Tuesday, July 9, 2013

Doctor's Behaving Badly - Part 2 - Steve Balt MD, Editor of the "Carlat Psychiatry Report"

Steve Balt MD, Editor of the "Carlat Psychiatry Report"
Doctor's Behaving Badly - Part 2 - Steve Balt MD, Editor of the "Carlat Psychiatry Report"

As a follow up to the last post - I thought readers might be interested in how this story has moved forward....as Dr. Balt has gone from a top prescription writer of the anti-psychotic drug Seroquel investigated-by-senator-grassley-top-10 to this recent report by Pro Publica showing Dr. Balt as now a top prescription writer for the anti-psychotic drug ABILIFY 

 (Now, I'm sure that being married to a BMS drug rep has nothing to do with this change in prescribing habits whats so ever right! **wink wink**)

One has to seriously wonder how a doctor with Dr. Balt's checkered criminal past and self created KOL (key opinion leader) want-2-be status; is not being investigated by the California Medical Board, and Federal Governments Medicare fraud task force?

Shall we have to be reminded of the real human suffering & consequences paid by these kinds of "Doctors Behaving Badly"
 Just in case you have forgotten, Please follow the link below as a reminder - Medicare Drug Program Fails to Monitor Prescribers, Putting Seniors and Disabled at Risk - http://www.propublica.org/article/part-d-prescriber-checkup-mainbar

Side Note:

Dr. Balt posted this Mea culpa http://thoughtbroadcast.com/2013/01/04/if-medications-dont-work-why-do-i-prescribe-them-anyway/ on January 4th, 2013, before riding off into the private practice underground sunset.....Call me a skeptic if you like, but I have a really hard time buying anything Dr. Balt writes or says...what do you think?


***For Readers: I do not plan on coming back here to post regularly. I fought this losing up hill battle here on these pages for long enough...Though I may come back every so often if I feel so inspired...basically this blog remains here as a resource for those that will pick up the gauntlet to move forward in this worthy endeavor.

 I would to thank all my readers over the years for their support of this blog...even when it got stuck in their throat...don't choke on it***

Monday, April 23, 2012

Steve Balt Editor of the "Carlat Psychiatry Report" threatens Robert Whitaker "Mad In America" with legal action over reader comment

Steve Balt MD, Editor of the "Carlat Psychiatry Report" threatens Robert Whitaker "Mad In America" with Legal Action over a reader comment

Steve Balt, a 4th year psychiatric resident has jumped on the legal intimidation bandwagon by ushering in legal threats to "Mad in America" blog & Robert Whitaker over an opinion comment that was left at the popular mental health advocacy blog.

This Following Comment: Which was retracted & deleted until further notice from the post comment section @ Mad In America Blog Why We Still Need Psychiatrists


Mad in America "Stan" deleted comment:

I find it incredibly hypocritical & quite sad that "MAD IN AMERICA" blog is choosing to edit and delete comments that state relative facts and commentary directly related to the topic being discussed.

I also happen find this eye opening in light of "Mad In America" giving a sounding board & platform to doctors who are ethically corrupted; acting as apologist and cheerleaders for the institutionalized psychiatric establishment of today.

Though, I serious doubt Bob personally edits, or is directly involved with the everyday operations of this blog. I would have to submit that deleting factual comments & opinions runs contrary to the blogs implied mission.

The unfortunate reality is: who ever is charged with editing or over seeing content on this blog appears to be acting with a selective & ingrained personal bias which detracts from it's stated purpose of an open and honest dialogue.

I will not hide or back away from my personal opinion that those using "Victimology" as their life narrative are actually acting as a hindrance to any positive change coming to this unapologetic, brutal, & failed psychiatric modality moving forward.(you can push your own PAY PAL buttons to that one my censorship friends) 

These few self ordained patient experts are doing both themselves and this movement a grave disservice. They avoid truth & facts with tainted personal innuendo, while replacing open conversation/debate with their own very limited and ignorant close minded rhetoric.

These are the very people that hide behind members only censorship walls do to their unwillingness to have honest debate, or to ask the critical & uncomfortable questions related to the pharmaceutical industry, spokesperson psychiatrist, and failing psychiatric treatment modalities of today. This appears to be manifested in their on going fear of any & all issue related to conflict. My honest question to them is; WHAT ARE YOU RUNNING & HIDING FROM? 

