Furious Seasons

Oh Come On SAMHSA: Let Bob Speak

Philip Dawdy — 2010-07-22T00:03:20-08:00

I'll have some news on my work on this site below, but let me first weigh in on something far more important.

Last evening, I learned through MindFreedom that Robert Whitaker, the Polk Award-winning journalist and author of the recent "Anatomy of an Epidemic," had had an invitation to be keynote speaker at the annual "Alternatives" conference withdrawn. The conference is funded by HHS' Substance Abuse and Mental Health Services Administration (SAMHSA) and apparently someone at the agency freaked when they learned that Whitaker, an authority on mental health issues and a tough critic of the bio-psychiatry mainstream, was set to speak. He's been quite critical of federal agencies (so have I). Whitaker tells MindFreedom:

"MFI: What is it that you write about in Anatomy of an Epidemic that is so threatening?"
"WHITAKER: The story told to the public by the NIMH and by academic
psychiatry is that psychiatric medications have greatly improved the
lives of those diagnosed with psychiatric illnesses. Yet, even as our
society has embraced the use of psychiatric medications during the
past two decades, the number of people receiving government disability
due to mental illness has more than tripled, from 1.25 million people
to more than 4 million people.

"So you can see, in that data, that something may be wrong with that
story of progress. And then, if you look at how psychiatric
medications affect the long-term course of psychiatric disorders, you
find -- in the scientific literature -- consistent evidence that they
increase the likelihood that a person will become chronically ill. I
know this is startling, particularly since we do know that some people
do well on the medications long term, but that evidence, in terms of
how the medications affect long-term outcomes in the aggregate, shows
up time and again in the scientific literature."

Certainly, there's a fair amount of overlap between what Whitaker argues in his new book and what I've argued on this site for years. But it doesn't matter if I agree with him or respect him as a colleague (and that he was very respectful of someone whose case I've written about for years), he was invited to speak and should be allowed to do so. SAMHSA should re-invite him before it winds up with yolk all over its collective face. The irony that the conference is called "Alternatives" should not be lost on any of us, although you've got to wonder exactly whose alternatives are to be touted.

If you have any thoughts you'd like to share with SAMHSA's director Pam
Hyde, then fire them off to her at Pam.Hyde@SAMHSA.hhs.gov.

For myself, I had hoped to be back at it on here this week. But I am simply torn up too much from a tough six-month initiative campaign to write with much clarity. I have severe tendinitis in my left elbow and much pain in both of my shoulders. All in the cause of what's now a two-year fight to legalize marijuana in Washington State. In the process, I established a Facebook page with 9,200 fans (a larger base than several well-known, longstanding drug reform groups) and a very active website for the campaign (I did many other things as well; some well, some not so well). Both of which bode well for Sensible Washington as we prepare to launch a new legalization initiative in January 2011.

My hope is that my body will be sufficiently healed by next week to return to regular postings.

In Fact, I Am Alive

Philip Dawdy — 2010-07-15T14:11:32-08:00

I know it's been four months since I last posted--and I'd never planned on being away so long--but I am on my way to coming back to this site. It'll likely be next week before I am back up to speed as I am trying to work six months of 90-hour weeks (no, I'm not exaggerating) out of my body. Suffice to say that running an all-volunteer initiative campaign in signature gathering phase is very tough work. The short story is the I-1068 campaign faced just about every obstacle you could imagine and some I never would've guessed at until they happened and we came up short on signatures. The main impediment was the weather: It was a very wet May and June (June was at 200 percent of normal rainfall) this year and that makes it extremely difficult to turn out volunteers to collect signatures. The initiatives that will qualify for this November's ballot in Washington State all relied upon paid signature gatherers. Some initiative backers will spend close to $1 million just on signature gathering. I-1068 spent around $40,000.

Sensible Washington--the group I co-founded earlier this year--is already hatching plans to take another run next year at signature gathering for what I call "Son of I-1068." So the next six months or so ought to be interesting as we ramp up for that. And pray for better weather. And more money.

I've appreciated the many kind sentiments that have come my way the last few months, especially this yesterday from PsychCentral's John Grohol.

