995–2002 were by non–mental health providers.¹⁰ Evidence-based guidance is necessary for implementing care that addresses patients’ severity and source of symptoms, development, primary diagnosis, coexisting conditions, and family situations.¹¹

To address these needs, the Rutgers Center for Education and Research on Mental Health Therapeutics, in collaboration with Columbia University, the REACH Institute, and others, launched a consensus development initiative to address the outpatient management of maladaptive, impulsive aggression in children and adolescents.

Treatment of Maladaptive Aggression in Youth: CERT Guidelines I. Engagement, Assessment, and Management

Treatment of Maladaptive Aggression in Youth: CERT Guidelines II. Treatments and Ongoing Management

updated 2-17-2014

18 and Depressed: diagnosed with schizophrenia the first time he went to the walk-in mental health clinic

Originally titled,
A Misdiagnosis of Schizophrenia: based on errors of attribution, lack of professional judgement and ethical integrity  
Schizophrenia is a diagnosis of exclusion, however many people do not have the necessary physical or neurological exams to discover if there is a physical or neurological cause for the symptoms they have before a diagnosis is applied, and drugs to treat it are prescribed. Some will, sooner or later, be Court Ordered to take the drugs to treat a diagnosis of schizophrenia, without ever having the requisite medical exams needed to exclude the medical conditions that could be the potential cause for their symptoms.

Then there are situations like what happened to my eldest son who was diagnosed with schizophrenia at the age of eighteen at the local community health clinic, Central Washington Comprehensive Mental Health. The diagnosis was based on the intake staff misunderstanding and misinterpreting what my son said; belief in the bio-medical disease paradigm; and an assumption that he must have a genetic defect. First, he was lied to about the diagnosis he was given, then he was lied to about why the drugs were prescribed.

He was depressed and eighteen and went to the walk-in mental health clinic for help. He saw an individual who did an evaluation and intake. When he came home with a prescription for a neuroleptic drug that he'd been told was to help him sleep; I was alarmed---scratch that---I was pissed off.  I told him that he had been lied to, and that I believed that he had been  diagnosed with Schizophrenia. Being eighteen, he thought mom was overreacting---and overly suspicious, if not "paranoid."  He basically believed I was wrong.

The drug prescribed had negative effects which he could not tolerate, so he went back to the mental health clinic and was prescribed another neuroleptic; again he was told it was to "help him sleep." I convinced him that he needed to go look at his medical record, as he had a legal right to do.  He went down to the clinic with a printout of the section of the law that states he has the right to examine his chart.

He discovered that he had indeed been given a diagnosis of schizophrenia. This psychiatric diagnosis was based on three things:

1. His brother had a diagnosis of schizophrenia

2. He told the person who did the intake and assessment that he was working at Earthlink, an internet service provider that provides technical assistance to it's customers over the phone. This was recorded in his chart as "He thinks he is an "earthling" in training."

3. At the time, he was interested in studying Neuro-Linguistic programming, (NL P™) is defined as the study of the structure of subjective experience and what can be calculated from that and is predicated upon the belief that all behavior has structure. The mental health professional had never heard of "Neuro-Linguistic Programming" and did not think it was an actual field of study; and assumed that my son had made it up.  This interest in an actual field of study was labeled an "entrenched delusion."

Don't forget this diagnosis was given to my elder son based on an intake appointment by a clinician who saw him ONE time--he had no history of hallucinations, or delusions.  He was depressed, he was eighteen and he was worried about his brother.  Nathan has always felt that it was his job to fix what was wrong, and overly-responsible for taking care of his brother and myself.---This is common for adolescent males raised by single mothers.  He was depressed in part because he felt as if he had failed.  

He needed support to deal with a great deal of grief, loss and trauma. He needed help figuring out what he is and is not responsible for.  He needed support in order to figure out it was never his responsibility to fix any of what had happened to his brother.  He needed help to learn how to deal with the emotional trauma he had experienced; and to learn that it is, and never was his fault.  He needed to be assured that none of what had happened and what was happening was his fault. He needed to know it was never his responsibility to take care of his mother and his brother--he was a kid and he had not failed anyone at all.

via The Wall Street Journal:

Confusing Medical Ailments With Mental Illness

An elderly woman's sudden depression turns out to be a side effect of her high blood-pressure medication.