I again will report the BALT comment..as Balt came here as a practicing doctor (not a patient) commenting/acting as a psychiatric apologist and defender of the status quo: his record and history should be known & considered fair game to expose as a factual backdrop to understanding where his opinions are derived...


"I find Steve Balt’s comment somewhat confusing…as a 4th year resident psychiatrist with a checkered past & record whom is now editor of “The Carlat Report”…

It is not true that you are actually married to Pharma in the form of a BMS sales person; one whom you dated for years prior to marriage, who you met professionally at an Oakland treatment clinic that was on her sales route while you were a practicing residence psychiatrist there..

Is it not true that you have consistently tried to hide & deflect away from documented public record & article regarding your personal actions & the findings of the medical board in the state of California…

 http://publicdocs.mbc.ca.gov/pdl/mbc.aspx then type in Balt as last name…eye opening information - "Medical license suspended"

Or how that public record information jives with the Heisel article series/interview featuring Balt "Doctors with addictions left hanging as diversion program dies"

Isn’t it also true that you are an active member of the APA with that terrible leadership you drone on about…and that you are attending the APA national convention in Philadelphia this year…

So while your inside hobnobbing it with that coined misled leadership, listening to the same KOL’s mislead the profession with continued corrupted nonsense, & are attending the many sponsored gala events…

The true advocates for change, truth, and accountability will be outside the convention halls in the streets making their voices heard…

I think people should know the person behind the MD who is beating this nice sounding two headed drum while at the same time being very careful not to offend that institutional medicine side of the fence…that is no doubt a very fine line that you’re walking…

I happen to believe in full professional disclosure & then letting people judge for themselves who they wish to trust…how about you Steve Balt?"


...I'm quite sure this comment will be deleted once again...Is that what "MAD IN AMERICA" is all about...if so, they have certainly lost one reader & supporter...

I wonder what Bob thinks about this situation? Guess I'll have to write him & find out!



 I wrote Robert Whitaker to ask about why the comment was being censored and found out that Balt had sent him an email that said "He wrote stating that the comments were slanderous and false, and that he was contacting his attorney"

I will now go through this comment point by point in this post, & let you the reader judge for yourself if there is anything inaccurate, slanderous, or falsehoods in the comment/opinion that was left on the Mad In America Blog that would merit Steve Balt using sleazy intimidation methods and legal threats to stifle free speech & opinion regarding his actions, record, and possible COI.

1. "I find Steve Balt’s comment somewhat confusing…as a 4th year resident psychiatrist with a checkered past & record whom is now editor of “The Carlat Report”…


Steven Balt, MD
Cornell University Medical School

 I'll get to that checkered past & record soon enough....

2. "It is not true that you are actually married to Pharma in the form of a BMS sales person; one whom you dated for years prior to marriage, who you met professionally at an Oakland treatment clinic that was on her sales route while you were a practicing residence psychiatrist there.."

 audrey steven.our wedding at the time this information was gathered, the site needed no password...making it an open public doc.for viewing


How we met

"We met at the Schuman Liles clinic in Oakland.  It's not the most romantic place in the world to meet your future love, but as the saying goes " you never know when you'll meet that special someone..."
For almost 2 years we were just two people who would discuss business with each other at the clinic.  However, in September of 2009, we started to connect by way of email and eventually built a close friendship.  From there the rest is history. "

"Favorite Memory with Steven: Our first "meeting" out of the office.  This is when I first knew I was going to fall in love" this man...."

"When it happened

Tuesday, May 17, 2011

How we got engaged

In May of this year, Steven and I traveled to Hawaii for the annual American Psychiatric Association meeting.  On Tuesday evening he took me to a wonderful restaurant in Waikiki called Orchids for dinner. We dined on sensational Hawaiian food and enjoyed good wine.  After dinner he took me for a walk along the beach where he took me in his arms and asked me if I would marry him.  Of course I said yes!"

"Career: I've been in pharmaceutical sales for almost 12 years."