It's interesting to be coming back just as the Avandia saga comes to a head and just as GlaxoSmithKline takes a $2.3 billion charge to settle various legal cases connected to Avandia and Paxil. Same as it ever was.

Yes, I'm Alive And So Is I-1068

Philip Dawdy — 2010-02-23T00:01:33-08:00

I apologize for the lack of posting here the last two weeks, but we rolled out signature petitions for I-1068--aka The Marijuana Reform Act of 2010--last week and it's been hell on wheels the last few weeks. I am the campaign director of Sensible Washington and a co-author of I-1068. Last week I worked 93 hours, unpaid. Our campaign is all-volunteer and while no one in the professional political observer class gives us a chance of getting the 241,153 valid signatures we need by July 2 to get on the November ballot, we think the enthusiasm level among regular citizens for our initiative is substantial and that we have a fighting chance. We expect to turn in 320,000 signatures by July 2.

Our main campaign website is here and if you're on Facebook you can add our fan page and follow what's going on. If you're a registered voter in Washington State, we want your signature!

Among others, I-1068 is endorsed by Seattle Chief of Police (Ret.) Norm Stamper.

With luck, I may be back to semi-regular posting in the near future, but until my hours back off to, say, 70 hours a week I am simply unable to do much of anything non-campaign related including eating and sleeping.

But I will be back. Guaranteed.

I hope you are all well and appreciate the many emails I've gotten the last few days.

Some Initial Thoughts On The Draft DSM-5

Philip Dawdy — 2010-02-10T10:01:59-08:00

As many of you know, a draft of the proposed DSM-5 is just out and it's bound to stir plenty of comment and controversy. First, I've got to congratulate the DSM-5 crafters for making the draft public and for seeking public comment. That's right: the APA wants to hear from members of the public, not just medical professionals. So let them know what you think.

Meanwhile, let me offer some preliminary comments:

1. Internet addiction isn't included, which is fine by me and likely will save the APA much sniggering and criticism.

2. Bipolar disorder type 3 or subthreshold bipolar disorder is not included either and that is definitely a victory for critics like me who've long held that the softening of mood disorders--such as with bipolar disorder type 2--has led to millions of Americans being overdiagnosed and overmedicated.

3. Perhaps the biggest losers in the politics of DSM-5 are the Harvard child psychiatry crew and the FDA. The Harvard folks have pressed hard for over a decade to establish mood lability and temper tantrums in children as pediatric bipolar disorder or child bipolar disorder. Harvard's Joseph Biederman and others claimed they had nothing but sound science driving their claims, ones the FDA bought hook, line and sinker. This all led to the wild overdiagnosis and overmedication of millions of American children, basically to shut them up when arguably they needed more attention to their diets and lack of physical activity.

Now, the DSM-5 authors have not included PBD in their proposal, certainly giving the lie to the Harvard crew. Instead, they chose to label these kids as having Temper Dysregulation Disorder with Dysphoria. While anything that steers diagnosis and treatment away from meds first, last and always is to be welcome, I cannot help but feel that slapping a syndrome of any kind on children is dangerous. Especially since the new syndrome is describing behavior that's been around for eons and hasn't been particularly troubling for humanity until child psychiatrists and pharma companies got their hands on all of this in the 1990s.

I'll have more to say on this one as the implications become clearer.

4. Advocates for including psychosis prodrome have won a victory as the DSM-5 draft contains a disorder called Psychosis Risk Syndrome. The research on all of tis is quite slim and such research as exists hasn't pointed to a high percentage of youngsters allegedly at-risk of developing a full-blown psychotic disorder as being readily identified by precursor symptoms. And those who recall the disastrous PRIME study will remember that medicating teens sure didn't help them out. I hope this proposed diagnosis is promptly dropped from inclusion in DSM-5.

5. I've not been able to poke into the newfangled, proposed severity scales for anxiety and depression, so that's something I'll have to push off until later. You can see an example here, however.