A new mother's exhaustion and disinterest in her baby seem like postpartum depression—but actually signal a postpartum thyroid imbalance that medication can correct.

A middle-aged manager has angry outbursts at work and frequently feels "ready to explode." A brain scan reveals temporal-lobe seizures, a type of epilepsy that can be treated with surgery or medication.

More than 100 medical disorders can masquerade as psychological conditions, according to Harvard psychiatrist Barbara Schildkrout, who cited these examples among others in "Unmasking Psychological Symptoms," a book aimed at helping therapists broaden their diagnostic skills.

Studies have suggested that medical conditions may cause mental-health issues in as many as 25% of psychiatric patients and contribute to them in more than 75%. read here.

via Cold Spring Harbor Laboratory:

ID 899

DSM-IV Criteria for Schizophrenia

Description:
Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) diagnostic criteria for schizophrenia and associated disorders.
Transcript:

DSM-IV-TR: Diagnostic criteria for schizophrenia: A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): (1) delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence (4) grossly disorganized or catatonic behaviour (5) negative symptoms, i.e., affective flattening, alogia (poverty of speech), or avolition (lack of motivation) Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other. B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement). C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal (symptomatic of the onset) or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D. Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive Episode, Manic Episode, or Mixed Episode have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. F. Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated). Subtypes Schizophrenia Subtypes: The subtypes of schizophrenia are defined by the predominant symptomatology at the time of evaluation. Because of the limited value of the schizophrenia subtypes in clinical and research settings (e.g. prediction of course, treatment response, correlates of illness), alternative subtypes are being actively investigates. Subtypes include 1. Paranoid Type 2. Disorganized Type 3. Catatonic Type 4. Undifferentiated Type 5. Residual Type Schizophreniform disorder, schizoaffective disorder, and delusional disorder are closely related to schizophrenia and their symptoms are also listed below. In addition symptoms are listed for the following related disorders: brief psychotic disorder, shared psychotic disorder, psychotic disorder due to a general medical condition, substance-induced psychotic disorder, and psychotic disorder not otherwise specified. 1. Paranoid Type A type of Schizophrenia in which the following criteria are met: A. Preoccupation with one or more delusions or frequent auditory hallucinations. B. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect. 2. Disorganized Type A type of Schizophrenia in which the following criteria are met: A. All of the following are prominent: (1) disorganized speech (2) disorganized behaviour (3) flat or inappropriate affect B. The criteria are not met for Catatonic Type. 3. Catatonic Type A type of Schizophrenia in which the clinical picture is dominated by at least two of the following: (1) motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor (2) excessive motor activity (that is apparently purposeless and not influenced by external stimuli) (3) extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or mutism (4) peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures) (5) stereotyped movements, prominent mannerisms, or prominent grimacing (6) echolalia (word repetition) or echopraxia (repetitive imitation) 4. Undifferentiated Type A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type. 5. Residual Type A type of Schizophrenia in which the following criteria are met: A. Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior. B. There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). Diagnostic criteria for Schizophreniform Disorder: A. Criteria A, D, and E of Schizophrenia are met. B. An episode of the disorder (including prodromal, active, and residual phases) lasts at least 1 month but less than 6 months. (When the diagnosis must be made without waiting for recovery, it should be qualified as "Provisional.") Specify if: Without Good Prognostic Features With Good Prognostic Features: as evidenced by two (or more) of the following: (1) onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning (2) confusion or perplexity at the height of the psychotic episode (3) good premorbid social and occupational functioning (4) absence of blunted or flat affect Diagnostic criteria for Schizoaffective Disorder: A. An uninterrupted period of illness during which, at some time, there is either a Major Depressive Episode, a Manic Episode, or a Mixed Episode concurrent with symptoms that meet Criterion A for Schizophrenia. Note: The Major Depressive Episode must include Criterion A1: depressed mood. B. During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. C. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness. D. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Specify type: Bipolar Type: if the disturbance includes a Manic or a Mixed Episode (or a Manic or a Mixed Episode and Major Depressive Episodes) Depressive Type: if the disturbance only includes Major Depressive Episodes Diagnostic criteria for Delusional Disorder: A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration. B. Criterion A for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme. C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre. D. