By Steven Francesco
Reviewed by Edward Opton, PhD, JD
Don’t peek. Can you guess the occupation of the author of these paragraphs?
[The] marketplace . . . is rife with financial and ethical conflicts of interest as well as, unfortunately, sloppy science . . . . increased . . . demand for pharmaceutical intervention . . . . [and] insurance . . . schemes that reward the medication approach.
The “invisible hand” of the market has pushed the toxic children’s mental health industry toward a single-minded medication-only approach with drugs that are largely ineffective and have horrible side effects. The invisible hand has caused pandemic overmedication and a corresponding gross undertreatment by squelching alternative therapies. There is a large and growing body of literature on the ineffectiveness and dangers of psychiatric drugs for children, written by great professionals, and researchers. Quite tragically, families are experiencing far fewer therapeutic alternatives to medication, and more coercion from schools to medicate. Many “old-school” doctors are even being pressured by the insurance companies to reduce [non-drug] therapy . . . .
Meanwhile, the drug and insurance companies are profiting at amazing levels, as are some doctors. There needs to be a pushback.
No, the author is not Peter Götzsche, Joanna Moncrieff, David Healy, or any of the other usual suspects who speak truth to power in Madinamerica.com’s pages.
The author is former pharmaceutical company executive Steven Francesco. So far as we know, he is the first executive-level insider to confirm the charges that Madinameria.com’s correspondents and other critics have been making for years.
The story of how Mr. Francesco arrived at these insights is almost unbearably sad. His son, Andrew, suffered from an early age with complex, episodic, and severe behavior problems, problems that led to his expulsion from school after school. At one point his parents felt compelled to hide their kitchen knives. A succession of teachers and school officials insisted that he be medicated. A parade of psychiatrists backed them up. By the time Andrew was 15, his psychiatrists, schools, and parents required him to swallow several drugs a day. “We were willing,” his father writes, “to make riskier choices, with even more off-label attempts.” Andrew’s last psychiatrist prescribed 900 milligrams of the “antipsychotic” Seroquel, a dose 50% over the FDA-label-approved maximum adult dosage. Andrew suffered an attack of neuroleptic malignant syndrome. His heart stopped in the emergency room.
Most of the pages of this slim volume tell the story of Andrew and his family from his toddler days, through ever more drastic drug regimes, to his sudden and untimely death. Mr. Francesco tells the story well, describing not just Andrew’s problem behaviors, but also how the adults in Andrew’s life behaved: his parents, teachers, school administrators, therapists, and physicians.
Steven Francesco’s book is remarkable in multiple ways:
- He tells the painful story in plain English, not greyed-out by the abstractions of medical jargon.
- In Andrew’s case, inadequate funding was not an issue. His well-to-do family, blessed with executive-level insurance, spent lavishly on his treatment and education. He did not die because of not enough money, too few child psychiatrists, or too little special education. Andrew received the best that money could buy. Anyone who thinks that more generous government appropriations will remedy the problems of child psychiatry may reconsider while reading this book.
- Andrew’s problems were serious and long-lasting. There can be no guarantee that he could have lived independently, with or without medications. If Andrew’s doctors had reduced or discontinued the drugs, he might have functioned better, or worse, or the same. His family will never know. Andrew’s is not the mere story of “good lad, bad drugs.” It is a more honest story: severely troubled boy, expensive and aggressive medical efforts, some of which may or may not have helped, and, in the end, a gross and unforgivable overdose of a powerful antipsychotic, unfortunately not uncommon, and, in this case, fatal.
Will Steven Francesco’s indictment of the psychopharmaceutical industry be the first of a wave of revelations by retired industry executives? We can hope so.