Rebecca Riley's Mother: Guilty Of Murder

Philip Dawdy — 2010-02-09T15:19:23-08:00

I wouldn't know what to add to this news:

"BROCKTON – A South Shore mother was found guilty today of second-degree murder in the death of her 4-year-old daughter who never woke up one night in December 2006 after ingesting toxic levels of psychotropic drugs.
"Carolyn Riley, 35, remained impassive as the jury, which had deliberated 19 hours at the end of a three-week trial, announced the verdict in the death of her daughter, Rebecca. Plymouth Superior Court Judge Charles Hely immediately sentenced Carolyn Riley to the mandatory term of life in prison with parole eligibility in 15 years."

Either way, it certainly isn't good news for child psychiatry either.

Paxil Interferes With Breast Cancer Drug

Philip Dawdy — 2010-02-09T00:03:32-08:00

This alarming bit of news hit yesterday:

"Women who took GlaxoSmithKline's Paxil while taking tamoxifen at the same time were more likely to die of their breast cancer, the researchers found. The longer the overlap between Paxil and tamoxifen, the more likely the patients were to die, they reported in the British Medical Journal.
"It is likely because Paxil, sold generically as paroxetine, interferes with the compound the body uses to process tamoxifen, the researchers said."

A separate study last year reached a similar conclusion about SSRIs as a class.

At this point, you've got to wonder if there's nothing Paxil cannot do. It increases suicidality, is linked to some birth defects, has all kinds of dependence and withdrawal problems and even damages male sperm. Awesome little pill, Glaxo.

One Thing Conservatives Are Right About

Philip Dawdy — 2010-02-05T00:01:52-08:00

I apologize for being silent for a couple of days on here, but I've been working 12 to 14 hour days--weekends included--since early January and my brain has turned to mush. Why so much work? Let's just say that over the last few weeks I've developed a rich appreciation for something conservatives and small business groups have told me during my reporting career: "There's too much red tape and bureaucratic nonsense involved in starting and running small businesses. It's an economic disincentive."

I'd thought for years that they were overstating the case for political reasons. I don't think that way anymore. There is far too much red tape and far too many hoops to jump through in starting a small organization of any kind--even one like Sensible Washington, which as a PAC is exempt from many reporting requirements--for many people to give it a go. Government red tape, bank red tape, etc., etc., and on and on it goes. It becomes mind numbing after a while.

I hope some time this weekend to pen a few posts, but for now my body and mind are screaming for rest. And less red tape.

What's The Point Of Articles Like This?

Philip Dawdy — 2010-02-02T10:55:17-08:00

There's an OK-ish piece in the New York Times today, penned by a psych nurse in Portland, Ore. It concerns a young woman admitted to a psych unit in that city--without name and history--and the nurse writing about her progress and such. The article really doesn't go anywhere although it does make the adroit observation that there are few "ah ha" moments in psychiatry (Breaking news!) and it's one of those pieces that I scratch my head about and wonder why it was appealing to an editor.

Lilly Settles Mississippi Zyprexa Claims For $18.5 Million

Philip Dawdy — 2010-02-01T10:04:48-08:00

News is out that Eli Lilly has settled yet another lawsuit with yet another state over claims that the company illegally marketed its antipsychotic Zyprexa for unapproved uses. This time out it's $18.5 million to the State of Mississippi. That brings Lilly's total settlements to date to around $2.8 billion and there's still more to go.

The Awful Way We Treat Our Elderly

Philip Dawdy — 2010-02-01T09:35:45-08:00

The Seattle Times today has part two of a big old investigative series on adult family homes in Washington State and the paper's findings are horrifying. I won't even try to summarize them because it is all sickening and makes me question some peoples' inherent humanity. So if your stomach is strong, the series home is right here.

Study: SSRIs Complicate Breast Feeding

Philip Dawdy — 2010-01-27T10:24:30-08:00

As if there hasn't been enough bad news around anti-depressants and pregnancy of late--formerly assumed to be safe, now linked to preterm births!--there is news of a new study showing that SSRIs can cause delayed lactation. I think I'll just let that stand for itself without comment.

DSM-5 To Dub Obesity A Mental Illness?