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods. E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Specify type (the following types are assigned based on the predominant delusional theme): Erotomanic Type: delusions that another person, usually of higher status, is in love with the individual Grandiose Type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person Jealous Type: delusions that the individual's sexual partner is unfaithful Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way Somatic Type: delusions that the person has some physical defect or general medical condition Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates Unspecified Type Diagnostic criteria for Brief Psychotic Disorder: A. Presence of one (or more) of the following symptoms: (1) delusions (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence) (4) grossly disorganized or catatonic behavior Note: Do not include a symptom if it is a culturally sanctioned response pattern. B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning. C. The disturbance is not better accounted for by a Mood Disorder With Psychotic Features, Schizoaffective Disorder, or Schizophrenia and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Specify if: With Marked Stressor(s) (brief reactive psychosis): if symptoms occur shortly after and apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person's culture Without Marked Stressor(s): if psychotic symptoms do not occur shortly after, or are not apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person's culture With Postpartum Onset: if onset within 4 weeks postpartum Diagnostic criteria for Shared Psychotic Disorder (Folie à Deux): A. A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion. B. The delusion is similar in content to that of the person who already has the established delusion. C. The disturbance is not better accounted for by another Psychotic Disorder (e.g., Schizophrenia) or a Mood Disorder With Psychotic Features and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Diagnostic criteria for Psychotic Disorder Due to a General Medical Condition: A. Prominent hallucinations or delusions. B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition. C. The disturbance is not better accounted for by another mental disorder. D. The disturbance does not occur exclusively during the course of a Delirium. Code based on predominant symptom: - With Delusions: if delusions are the predominant symptom - With Hallucinations: if hallucinations are the predominant symptom Diagnostic criteria for Substance-Induced Psychotic Disorder: A. Prominent hallucinations or delusions. Note: Do not include hallucinations if the person has insight that they are substance induced. B. There is evidence from the history, physical examination, or laboratory findings of either (1) or (2): (1) the symptoms in Criterion A developed during, or within a month of, Substance Intoxication or Withdrawal (2) medication use is etiologically related to the disturbance C. The disturbance is not better accounted for by a Psychotic Disorder that is not substance induced. Evidence that the symptoms are better accounted for by a Psychotic Disorder that is not substance induced might include the following: the symptoms precede the onset of the substance use (or medication use); the symptoms persist for a substantial period of time (e.g., about a month) after the cessation of acute withdrawal or severe intoxication, or are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use; or there is other evidence that suggests the existence of an independent non-substance-induced Psychotic Disorder (e.g., a history of recurrent non-substance-related episodes). D. The disturbance does not occur exclusively during the course of a delirium. Note: This diagnosis should be made instead of a diagnosis of Substance Intoxication or Substance Withdrawal only when the symptoms are in excess of those usually associated with the intoxication or withdrawal syndrome and when the symptoms are sufficiently severe to warrant independent clinical attention. Diagnostic Criteria for Psychotic Disorder Not Otherwise Specified: This category includes psychotic symptomatology (i.e., delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) about which there is inadequate information to make a specific diagnosis or about which there is contradictory information, or disorders with psychotic symptoms that do not meet the criteria for any specific Psychotic Disorder. Examples include: 1. Postpartum psychosis that does not meet criteria for Mood Disorder With Psychotic Features, Brief Psychotic Disorder, Psychotic Disorder Due to a General Medical Condition, or Substance-Induced Psychotic Disorder 2. Psychotic symptoms that have lasted for less than 1 month but that have not yet remitted, so that the criteria for Brief Psychotic Disorder are not met 3. Persistent auditory hallucinations in the absence of any other features 4. Persistent nonbizarre delusions with periods of overlapping mood episodes that have been present for a substantial portion of the delusional disturbance 5. Situations in which the clinician has concluded that some type of psychotic disorder may be present, but is unable to determine whether it is primary, due to a general medical condition, or substance induced.
Keywords:
dsm, schizophrenia, schizoaffective, diagnosis, diagnostic, delusions, hallucinations, paranoid, paranoia, disorganize, catatonic, catatonia, undifferentiated, residual, schizophreniform, delusional, delusion, psychosis, psychotic