Oh Yes, the clinic where they met: Schuman Liles Clinic

Interesting a clinic for the "poor" has a board stacked with pharmaceutical sales people. Makes me wonder what drugs do they prescribe most often while billing medical & medicare?
It brings questions to mind when Balt writes articles such as the below screen shot on his blog without disclosing possible COI

 3. "Is it not true that you have consistently tried to hide & deflect away from documented public record & article regarding your personal actions & the findings of the medical board in the state of California…
 http://publicdocs.mbc.ca.gov/pdl/mbc.aspx then type in Balt as last name…eye opening information - "Medical license suspended"
 Or how that public record information jives with the Heisel article series/interview featuring Balt "Doctors with addictions left hanging as diversion program dies""

22 pages of worthwhile reading in this doc.

recent reinstatement doc.

first in a series of articles
Audrey failed to mention that she was Balt's BMS drug rep. in this apologist comment. Of course we also know she would become Balt's wife.

followed by these interviews that you can cross compare to the California Medical Board doc.

4. "Isn’t it also true that you are an active member of the APA with that terrible leadership you drone on about…and that you are attending the APA national convention in Philadelphia this year…

So while your inside hobnobbing it with that coined misled leadership, listening to the same KOL’s mislead the profession with continued corrupted nonsense, & are attending the many sponsored gala events…

The true advocates for change, truth, and accountability will be outside the convention halls in the streets making their voices heard…"

Okay, you might have a tiny complaint here...though you have a documented record & history of attending APA convention events...I took a huge leap by making an assumption in an blog opinion comment section that you are an active APA member...please correct me if I'm wrong with that assumption... 

5. "I think people should know the person behind the MD who is beating this nice sounding two headed drum while at the same time being very careful not to offend that institutional medicine side of the fence…that is no doubt a very fine line that you’re walking…

I happen to believe in full professional disclosure & then letting people judge for themselves who they wish to trust…how about you Steve Balt?"

Now this last part of the comment was stating a personal opinion related to the topic in discussion. & asking pertinent questions? Of course Balt did not come back to the comment section to respond to my comment. instead he wrote Robert Whitaker calling my comment  slanderous and false, and you were contacting your attorney.

Well,  I believe I have shown here that in fact my comment was based in factual content & research. Why are you Steve Balt Editor of "The Carlat Psychiatry Report" using sleazy intimation methods and legal threats against Robert Whitaker & the Mad in America Blog?

What are you trying to hide Steve?

Please Stop by & leave a comment!

I will stand by my comment & the facts Steve Balt....I'll be waiting to hear from your lawyers with bated and breathless anticipation. Maybe one of your new relations by marriage (a federal judge) can give you some sound advice....

In closing I would just like to say "I'll drink to that"


Saturday, December 3, 2011

Sunday, August 21, 2011

Important AstraZeneca Seroquel Litigation Settlement Offer Rejection Update

Important AstraZeneca Seroquel Litigation Settlement Offer Rejection Update

As many of my faithful and regular reading already know...I try to make a earnest effort in keeping in the time honored tradition of providing important and breaking developments/happening related to the no so subtle & questionable deeds that have transpired in the pharmaceutical industry and in this case; AstraZeneca...

Today I would like to bring to your attention some very informative and important blogs or forums related to recent developments in the AstraZeneca Seroquel Lawsuits...so without further ado let me wholeheartedly recommend that you read the following blogs and forums to arm yourself with knowledge related to you and your loved ones health & safety...


soulful sepulcher blog has been all over this story for some time now.....don't miss her breaking news reports, informational scoops, and thoughtful commentary related to these matters...

Quote: AstraZeneca "Made patients into guinea pigs in an unsupervised drug test"-Michael Levy
Diabetes from taking antispsychotic Seroquel: CDC stats on life with diabetes

$5967.00 for a lifetime body damage - diabetes settlement: Exclusive documents from the Seroquel Lawsuit Blog --AstraZeneca payout equals chump change

and so many more writings you are sure to enjoy...


Seroquel Lawsuit Blog

                                                     Hat Tip to Seroquel Lawsuit Blog for photo

This blog contains so much information/links/facts/documents directly related to this litigation and much more pertaining to the sordid story behind the Seroquel crimes. You could easily spend a few days consuming the wealth of information it provides..


In the News: from Reuters



Finally, to balance things out and add a dose of satirical humor into the mix..

There is Topix Seroquel Lawsuit Forum 

Here is a small smattering sample of the nonsensical insightful bantering this forum may provide for your reading enjoyment:

We need to keep this forum scrolling along based on the spammer contractual agreement creed code page 453 paragraph 3 line 6.