Philip Dawdy — 2010-01-26T00:05:27-08:00

In a fascinating piece in the Boston Globe, which echoes one of my regular themes about weight gain problems with psych meds, Harvard psychologist Paula Caplan delivers some shocking news about the forthcoming DSM-5:

"Another disturbing link could be on the way. The fifth edition of the major psychiatric diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), is expected to be released in 2013. One proposal under consideration: listing obesity as a mental illness. That would be a mistake, since obesity can be caused by metabolic and other physical problems that are often undiagnosed. And because obesity can also result from psychiatric drugs, calling it a mental illness would create a vicious cycle: Someone is troubled, put them on drugs, they become obese, therefore diagnose them as mentally ill, give them more drugs."

Every so often I just have to say it: psychiatry has absolutely lost its mind.

AstraZeneca Exec Was Pressed To Lie About Seroquel Weight Gain

Philip Dawdy — 2010-01-26T00:03:38-08:00

Well, this ought to be fun for AstraZeneca to explain in court. The BBC is reporting that a former UK AZ executive was pressed by AZ marketing execs to lie about weight gain issues with Seroquel in the late-1990s.

"John Blenkinsop, the company's former UK medical manager, claimed he was pressurised by the company's marketing arm to approve claims about the drug which he felt did not reflect the medical evidence.
"'The clinical studies at the time of the launch of Seroquel showed patients developed significant weight gain, significant both statistically and clinically,' he told the BBC's File on 4.

"'They [the marketing team] came at me with a number of potential claims all of which were trying to intimate that Seroquel was not associated with weight gain - the data pointed in the opposite direction,' added Mr Blenkinsop who was speaking publicly for the first time since he left the company in 2000.

"He said: 'I understood where they were coming from. I had some robust discussions and exposed them to the data but that didn't seem to stop them because they were desperate for a differential advantage over one of the competitor products and they didn't have one.

"'In the end I was put under quite a significant amount of pressure by the marketeers to sign off claims with regards to the lack of weight gain and I was unwilling to sign that off. The marketeers made it clear it could be career limiting for me," Mr Blenkinsop added.'"

Of course, this weight gain would have absolutely nothing to do with diabetes associated with the use of the drug, so there's no need for the public to know.

Doctor Diagnosed 2-Year-Old With Bipolar For Seeing Monsters, Ghosts

Philip Dawdy — 2010-01-25T11:05:56-08:00

Some interesting news from this morning's session of the murder trial of Rebecca Riley's mother back in Massachusetts. The testimony is from child psychiatrist Kayoko Kifiju and concerns Rebecca's older sibling, Kaitlynne.

"At the time, Kaitlynne Riley was 2 years old, and Carolyn Riley had turned to doctors because the girl was being aggressive toward her older brother, Kifuji testified.
"The psychiatrist said she met with the little girl for an hour, during which the girl talked about seeing 'monsters' and 'ghosts'--but did not display any sign of excessive aggressive behavior. Yet, Kifuji testified, she diagnosed Kaitlynne Riley as having bipolar disorder and prescribed Depakote for treatment.

"'I made a diagnosis of bipolar disorder on Kaitllynne Riley based on information I got and I put her on medication,' Kufiji testified.

"Asked by Middleton whether she saw any sign that the 2-year-old was unduly aggressive, the doctor replied, 'no.'"

Evidence-based medicine at work. Sarcasm aside, who diagnoses a kid so young who is not displaying outward signs of dysfunction based upon a one-hour appointment? If a 2-year-old seeing monsters and ghosts--meaning having an active imagination--is enough to get a kiddo diagnosed and medicated then we are in deep trouble as a society.

Study Finds Preterm Births Linked To SSRI Use

Philip Dawdy — 2010-01-25T00:03:34-08:00

A new study out in the American Journal of Obstetrics & Gynecology adds more fuel to the controversy around pregnancy and anti-depressants. In it, researchers report that among 3,000 pregnant women in Washington State those who took an SSRI anti-depressants during the second or third trimester had an almost five times higher risk of delivering a preterm baby. The study also found a higher risk among women taking benzodiazepines.

The new study joins other recent studies casting doubt on doctors' longstanding claim that anti-depressants aren't linked to birth complications and it sure makes you wonder how post-partum depression can be properly addressed without putting babies at risk.