United States

How Kids Are Getting Hooked on Pills for Life

By Evelyn Pringle and Martha Rosenberg

Where do parents and teachers get the idea there’s something wrong with kids that only an expensive drug can fix? From Big Pharma’s seamless web of ads, subsidized doctors, journals, medical courses and conferences, paid “patient” groups, phony public services messages and reporters willing to serve as stenographers.

Free stenography for Pharma from sympathetic media includes articles like “One in 40 Infants Experience Baby Blues, Doctors Say,” on ABC News1 and “Preschool Depression: The Importance of Early Detection of Depression in Young Children,” on Science Daily2.

For many, the face of the drugs-not-hugs message is Harold Koplewicz, author of the pop bestseller It’s Nobody’s Fault, and former head of NYU’s prestigious Child Study Center. In a 1999 Salon3 article, Koplewicz reiterated his “no-fault” statement, assuring parents that psychiatric illness is not caused by bad parenting. “It is not that your mother got divorced, or that your father didn’t wipe you the right way, he said. “It really is DNA roulette: You got blue eyes, blond hair, sometimes a musical ear, but sometimes you get the predisposition for depression.”

Many regard the NYU Child Study Center, which Koplewicz founded and led before leaving in 2009 to start his own facility, as helping to usher in the world of brave new pediatric medicine in which children, toddlers and infants, once expected to outgrow their problems, are now diagnosed with lifelong psychiatric problems. The Child Study Center is “a threat to the health and welfare of children,” and its doctors are “hustlers working to increase their ‘client’ population and their commercial value to psychotropic drug manufacturers,” charged Vera Sharav,4 president of the watchdog group, Alliance for Human Research Protection.

A look at the center’s stated mission5 provides no reassurance. Its goal of “eliminating the stigma of being or having a child with a psychiatric disorder,” and “influencing child-related public policy,” sounds a lot like a Pharma sales plan. And its boast about having “a structure that allows recruitment of patients for research studies and then provides ‘real-world’ testing for successful controlled-environment findings,” could send chills down the backs of parents afraid their kids will be guinea pigs or money-making subjects.

In 2007, the fears of the Child Study Center’s skeptics were confirmed when it launched an aggressive, scare tactic marketing campaign called Ransom Notes in 2007. “We have your son,” said one ad6, created with bits of disparate type like a ransom note from a kidnapper. “We will make sure he will no longer be able to care for himself or interact socially as long as he lives. This is only the beginning…Autism.”

“We have your daughter. We are forcing her to throw up after every meal she eats. It’s only going to get worse,” said another ad signed “Bulimia.”

“We are in possession of your son. We are making him squirm and fidget until he is a detriment to himself and those around him. Ignore this and your kid will pay,” said another add from “ADHD.” Other ransom ads came from kidnappers named Depression, Asperger’s Syndrome and OCD.

Created pro bono by advertising giant BBDO, the ads were planned to run in New York magazine, Newsweek, Parents, Education Update, Mental Health News and other publications and on 11 billboards and 200 kiosks, according to the press release.7

Immediate outrage

The hostage campaign drew immediate public outrage and more than a dozen advocacy groups joined together in an online petition calling for an end to it. “This is a demonstration of the assaultive tactics used by psychiatry today—in particular, academic psychiatrists and university-based medical centers that are under the influence of their pharmaceutical partners,” Vera Sharav wrote in alerts to AHRP’s mailing list. “If Dr. Koplewicz et al. are not stopped, the campaign will be hitting the rest of the country,” she warned, and informed readers that the campaign was formulated by BBDO, “a major direct to consumer prescription drug advertising firm,” asking the New York State Attorney General’s office to investigate.

Days after the backlash, the center revoked the advertising campaign “after the effort drew a strongly negative reaction,” reported8 the New York Times. Koplewicz told the Times the decision was made by the center with no pressure from New York University and they planned to introduce a new campaign in the next three months. However, he left the Child Study Center at NYU in 2009 to start his own facility, initially called the Child Study Center Foundation, but changed to the Child Mind Institute, in 2010.