"always revert to the spammer sworn by laws which state when you don't have or can win an argument; just keep the conversation moving along...remember if you can beat the message...slay the messenger" :)"

 "AZ reached private deals with plaintiffs firms that controlled big Seroquel dockets, offering token amounts of money to plaintiffs in exchange for their lawyers agreeing to drop out of the litigation."


Your life, Your injury, Those life long conditions you must burden including diabetes, related conditions, and even death caused by AstraZeneca's Seroquel are worth but a mere TOKEN....not a fair amount...not anything close to justice....no admission of any wrong doing by AstraZeneca...and as an added bonus your silence is bought for this mere TOKEN in the process...

If you really feel your life is worth a mere TOKEN...if all those years you have suffered waiting upon justice to do "DO THE RIGHT THING" is worth a mere TOKEN....then by all means, jump all over this settlement...

There is no more debate, hiding the facts, or smoke & mirrors platitudes now...your life without a shred of doubt has been placed on the litigation discount bargain rack....Price: a mere TOKEN

For a mere TOKEN...AstraZeneca & these many law firms walk away handsomely rewarded and confident they can continue this criminal "Business as Usual" model.

Look at the facts...look at the numbers....look in the mirror....Do you see a mere TOKEN peering back at you....or do you see a worthy dignified human being worthy of respect and justice...

Contrary to what "others" are telling you here; you (the injured party) get to decide whether this mere TOKEN serves your "Best Interest".

The spam parade crew will continue their "SELL THE SETTLEMENT' propaganda campaign right after this important message & words from are forum sponsor....

"do you feel like a cloud of depression is following you around....do you maybe sometimes feel a little anxiety when making public speeches in front of large ruckus crowds....maybe that other series of potent & dangerous antidepressant drugs you have been taking aren't making you feel absolutely perfect and better than good....that's why we want you to ask your doctor for PoisonXR....proven to be no more effective than a placebo in clinical studies...insert quiet sedative background music: this is usually the section where we tell all about PoisonXR's nasty & debilitating side effects, but that might just make you feel depressed or anxious...so just try PoisonXR....and roll the dice for yourself..."

We now resume regularly scheduled spam wars programing....

Was just sitting here waiting on the edge of my seat for the packet to arrive and spending some quality time watching the setting spammer trolls roll in...LMAO....wonder when that damned packet will arrive....My packet is going to be better than your packet you know...BPB is going to give me a much better packet than all the others packets you know....I heard it will come soon...now I'm just dreaming about all the great stuff I can buy when my packet arrives....I may have to knit me up one of those padded packet jackets to hold my wondrous packet....I called (where in the world is) Carmen Sandiego over at the BPB client assistance and Fred's Pizza delivery service answer line...I was assured for the 17th time this year my packet was being delivered to me ASAP by a personal limousine service.

They said it would come in an expensive Italian leather bound packet holder embossed with 14 carat gold lettering...I'm sure this will be the day it will arrive...in fact I'd bet my failing pancreas and high glucose level on it...I figured since I'm here in such hopeful spirits, I'd just repost a little truth while I was waiting with baited & breathless anticipation...thanks for asking & being concerned about my precarious packet predicament...
Great Packet News

GREATS NEWS!! I was sitting here in my easy chair motorized entertainment center that I obtained in a legal settlement with an unnamed or con I mention boat manufacturer due to confidentiality agreement I signed onto more than decade ago. Though I am allowed to reveal it was a horrible fishing accident where a great white shark leaped over an obviously defective railing and bit my damned legs off.

I was able to retain some highbrow-ed ligament legal counsel in that particular case because of the huge settlement I received from an undisclosed and confidential vacation package corporation suit settled over a horrible & maliciously irresponsible incident that transpired while I was traveling through the outback in Australia when out of preventive no where a wild Dingo ate my Baby...

OH Yeah, back to the GREAT NEWS...I was looking out the window when I caught the glimpse of a shiny brand new limousine with balloons and confetti ejecting from the sunroof headed my way from off in the pristine distant...

Well in a lick-a-Ty split second I popped in my glistening white teeth that I had received in an employment injury settlement from a unnamed confidential behemoth multinational candy manufacturing corporation where I was a taste tester. They should have warned me that stuff could have cavity side effects related the suffering loss of my treasured chompers.

So anywho, I hooked up my chair super charger and headed out to the road in front of my glorious double wide abode to greet them from the middle of the HWY...