Cold Spring Harbor Laboratory / CC BY-NC-ND 3.0

A link from Pat Risser: Medical Problems Related to Psychiatric Symptoms

Portions of this blog post were originally published with the title:

"Making a diagnosis without a complete neurological and physical examination can lead to misdiagnosis" on 8-21-2011

photo from fisher price

"I believe we must speak our conscience in moments that demand it, even if we are but one voice"

"I believe we must speak our conscience in moments that demand it even if we are but one voice"  

Richard B. Sanders

This article was first posted on October 6, 2011. In light of the recent publicity from the ABC News investigation and the Senate Hearings which were held by Senator Tom Carper last week; I have updated it.

I was thoroughly disgusted, and I have felt physically ill since I read Jon McClellan's testimony offered in last week's Senate Hearing on the drugging of children in foster care.  As I see it, this psychiatrist decrying the drugging of foster children is questionable at the very least; in my opinion, the man is either disingenuous, delusional, or simply lacks any professional insight.  I say this primarily due to my personal experience with how unethically he conducted himself when he "treated" my son at what he referred to as, "my State hospital," in his testimony.  I  also say this because I know that he has in fact written the book, so to speak, on how to drug children in distress, using teratogenic drugs off-label.  He advises and teaches other professionals how to do this very thing, and actually is the AUTHOR of the Practice Parameters and Treatment Protocols which guide other professionals in this disgusting practice!  So, the real question is HOW can he not realize his own writing and teaching has had a great deal to do with the drugging of children with dangerous drugs?!  

The fact of the matter is, the way the man ignored State, Federal and International Law in the "treatment" of my son, leaves absolutely no doubt in my mind he should not even have a medical license.  Much less, be relied upon to give truthful testimony; allowed to treat children; or teach students of psychiatry.  Jon McClellan has committed Crimes against Humanity in his role as Medical Director of Child Study and Treatment Center, and he should be in Federal Prison; not being hailed as a "lead researcher" funded by the NIMH!

"DOCTORS and academics risk "professional suicide" if they reveal the adverse side-effects of anti-depressants and other psychiatric medicines, a leading academic psychiatrist has claimed."  Dr. David Healey, is quoted in  the The Irish Examiner on September 24, 2011 under the title, "Doctors risk 'professional suicide' with drug alerts" This is one of the ways used to exert power and control over people and the dissemination of information while stifling dissent.

Evidence or Science-Based medical research is conducted within parameters: ethically and honestly; seeking scientifically valid information, that can be reliably duplicated and validated, by others.   All data from research is valid; while not all data collected may be relevant for the purpose that the research is being conducted, it is still data that should not be hidden, even data considered "statistically insignificant." 


Historically, pharmacological research with respect to psychiatric conditions has relied heavily on poorly constructed research models, discarding of data which does not serve the outcomes hoped for---usually to validate prescribing a particular drug for another purpose or for submitting a drug for FDA approval.  True scientific inquiry requires safeguards be established and adhered to, to minimize the potential for bias and maintain the ethical integrity of the scientific method.  Ethical research also recognizes that subjective observation is the weakest type of data and should not be relied upon without being validated by data gathered by other means.  The potential for subjective bias and errors of attribution--which are part and parcel to being a human being; can not be entirely "controlled for," this reality is taken seriously by ethical  researchers.  