There was more controversy when Koplewicz left the center. When he announced his resignation, New York University “forbade him from entering his office and it pushed out professors who had said they wanted to join him at Child Mind Institute,” reported the New York Times 9. Twelve NYU professors nevertheless followed Koplewicz to the Child Mind Institute as well as most of the Child Study Center’s influential board of directors, which included Garber Neidich, a chairwoman at the Whitney Museum, the founders of the Tribeca Film Festival and some well known financiers. The toxic send-off was followed by the New York State Office of Mental Health firing Koplewicz10 from his job of nearly four years as director of the Nathan Kline Institute for Psychiatric Research, an affiliate of NYU School of Medicine.

Though Koplewicz’ Child Mind Institute is supposedly a non-profit, it is ensconced on Park Avenue in Manhattan and Koplewicz’ hourly rate “can be as high as $1,000 (three to four times that of the average Manhattan therapist),” says the Times. In a chilling interview on Education Update Online11, Koplewicz says the reason his institute works closely with schools “is simply that’s where the kids are” (bringing to mind Willy Sutton, who robbed banks because “that’s where the money is.”)

Last month (September) in the Wall Street Journal,12 Koplewicz wrote that “no studies have examined the effect of long-term use” of ADHD meds, but they “have been in use for 70 years, and there is no evidence that suggests any adverse effects.” But there has been a large federal study of the long-term effects of the drugs and it shows they are “ineffective over longer periods,” and “that long-term use of the drugs can stunt children’s growth,” reported the Washington Post.13 Oops.

Other pediatric drug proponents

Only one child in 10,000 has pediatric schizophrenia—some say one in 30,000—but for Pharma it is an untapped market. Symptoms of childhood schizophrenia include “social de?cits” and “delusions...related to childhood themes,” writes Gabriele Masi, in an article titled “Children with Schizophrenia: Clinical Picture and Pharmacological Treatment,” in the journal CNS Drugs.14 What child doesn’t have “social de?cits” and “delusions” like imaginary playmates?

Masi has received research funding from Eli Lilly, served as an adviser to the drug company Shire, and been on speakers’ bureaus for Sano? Aventis, AstraZeneca, GSK and Janssen, according to the American Academy of Child & Adolescent Psychiatry.15

Joining Masi in pursuing pediatric pathology is Joan L. Luby, director of the Early Emotional Development Program at Washington University School of Medicine in St. Louis. In an article in the Archives of General Psychiatry, she alerts the world to the problem of “preschool depression.”16 Researchers used to believe that “young children were too cognitively and emotionally immature to experience depressive effects,” says the paper, which was widely picked up the mainstream press, but they now believe preschoolers can and do suffer from major depressive disorder (MDD). “The potential public health importance of identi?cation of preschool MDD is underscored by the established unique ef?cacy of early intervention during the preschool period,” says the article.17 Translation: Big Pharma can clean up if kids are diagnosed young.

Luby “has received grant/research support from Janssen, has given occasional talks sponsored by AstraZeneca, and has served as a consultant for Shire Pharmaceutical,” according to a journal article she co-wrote.18

Then there is Mani Pavuluri, a doctor who ?nds deficiencies of mania and bipolar drugs in tots. “Pediatric bipolar disorder (PBD) is complex illness with a chronic course, requiring multiple medications over the longitudinal course of illness, with limited recovery and high relapse rate,” she wrote in the journal Minerva Pediatrica last year.19 Pavuluri receives research dollars from GlaxoSmithKline20 as well as from the National Institutes of Health, aka our tax dollars, according to the Journal of the American Academy of Child & Adolescent Psychiatry.

Two features that characterize the pediatric medicine practiced by the NYU Child Study Center, Koplewicz, Mani, Luby and Pavuluri are they term the “diseases” they identify undertreated and underdiagnosed and they urge early treatment when symptoms first appear. (Before the symptoms go away on their own?)

Yet the very fact that such diseases are lifelong conditions is reason to wait to medicate, said Mark Zimmerman, director of outpatient psychiatry at Rhode Island Hospital at the 2010 American Psychiatric Association annual meeting in New Orleans.21 Nor can parents with medicated children know if their kids even needed the drugs, since symptoms from the drugs are often called the “disease,” says Peter Breggin in a recent interview.22

One thing doctors on both sides of the pediatric drug controversy agree on is that the decision to put a child on drugs will likely sentence him or her to a lifetime of medications. What they disagree about is whether that is a good thing or a bad thing. 

AlterNet, October 18, 2012