In no time at all you could hear the magical sound of screeching tires and the sweet smell of burning rubber inches from my statuette joyous pose in anticipation of an incredible and long overdue packet arrival.

Yet, to my sad dismay and tremendous disappointment...the limo was just full of lawyers and scantly clad harlots off for a wild night out on the town celebrating some huge settlement victory they just won over a bunch of ambulance chasers adversaries and as they stated laughingly "Pathetic Chump Losers" that they also revealed were pharmaceutical drug victims or something to that effect...

At that moment, to be quite honest...I felt my very gizzard sink into the howling bowels of my suffering reality...

But just when all appeared lost; a disdainful melody of cheap boom box chiming Christmas music was heard in faint distinct. I knew from prior litigation experience and a confidential settlement agreement with this particular company over some bad product temperature control procedures and inflicted emotional distress this had to be no other than Handy Dandy Mike's Tricycle ice cream vender and newspaper delivery service headed my way.

Yes Sir, I was absolutely correct as that Tricycle headed straight toward me as I scooter-ed my way up to the front porch to join my faithful one eyed dog “Uni-corn”… who just so happened to have suffered the loss of his eye from an unprovoked altercation with the neighborhood Tom Cat named “PUSS” a few years back…. In that particular litigation myself and the dog settled out of court for a hefty undisclosed and confidential amount…..

Anywise, Handy Dandy Mike road on by at top peddling speed while flipping me a nice gesture greeting bird and threw a crumpled up wad of ice creamed stained papers in close proximity to my now missing feet….

Well low and behols...it was my danged Packet! May Glory be to God, and the Litigation Almighty @ BPB headquarters; my day had been made whole, fulfilled, brimming over with Halleluiah jumping beans joy, and free of all immediate burdens….

Now what to do?

Says right here I have 3 hours from the time the Packet was tossed at me to return this document signed and notarized to be part of this settlement agreement monopoly

Coming soon in Part 2 of GREAT PACKET NEWS

SIDE NOTE: AstraZeneca embroidered crying towels will be distributed at the end of this heart wrenching and touching true cross my toes story...


Word sure does spread like a wild fire in a hornets nest around these parts. before you could shake a crooked stick, all my Grifter neighbors (GregloryWV, Myra SmCoxx, Paddy Cakes, Billy Bob RR Jerkins, Snake Oil Sam SPAM , David Brinnen CEO, & Ambulance Chaser Baily Barnum & Baily LLC ) where knocking down my door wanting to celebrate my newly discovered dubious good fortune.

All of my law-challenged friends, neighbors, and cohorts were also mysteriously & magically involved intimately in this & many other related pharmaceutical litigation matters (call it Karma, Kismet, Kermit, a gravitational paradox, or just some parole office chatter the has brought this Mary Sunshine band of misfits together).

Anywho, this loving, supportive, & nurturing factious extended family of various legally falsified documented SSDI verified and constitutionally protected second class citizens were bubbling over with enthusiasm to find out what my newest lotto prize winning settlement entailed.

As I swiftly scurried about tidying up & hiding away any pertinent & important valuables that weren’t other wise nailed or screwed down that might offer subsequent pilfering opportunities during this gleeful atmospheric gathering of community conscience; We all sat around spending some quality time gleefully laughing & smiling to the crackling sounds of celebratory beer can pop tops opening, each pouring down a few eye watering fine jug shots of 99% pure moonbeam, and then munched away on various bags and boxes of scrumptious diabetic FDA approved snack foods.

So without further mountain a dew suspense…I proceeded to UN-crumple the packet envelope fully intending to unveil my “Praise be to the almighty whatever” Packet offer information.

Then all the sudden it occurred to me like momma beating me over the head with a wooden spoon or experiencing a unfortunate super sized “Depend” accident moment, that I was still under the omni puss (or was that octopus) of an unspecified confidentially clause undetermined in this implied pycho-babble legalized retention syndrome speak cover-up document.

Of course being the conniving bastard SOB that I am purported and unconfirmed to be; I knew there was little doubt I could subvert the implied intentions of this keep your damned lips zipped covenant, and proceeded to share in board undesirable context the parameters of my settlement tally with everyone….
So here it is Folks….


stay tuned - to be continued in Part 3


I’m getting way more than you…. In fact that $39.99 some of you out there having been crowing like a dawn rooster about or your reported $3999.00 under cooked fried chicken offer… that isn’t even in the same ballpark or mud bog in relationship to my settlement offer…..