We now know, as a society, that a great deal of fraud and corruption have in fact occurred in the FDA drug approval process, and in the marketing of drugs.  Conflicts of Interest have permeated every aspect of psychiatric research, education, and practice; including public policy formation.  Students of psychiatry in medical training are taught utter bullshit about the history of the practice of psychiatry; the efficacy and safety of the drugs used; and what is and is not known about the etiology of mental illnesses, and even the validity of psychiatric diagnoses themselves.  Students in our Institutions of Higher Learning are using texts written by some of the worst offenders known for conducting unethical, or otherwise questionable research; which is then falsely or incompletely reported.  Conflicts of Interest and corrupt reporting of Federally funded research; i.e., academic fraud.   Moral and ethical deficits that allow a psychiatrist/researcher to ignore scientific research ethics, the Hippocratic Oath, the Ethical Guidelines of the Medical profession and/or the Nuremberg Code, would certainly make an individual unsuitable to inform the next generation of psychiatrists, and/or to treat patients?  

The same psychiatric researchers have then relied on this unethical psychiatric drug research, to suppport the researched drug becoming FDA-approved.  Many have then participated in illegally marketing of the drugs to boost corporate profits; in careless disregard for patient safety.   Illegal marketing schemes rely on the fact that the FDA allows drugs once approved for any purpose or population to be used "off-label;" for anyone and any diagnosis.  "Off-label" prescribing is in reality, is more accurately described as "EXPERIMENTAL."  In effect, and by definition, "off-label" prescribing of psychiatric drugs is HUMAN EXPERIMENTATION; which is now STANDARD PRACTICE.


Another result of unethical psychiatric research and unethical psychiatric standard practice, is  that we now have Laws which mandate that people who are given a psychiatric diagnosis lose upon diagnosis the equal protection under the law of their individual rights.  The standards for obtaining a Court Order lower this standard, so that Rules of Evidence, Proper Notice and Proof of Service, Standard Court Procedures, and Effective Assistance of Counsel that people without a diagnosis have, are diminished for people with a psychiatric diagnosis.  This is to make it easier for them to be Court Ordered to take teratogenic drugs which are, in all reality, mimimally effective for a minority of the people with a diagnosis of schizophrenia.  


Whether the drugs are effective for a particular patient or not, the people who take them risk developing the debilitating iatrogenic illnesses the drugs are known to cause.  Illnesses that can be disabling; and include the risk of sudden death.  Neuroleptics, called 'antipsychotics,' can cause permanent brain damage: e.g., loss of intellectual and cognitive abilities; loss of executive function, the very thing that makes us human.  The treatment protocols for treating schizophrenia and bipolar disorder are now legally mandated in most states as "necessary medical treatment;" even though these treatment protocols exist in spite of the evidence, they are not derived from the evidence; but are in fact validated by a consensus of subjective opinions in committee and voted on; as is the diagnostic criteria itself.  This is not a 'scientific' process; it is a quasi-democratic process.

Instead of being held accountable for their crimes, psychiatrists are allowed to continue damaging the ethical integrity of the medical profession while subverting the purpose of genuine ethical medical research; causing real harm to real people, directly and indirectly.   All the while attempting to maintain political control over valid academic inquiry.  All medical research and scientific discovery which is conducted for the benefit of man should be conducted ethically, openly, and honestly; with uninhibited respectful debate being encouraged.  This is not how psychiatric research is done under the auspices of the NIMH; under Thomas Insel's leadership.  

The lack of open honest discussion and valid scientific inquiry is distorted by commercially driven motives.   Drug treatment protocols are developed, then implemented using coercion and abuse of authority.  These methods are used on other professionals, on the patients/victims, and on family members of those with a psychiatric diagnosis.  Not like any other field of medicine, this is how psychiatry is practiced.  Thoughtful criticism is treated with contempt and those who are critical of the effects of the drugs and the real world outcomes of the patients themselves are censured or ridiculed instead of simply being  responded to, respectfully.   Valid medical science can always stand up to being challenged; it  can even be invalidated when research leads to new information, or when analysis of existing information leads to a different perspective or a deeper understanding. 



