Experts attempt to persuade parents struggling with the decision to medicate their children that the "benefits outweigh the risks"

When you see a USA TODAY headline like this – “Parents struggle with decision to medicate bipolar kids” – and a subheading like this…

Because treating a child with heavy medication has far-reaching implications, parents wonder whether using psychiatric drugs is the best way to help their children with bipolar disorder.

… you might be surprised to find that what you’re reading is far from a balanced consideration of the true risks and benefits of psychotropic medication and polypharmacy in children. Instead, what you get is an out-and-out endorsement for drugging children, fast and furious.

Never mind the consequences!

We begin with scare tactics:

“Without treatment [read: medication], I see my daughter as killing herself,” says a weeping McQuilkin, 60.

As quoted in USA TODAY’S article Parents struggle with decision to medicate bipolar kids [emphasis added]

Next, prognosis:

Bipolar is a lifelong disease, and you don’t want to diagnose it too early and be wrong, or miss something and be too late.

Gabrielle Carlson, professor of psychiatry & pediatrics at Stony Brook University
As quoted in USA TODAY’S article [emphasis added]

We move quickly on to more expert opinions:

I understand the reason why a parent would be afraid to medicate their child. There are often serious and unknown side-effects to consider. But parents also need to consider that there may be a downside to not medicating and missing an opportunity to interrupt the course of a serious illness. … Not medicating may also carry with it risks.

Janet Wozniak, psychiatrist at Harvard Medical School
As quoted in USA TODAY’S article [emphasis added]

Finally, we are assured that the benefits outweigh the risks:

 There’s no free lunch with medication. But if an eye tic is what a child gets vs. getting kicked out of school because his behavior is unmanageable, then it’s worth the risk.

Gabrielle Carlson [emphasis added]

No free lunch?

An odd choice of words for Gabrielle Carlson, who has this additional list of credentials (from a 2010 Conflict Of Interest [COI] disclosure):

- Advisor/Consultant: Bristol-Myers Squibb Company, Eli Lilly and Company, Otsuka America Pharmaceutical, Inc., Validus

- Honorarium and Travel Expenses: Ortho-McNeil-Janssen Pharmaceuticals, Inc., Shire Pharmaceuticals, Inc.

- Research Funding: Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline, Otsuka America Pharmaceutical, Inc.

Janet Wozniak, too, is no stranger to the free lunch:

- Faculty: Johnson & Johnson Center for Pediatric Psychopathology at the Massachusetts General Hospital (more on that momentarily…)

- Consultant:  to Pfizer, Shire Pharmaceuticals, and Eli Lilly

- Research Funding: Eli Lilly

- Speaker’s Bureau: Eli Lilly and Janssen
(from a COI statement issued 2009)

Don’t you think it’s more fair to say that there IS a free lunch for some (medical experts, or “key opinion leaders” as they’re referred to by pharmaceutical companies) but NOT for others (children subjected to the horrors of polypharmacy and the mortal risks included therein)?

What they forgot to mention

Wozniak, Carlson, and the other experts quoted by USA TODAY neglected to include a few key facts that parents struggling to decide whether or not they should medicate their children for so-called “pediatric bipolar disorder” DEFINITELY ought to consider:

1. The relatively recent (we’re talking mid-90s) rise of the idea that so-called “bipolar disorder” is not an almost exclusively adult phenomenon but a widespread pediatric disease which must be aggressively treated with hardcore psychotropic medications, possibly for life. Authors Joseph Biedermann and Janet Wozniak’s turn-of-the-millennium publications put forth this cash cow of an idea and jump started the 4000% increase of this diagnosis in children between 1994 and 2003.

2. Biedermann et al also established – at (coincidentally!) the very same time – a lucrative partnership with Johnson & Johnson, which generously provided grant funding for the “Johnson & Johnson Center for Pediatric Psychopathology at the Massachusetts General Hospital” in 2001. A report to the funders (that would be J&J) dated 2002 reads, in part:

An essential feature of the Center is its ability to conduct research satisfying… [certain] criteria…. [including that] it will move forward the commercial goals of J&J.

…many clinicians question the wisdom of aggressively treating children with medications, especially those like neuroleptics, which expose children to potentially serious adverse events….

Through the funding provided by J&J, we [the J&J Center for Pediatric Psychopathology] are creating a team of investigators focusing on the following issues:

…We will generate and publish data on the efficacy and safety of medications for improving currently available treatment options for child psychopathology.  This work is an essential precursor to the … widespread use of medications

[more on Biedermann and Wozniak’s collusion with J&J to carve out a market for Risperdal in the pediatric population here.]

Thanks to the tireless work of the “J&J Center for Pediatric Psychopathology,” the marketing of antipsychotics to children became so acceptable that pharma sales reps could leave these Risperdal-branded legos in pediatricians’ and psychiatrists’ offices around the country.

3. The very serious side effects of antipsychotic medications in children, including extreme weight gain, type 2 diabetes, obesity, and heart conditions, and brain shrinkage. Antipsychotics have also been shown to significantly worsen symptoms of psychosis over time, making a potentially one-time occurrence into a chronic disease.

4. And finally, for children and adults alike, the Physician’s Desk Reference warns that use of antipsychotics can cause suicidal ideation, aggression, and violence. For example, the entry for Seroquel lists “thoughts of suicide or dying,” “feeling very agitated or restless,” “new or worse irritability,” “acting aggressive, being angry, or violent,” “acting on dangerous impulses,” and “mania” as symptoms that may occur in conjunction with use of Seroquel.

Final Thoughts

Bipolar disease is treatable, that’s the most important thing. I always tell young people who are at the beginning of treatment that bipolar is bad, but now is a great time to get it.

Kay Redfield Jamison, professor of psychiatry at John Hopkins School of Medicine
As quoted in USA TODAY’S article Parents struggle with decision to medicate bipolar kids [emphasis added]

Let’s be real: now is a great time for children to get themselves prescribed a whole bunch of pills under the guise of treating their  ”lifelong, chronic, REAL bipolar disorders,” so that Wozniak and friends might partake in their free lunches.

But are those lunches really free if the children are the ones paying for them?

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