In undisputed fact my offer in much closer to the total accumulated debt of the United Corptopian States of America, than it is to that poultry figure y’all having been tossing around like you were making love to somebody elses' wife/husband or related mammalia species ….

So take that & smoke in your crack pipe or other related crack Orpheus or Orifice.

In a futile attempt at rapping up this important presentation of unverified pertinent shared information here; and after pushing the last drunken carcass off my porch out unto the yard weeds & other strewn paraphernalia; I sat down to ponder in short order & within the constricted settlement return time frame what the heck in tar nation was I going to dew.

So I decided to roll my easy chair be-hide my abode to my self contained temple of spiritual enlightenment & converted cold war bomb shelter to pray/chant/meditate before an accumulation of shrines, idols, religious artifacts, and wee gee boards related to all the popular denominations of spiritual guidance available in today’s crazy consortium of faith based pandemonium.

As I pondered the settlements I had received in prior litigation related to the lead poisoning and asbestos contamination from this poorly constructed spiritual facility of sanctimonious bull plucky. I knelt humbly and hillbilly before the sacrificial alter of all known wisdom; time honored historical indoctrination, and the all mighty one and only God, or similar facsimiles of the aforementioned stated deities for guidance.

Who would of thunk that in a million eons the Good Old Boy sitting on that pearly gated Throne of all predetermined fate and destiny would be listening to inconsequential me…

The “MAN” appears to me in a vivid kaleidoscope flaming vision of such overwhelming magnitude that I was frozen in awe struck earth shattering interest & attention.

The soulful vision directed me to immediately discard all my evil ways and reject blood money of evil and nefarious intent…...

to go on a pilgrimage across this land…and burn this demon inspired “Packet” document at the steps of AstraZeneca headquarters located in Wilmington Delaware, and declare before all mankind and the sub-species of corporate board members that God has instructed them in no uncertain or negotiated terms to “LET MY PEOPLE GO”.

So for now or until another all consuming Deity comes along with an alternative opinion, option, or concrete uncompromising demands; I must in all good conscience REJECT THIS OFFER, based on doing the right thing… based on the greater good, health, and safety of all people…

THE END or just the beginning...

Now, back to your regularly scheduled spammer programming…

Friday, August 12, 2011

Wednesday, July 13, 2011

America, a Nation Hooked on Anti-Psychotics - how did we allow this to happen?

America, a Nation Hooked on Anti-Psychotics - how did we allow this to happen?

Hat Tip pharmagossip via english.aljazeera.net

Has America become a nation of psychotics? You would certainly think so, based on the explosion in the use of antipsychotic medications. In 2008, with over $14 billion in sales, antipsychotics became the single top-selling therapeutic class of prescription drugs in the United States, surpassing drugs used to treat high cholesterol and acid reflux.

Once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses - primarily schizophrenia and bipolar disorder - to treat such symptoms as delusions, hallucinations, or formal thought disorder. Today, it seems, everyone is taking antipsychotics. Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics. Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.

It is anything but a coincidence that the explosion in antipsychotic use coincides with the pharmaceutical industry's development of a new class of medications known as "atypical antipsychotics." Beginning with Zyprexa, Risperdal, and Seroquel in the 1990s, followed by Abilify in the early 2000s, these drugs were touted as being more effective than older antipsychotics like Haldol and Thorazine. More importantly, they lacked the most noxious side effects of the older drugs - in particular, the tremors and other motor control problems.

The atypical anti-psychotics were the bright new stars in the pharmaceutical industry's roster of psychotropic drugs - costly, patented medications that made people feel and behave better without any shaking or drooling. Sales grew steadily, until by 2009 Seroquel and Abilify numbered fifth and sixth in annual drug sales, and prescriptions written for the top three atypical antipsychotics totaled more than 20 million. Suddenly, antipsychotics weren't just for psychotics any more.

