This post was written by Dr Irene Campbell-Taylor, a former Clinical Neuroscientist and Assistant Professor of Medicine at the University of Toronto.
This phrase means, of course, to allow the little children but today I want to write about children who are suffering in the other sense. The word “patient” comes from the Latin patire, to suffer or to endure. The children I write of here are suffering what I can only call medical abuse. Anyone interested however marginally in controlling what Big Pharma is doing should watch the PBS program “The Medicated Child”.
We become outraged at the actions of pharmaceutical manufacturers that negatively affect young adults, the middle aged, and the elderly; but when one sees the pharmaceutical abuse of children, outrage takes on a whole new meaning.
The most striking thing about this program is, of course, the number of antidepressants and antipsychotics these children are given, often from toddler age. It is deeply disturbing to hear parents declare that they have become convinced that their child needs to be constantly drugged and will probably continue to need these medications for life. When one mother expresses concern about the effect these may be having on her child’s development, she is, politely but definitely, dismissed. It is even more distressing to hear a thirteen year old say that she has to take several medications because they “make me more like I’m supposed to be.” Who decides how she’s “supposed to be”? It is to weep.
Having worked for many years with children and adults who have developmental and/or cognitive impairments, I couldn’t help but be amazed at the physical signs and behavioural aspects that, in this film, are repeatedly missed by pediatricians and psychiatrists. In several of the children in the program, I would want to investigate the possibility of a genetic condition, the physical aspects are so clear.
The parents are, in a word, brainwashed. Over and over we hear that “if we stop the medications his behaviour returns, sometimes worse.” Have none of these physicians ever heard of withdrawal syndrome? To illustrate just how far this propaganda has spread, we hear that the schoolteachers are suggesting medications. And being listened to by parents.
The “tantrums”, aggression and self-harm that lead to this appalling medication cascade don’t seem to be examined for what they might actually represent. There are genetic conditions in which these are prevalent behaviours and require specific approaches, depending on the particular disorder. But let’s imagine we are three years old again and are afraid of something real or anticipate fear or feel pain that we can’t express. What are we going to do to get the message across? What if you’re three years old and have been abused? How might you react? I’m not suggesting that this is the case with any of the children in the program but I have seen a sufficient number of children who have been physically and sexually abused, at ages you probably wouldn’t believe, to keep it in the forefront as a possible explanation for behaviours that have been described as “oppositional”, “aggressive”, “violent” and so on but now are…BIPOLAR.
I hardly know where to begin. Bipolar disorder in adults is extremely rare and to have the arrogance to assert, on the basis of no evidence whatsoever, that it is common in children is staggering. It is probably possible to do as Dr. Biedermann has done, to take the signs of several disorders, overlap them, pick out those that occur in common and create a whole new disease.
It is important to note that Massachusetts General Hospital disclosed sanctions against Drs. Joseph Biederman, Thomas Spencer and Timothy Wilens for violating hospital ethics guidelines by failing to adequately report, internally, seven-figure payments they received from drug companies. The disciplinary actions include:
• They must refrain from “all industry-sponsored outside activities” for one year.
• For two years after the ban ends, they must obtain permission from Mass. General and Harvard Medical School before engaging in any industry-sponsored, paid outside activities and then must report back afterward.
• They must undergo certain training (type not specified).
• They face delays before being considered for “promotion or advancement.”
Each disclosed previously undeclared payments of over $1M each from pharmaceutical companies. It is inevitable that the integrity of their work has become, at best, questionable yet many psychiatrists and other physicians cling to the conviction that juvenile bipolar disorder is a real disorder probably because it gives them something to do about it – treat it with the same drugs they give to adults.
To proceed, with no supporting evidence, to prescribe ever-increasing dosages of powerful drugs, never intended for children is, in my opinion, malpractice including medical battery because who is capable of giving informed consent? Certainly not the child and the parents are not told that there’s no scientific evidence for any of this and we really don’t know what we’re doing. Informed consent is, I submit, impossible.