How did the practioners of bio-psychiatry get away with using unethical procedures and manipulation of data to subvert the scientific integrity of medical research?  By using political control to quell dissent.  Bio-psychiatric research is sometimes a very weak imitation of scientific inquiry; in reality, pseudo-science.  The reality is that much of standard practice relies on Practice Parameters and treatment protocols which were developed by a quasi-democratic process; not a scientific one, and often are entirely unsupported by clinical research data.


Psychiatric diagnoses and Practice Parameters are developed by a consensus of subjective  opinions, and loosely based on scientific evidence; if at all.  The Evidence-Base consists of: clinical trial data---all of it--not just what is published, or favorable to using a particular drug.  It also includes the real world outcomes of those who have been treated with the drugs---including adverse events and fatal outcomes.  (it is estimated only 10% of adverse events are reported--Prescribers are not required to report fatal outcomes or other adverse events, so we are actually not collecting the very data needed to quantify risk vs. benefit in Real World Practice.  The evidence base also includes the people with a psychiatric diagnosis, who have not been treated with psychiatric drugs.  


In the bio-medical pardaigm of care, psychiatry relies on anecdotal evidence and consensus to develop treatment protocols.  The bio-medical model uses manipulation, coercion and abuse of authority and claims that "medical treatment" is absolutely necessary.  It uses these same social control strategies to institute and enforce "treatment compliance protocols;" and now has Court and Police powers to force treatment compliance.  Simultaneously, psychiatrists attempt to control the dissemination of information; including attempting to stifle dissent or discredit any professional who is critical of the bio-medical model.  The methods used in clinical psychiatric practice and the methods used to censure or discredit professionals who are critical of psychiatry's standard practices have much in common with social and/or political control strategies.   These methods are contradictory to open scientific inquiry and contradictory to the principles required to provide therapeutic psychiatric care in compliance with the Ethical Guidelines of Informed Consent of the American Medical Association.


The supposed "elite" who are Key Opinion Leaders, "KOLs," are also the same psychiatric researchers who have conducted the unethical research and participated in illegal marketing schemes; and who do not taking kindly to having their work critically analyzed; to say the least.  Many are defensive and disrespectful of those whose question how they arrived at their conclusions.  


Some are strangely callous towards those who have been grievously harmed, and family members who are witness to psychiatric malfeasance as well as those who grieve a loved one killed by psychiatric drugs.  The real world outcomes of those who are killed, disabled and who are not "effectively treated" are dismissed, as irrelevant.  People who have been harmed are not even quantified for statistical purposes, in spite of valid scientific reasons to do so.  Surely it is important to consider not only the benefits experienced by these Court Ordered 'patients' but also the harm done the victims?  


Mainstream advocacy groups apparently do not consider the people who speak of harm done to them by psychiatry or their families as people in need of advocacy, support or consideration.  These people are in effect, considered collateral damage by bio-psychiatry practitioners and are not acknowledged, let alone supported by mainstream " 'advocates' for the 'seriously mentally ill'."

Watch out for people who begin with another's concern to end with their own. 

Balthasar Gracian

God grant me the courage not to give up what I think is right even though I think it is hopeless.

Chester W. Nimitz

Whenever a doctor cannot do good, he must be kept from doing harm.
Hippocrates

Psychiatry: 60 Years in an Increasingly Corrupt Specialty Dr. Nathaniel S. Lehrman  


Integrity and Misconduct in Research Report 1995


Psychrights: ADHD Total 100% fraud By Fred A. Baughman Jr., Neurologist, Pediatric Neurologist


Mind Freedom: A list of investigations of the undue influence by companies producing psychiaric medications


POGO: Chair of Obama's Bioethics Commission Ignores Ghostwriting on Her Own Campus


Psychology Today: Child Bipolar Disorder Imperiled by Conflict of Interest