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NYT: Doctors' Hidden Motives for Prescribing Dangerous Drugs to Kids

Posted Aug 26 2008 4:31pm
photo: Fabrizio Costantini for The New York Times

I think Risperdal is a scary scary drug that docs are starting to hand out like candy for ADHD, autism, acting out, and now eating disorders! Among the autistic kids, I can usually tell when a kid's been put on it: he blimps up and acts lobotomized--not exactly a great therapeutic outcome, not to mention that this works on the brain's dopamine receptors (so does crystal meth), who knows what that's going to do to the developing brain. What also scares me is that this drug has PERMANENT side effects like tardive dyskinesia, a disorder that involved involuntary jerky movements of muscles...can you imagine sentencing someone to have this for the rest of their lives?

Minnesota is the only state that actually demands transparency laws (Uh, so what's going on in the states where the docs and drug companies KNOW they won't be taken into account?--eeek!), so we get to see how much the doctors are being bribed (is there another word for it?) to push these drugs on desperate parents and children who can't really give consent.

And don't forget, every time someone is prescribed a drug (instead of counseling, better diet, etc.) it gets peed back out into the water system...

By GARDINER HARRIS, BENEDICT CAREY and JANET ROBERTS

Anya Bailey is among a growing number of children given antipsychotic drugs by doctors who are paid by the makers of those drugs.

When Anya Bailey developed an eating disorder after her 12th birthday, her mother took her to a psychiatrist at the University of Minnesota who prescribed a powerful antipsychotic drug called Risperdal.

Created for schizophrenia , Risperdal is not approved to treat eating disorders, but increased appetite is a common side effect and doctors may prescribe drugs as they see fit. Anya gained weight but within two years developed a crippling knot in her back. She now receives regular injections of Botox to unclench her back muscles. She often awakens crying in pain.

Isabella Bailey, Anya’s mother, said she had no idea that children might be especially susceptible to Risperdal’s side effects . Nor did she know that Risperdal and similar medicines were not approved at the time to treat children, or that medical trials often cited to justify the use of such drugs had as few as eight children taking the drug by the end.

Just as surprising, Ms. Bailey said, was learning that the university psychiatrist who supervised Anya’s care received more than $7,000 from 2003 to 2004 from Johnson & Johnson, Risperdal’s maker , in return for lectures about one of the company’s drugs.

Doctors, including Anya Bailey’s, maintain that payments from drug companies do not influence what they prescribe for patients.

But the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.

These best-selling drugs, including Risperdal, Seroquel, Zyprexa, Abilify and Geodon , are now being prescribed to more than half a million children in the United States to help parents deal with behavior problems despite profound risks and almost no approved uses for minors.

A New York Times analysis of records in Minnesota, the only state that requires public reports of all drug company marketing payments to doctors , provides rare documentation of how financial relationships between doctors and drug makers correspond to the growing use of atypicals in children.

From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold...

Drug makers underwrite decision makers at every level of care. They pay doctors who prescribe and recommend drugs, teach about the underlying diseases, perform studies and write guidelines that other doctors often feel bound to follow....

In Minnesota, psychiatrists collected more money from drug makers from 2000 to 2005 than doctors in any other specialty. Total payments to individual psychiatrists ranged from $51 to more than $689,000 , with a median of $1,750. Since the records are incomplete, these figures probably underestimate doctors’ actual incomes.

Such payments could encourage psychiatrists to use drugs in ways that endanger patients’ physical health , said Dr. Steven E. Hyman, the provost of Harvard University and former director of the National Institute of Mental Health. The growing use of atypicals in children is the most troubling example of this, Dr. Hyman said.

You can read more (once you stop vomiting) here .



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