Not just for psychotics anymore

By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. "Psychiatrists are particularly targeted by Big Pharma because psychiatric diagnoses are very subjective," says Dr. Adriane Fugh-Berman, whose PharmedOut project tracks the industry's influence on American medicine, and who last month hosted a conference on the subject at Georgetown. A shrink can't give you a blood test or an MRI to figure out precisely what's wrong with you. So it's often a case of diagnosis by prescription. (If you feel better after you take an anti-depressant, it's assumed that you were depressed.) As the researchers in one study of the drug industry's influence put it, "the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence." For this reason, they argue, it's particularly important that the guidelines for diagnosing and treating mental illness be compiled "on the basis of an objective review of the scientific evidence" - and not on whether the doctors writing them got a big grant from Merck or own stock in AstraZeneca.

Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: "Psychiatrists are in the pocket of industry." Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association's most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.

In a recent article in The New York Review of Books, Angell deconstructs what she calls an apparent "raging epidemic of mental illness" among Americans. The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children." Under the tutelage of Big Pharma, we are "simply expanding the criteria for mental illness so that nearly everyone has one." Fugh-Berman agrees: In the age of aggressive drug marketing, she says, "Psychiatric diagnoses have expanded to include many perfectly normal people."

Cost benefit analysis

What's especially troubling about the over-prescription of the new antipsychotics is its prevalence among the very young and the very old - vulnerable groups who often do not make their own choices when it comes to what medications they take. Investigations into antipsychotic use suggests that their purpose, in these cases, may be to subdue and tranquilize rather than to treat any genuine psychosis.

Carl Elliott reports in Mother Jones magazine: "Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003." And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

A remarkable series published in the Palm Beach Post in May true revealed that the state of Florida's juvenile justice department has literally been pouring these drugs into juvenile facilities, "routinely" doling them out "for reasons that never were approved by federal regulators." The numbers are staggering: "In 2007, for example, the Department of Juvenile Justice bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children…That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day." Further, the paper discovered that "One in three of the psychiatrists who have contracted with the state Department of Juvenile Justice in the past five years has taken speaker fees or gifts from companies that make antipsychotic medications."

In addition to expanding the diagnoses of serious mental illness, drug companies have encouraged doctors to prescribe atypical anti-psychotics for a host of off-label uses. In one particularly notorious episode, the drugmaker Eli Lilly pushed Zyprexa on the caregivers of old people with Alzheimer's and other forms of dementia, as well as agitation, anxiety, and insomnia. In selling to nursing home doctors, sales reps reportedly used the slogan "five at five"—meaning that five milligrams of Zyprexa at 5 pm would sedate their more difficult charges. The practice persisted even after FDA had warned Lilly that the drug was not approved for such uses, and that it could lead to obesity and even diabetes in elderly patients.

In a video interview conducted in 2006, Sharham Ahari, who sold Zyprexa for two years at the beginning of the decade, described to me how the sales people would wangle the doctors into prescribing it. At the time, he recalled, his doctor clients were giving him a lot of grief over patients who were "flipping out" over the weight gain associated with the drug, along with the diabetes. "We were instructed to downplay side effects and focus on the efficacy of drug…to recommend the patient drink a glass a water before taking a pill before the meal and then after the meal in hopes the stomach would expand" and provide an easy way out of this obstacle to increased sales. When docs complained, he recalled, "I told them, ‘Our drug is state of the art. What's more important? You want them to get better or do you want them to stay the same--a thin psychotic patient or a fat stable patient.'"

For the drug companies, Shahrman says, the decision to continue pushing the drug despite side effects is matter of cost benefit analysis: Whether you will make more money by continuing to market the drug for off-label use, and perhaps defending against lawsuits, than you would otherwise. In the case of Zyprexa, in January 2009, Lilly settled a lawsuit brought by with the US Justice Department, agreeing to pay $1.4 billion, including "a criminal fine of $515 million, the largest ever in a health care case, and the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind,''the Department of Justice said in announcing the settlement." But Lilly's sale of Zyprexa in that year alone were over $1.8 billion.

Turning people into zombies

As it turns out, the atypical antipsychotics may not even be the best choice for people with genuine, undisputed psychosis.

A growing number of health professionals have come to think these drugs are not really as effective as older less expensive medicines which they have replaced, that they themselves produce side effects that cause other sorts of diseases such as diabetes and plunge the patient deeper into the gloomy world of serious mental disorder. Along with stories of success comes reports of people turned into virtual zombies.

Elliott reports in Mother Jones: "After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

Bottom line:Stop Big Pharma and the parasitic shrink community from wantonly pushing these pills across the population.

by James Ridgeway

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