I am not even going to touch the theories around “abnormal amygdala”. It may very well be the case that there is an influence but even if there is, we are far from knowing what it means. Courchesne, many years ago, identified children who have what I insist on calling “true autism” as opposed to the “autistic spectrum disorders” now prevalent. He found that they were born with a part of the brain called the cerebellum smaller than normal. Similarly, persons with Down syndrome have abnormally sized parts of the cerebellum, but in different areas than in the person with autism. This is all very well but so far hasn’t led to effective treatment although in the future we may have some sort of breakthrough based on these initial findings.
There is, however, a growing reliance on MRI and PET scanning as though these were diagnostic instead of mere tools to aid in diagnosis. This month, in the American Journal of Psychiatry, we find a chilling report of the evaluation of “92 children who were at high risk for developing autism, because they had older siblings with the disorder. At age six months, the children underwent (MRI) imaging. Additional imaging data was obtained from most of the children at 12 months and/or 24 months old. Behavioral assessments were also performed at 24 months. Twenty-eight of the 92 children met the criteria for autism spectrum disorders at 24 months.” There are literally dozens of genetic abnormalities that carry the label of “susceptibility to autism” but from this report, I can’t see that any genetic investigation was conducted. The researchers apparently made the assumption that if an older sibling had one of the “autistic spectrum disorders”, the infant was at risk and, lo and behold, by age two, they were so diagnosed. Well, when you’re a hammer, everything looks like nail and, if you can increase the numbers of MRIs and, in turn, massively increase the probability of selling drugs on a scale never seen before, so much the better – except for the children, of course.
Now, let’s consider lithium as a treatment for bipolar disorder. When swallowed, lithium becomes widely distributed in the central nervous system and interacts with a number of substances. Lithium is known to be responsible for significant amounts of weight gain as do several of the antipsychotics such as olanzapine. Lithium also increases water output into the urine, a condition called nephrogenic diabetes insipidus. It increases appetite and thirst, and reduces the activity of thyroid hormone (hypothyroidism). And we give this to children. The recent discussion about mercury and arsenic as medications seems somehow connected. I hope that one day soon we will come to regard lithium given to children as a treatment with same disbelief that we now consider mercury, white lead and arsenic.
The adverse reactions to antipsychotics, antidepressants and similar medications are very clear in the young fellow called Jacob in the program. By age nine he was showing an unusual neck and head movement. The narrator refers to these movement disorders as “tics” and, while not accurate, serves as well as anything to describe abnormal muscle movement as a result of the drugs he was taking. In Jacob, the neck muscles are the ones most involved in that involuntary contraction of the muscles at the side, back and front of his neck cause his head to roll. Apparently, no-one has introduced a simple method of controlling this when it starts and that is to touch the chin or the back of the head gently when it is about to happen. This breaks the cycle. Of course, it should never have occurred in the first place and is entirely due to the antipsychotics he is ingesting like candy. The other effect the medications have had, is on his speech. He is dysarthric, that is unclear in articulation, a common side effect of antipsychotic medications. He is at increased risk of choking because of disruption of the muscles used for speaking and swallowing and this is something I find patients and parents are never told.
Fewer and fewer health professionals seem to learn about the multiplicity of ways in which one can identify and treat the behaviours that are identified in these children as “pathologic”. No-one seems to care about treating the child and not the “disease” or getting entire families into programs that will examine what factors, environmental, familial or genetic may be causing or maintaining the perceived problems. But, of course, as one pediatrician says,” When you see a new child every fifteen minutes….” We have allowed a very wrong turn in the assessment and treatment of all of us, at all ages for conditions that are too often misidentified and then, for want of knowing about anything else, dismissed with drugs that have unknown and untold effects on DNA, physical functioning and mood.
The prescription pad is the only thing doctors now have. As the little fellow in the film, asked why he is going to see Dr X, reply gleefully and accurately, “To get medicine!”