Heavy Pharma Funding Increasing Antipsychotic Prescriptions to Kids
A video exposing the extensive conflicts of interest between the American Psychiatric Association (APA) and the pharmaceutical industry was released in May 2008 on a new website—www.psychconflicts.com. It was launched to coincide with the 161st anniversary of the APA and its annual convention held in Washington, D.C. Widespread psychiatric drugging of children has become an increasingly contentious issue, with pharma-funded psychiatrists at the center of this. In particular, the drugging of foster care children was the subject of a May 8th Congressional hearing. Further, a study in the May issue of the journal Pediatrics that garnered international attention, found that American children take antipsychotic drugs at a rate of about six times that of UK children. And a January, 2008 New York Times (NYT) investigation revealed that “the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical [new] antipsychotics to children.”
The soaring increase in psychotropic drugs being prescribed to children in the United States is the result of the incestuous relationship between the APA, psychiatrists and the pharmaceutical industry—representing more than $10 million a year conflicts of interest. Government investigations into these conflicts are needed in every country.
Today, about 30% of the APA’s income derives from pharmaceutical industry advertising and nearly 20 drug companies in 2008 invested an estimated $3 million into the APA’s annual convention alone. Additionally, of the nearly 30 pharmaceutical industry-supported symposiums, speakers’ fees totaled an estimated $250,000. The APA has also made an estimated $40 million from sales of its Diagnostic & Statistical Manual of Mental Disorders (DSM), an “insurance billing bible” that pharmaceutical interests also potentially influence.
In 2006, a Psychotherapy and Psychosomatics study determined that 56% of psychiatrists on panels determining what disorders would be included in the DSM-IV had undisclosed financial interests in drug companies. Researchers also found that 100% of the psychiatrists on panels overseeing so-called “mood disorders” (which includes the lucrative “bipolar disorder”) and “schizophrenia/psychotic disorders” were financially involved with drug companies that manufacture the drugs prescribed for these conditions, the sales of which are around $40 billion a year worldwide.
Lisa Cosgrove, a clinical and research psychologist from the University of Massachusetts, Boston and co-researcher in the study reported that these disorders are not based on medical science: “No blood tests exist for the disorders in the DSM. It relies on judgments from practitioners who rely on the manual,” she stated.
In December 2007, U.S. News and World revealed that 19 out of the 27 task force members for DSM-V, due to be published in 2012, have financial ties to drug companies.
The January NYT investigation further found that psychiatrists earn more money from drug makers than doctors in any other specialty. In one state, Vermont, drug company payments to psychiatrists more than doubled from $20,835 in 2005 to an average of $45,692 in 2006. Antipsychotic drugs were among the largest expenses for the state’s Medicaid insurance program. On September 4, 2007, the NYT reported, “Drug makers and company-sponsored psychiatrists have been encouraging doctors to look for [bipolar] disorder.” The expanded use of bipolar as a pediatric “disorder” has made it the fastest-growing part of the $13.1 billion U.S. market for antipsychotics, reported Bloomberg News.
Melissa Delbello, research psychiatrist with the University of Cincinnati spoke at the APA convention on May 7, yet less than a month earlier, Senator Charles Grassley of the Senate Finance Committee cited her for her failure to disclose to the university how much she had earned from pharmaceutical companies. In 2002, she was the lead author of a study that concluded that children responded well to the antipsychotic drug Seroquel, which is manufactured by AstraZeneca, one of the companies funding symposiums at the APA convention. She disclosed that she’d received $100,000 from the company between 2005 and 2007, but Senator Grassley discovered it was more than double that—$238,000.
EXAMPLE OF SPEAKERS AT THE APA CONVENTION INCLUDED:
David Kupfer, Professor and Chair, Department of Psychiatry, University of Pittsburgh School of Medicine, was a member of the DSM-IV Task Force and is Chair of the DSM-V Task Force. He has been a consultant to Eli Lilly & Co., Hoffman-LaRoche, Pfizer, Forest Labs and Servier and also sat on the advisory boards of Eli Lilly & Co., Forest Labs and Pfizer.
Kupfer’s wife, Ellen Frank, Ph.D., has received research support from Eli Lilly & Co. and Pfizer and was also a member of the DSM-IV Task Force.
Joseph Biederman, Chief of the Clinical & Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital gave seminars at the APA convention on pediatric bipolar disorder and ADHD, the latter funded by Ortho-McNeil Janssen Scientific Affairs. Biederman has received research funds from 10 pharmaceutical companies, including manufacturers of antipsychotic drugs prescribed for bipolar. He was a member of the DSM-IV committee overseeing what infant, childhood and adolescent disorders would be included. His labeling of children with “bipolar” has been attributed to the increase in antipsychotic drug sales for pediatric use. In 2007, such promotion was blamed, in part, for the death of 4-year-old Rebecca Riley from Massachusetts. She died from a prescribed cocktail of psychiatric drugs that included antipsychotics. Dr. Lawrence Diller, a California behavioral pediatrician, told The Boston Globe, “I find Biederman and his group to be morally responsible in part. He didn't write the prescription, but he provided all the, quote, scientific justification to address a public health issue by drugging little kids.” The New York Times exposed how Biederman earned $1.6 million in consulting fees from drug makers between 2000 and 2007 but did not report much of this income to Harvard University officials. In 2008, his financial conflicts of interest were the subject of a U.S. congressional investigation.
David Shaffer, Professor of Child Psychiatry at Columbia University and Director, Division of Child Psychiatry, New York State Psychiatric Institute, is part of a symposium discussing “disorders of childhood: A DSM-V research agenda.” Shaffer was a member of the DSM-IV Task Force and is responsible for inventing TeenScreen, a subjective survey conducted on teens in schools to determine if they are potentially suicidal. He admits there’s a potential 84% chance of wrongly identifying students using his survey, potentially put them at risk of being prescribed suicide-inducing antidepressants. Shaffer has served as an expert witness for Hoffman la Roche and Wyeth. He was also a consultant to GlaxoSmithKline on Paxil (paroxetine) and adolescent suicide and has been a paid consultant for Pfizer, another antidepressant maker.
S. Charles Schulz, Professor and head of the Department of Psychiatry, University of Minnesota Medical School Minneapolis, Minnesota, was a DSM-IV project participant. His industry-supported seminar about “medication treatment for youth” was funded by AstraZeneca, the manufacturer of the antipsychotic Seroquel. The company has faced multiple suits alleging that it downplayed the risk of diabetes with the drug. Schulz has been a consultant for AstraZeneca and Eli Lilly & Co. and has received grants from them, Abbott Laboratories and Janssen Pharmaceutica.
Charles Nemeroff, Professor of Psychiatry and Behavioral Sciences and Chairman of Psychiatry and Behavioral Sciences, Emory University School of Medicine in Atlanta, is conducting a seminar on depression supported by Sanofi-Aventis. Dr. Nemeroff was one of the psychiatrists on an FDA Advisory Panel in 1991 that exonerated Prozac (the first SSRI antidepressant) from causing suicidal behavior—a fact established 13 years later when the FDA ordered drug companies to add a “black box” warning that all SSRIs induce suicidal behavior in children and teens. Nemeroff is a consultant for at least 20 pharmaceutical companies and has received research funds from at least 8 psychiatric drug manufacturers. On October 4, 2008, The New York Times reported that Nemeroff had failed to report to Emory University that he had earned at least $1.2 million from drug companies between 2000 and 2007. According to the NYT, “Dr. Nemeroff signed a letter dated July 15, 2004, promising Emory administrators that he would earn less than $10,000 a year from GlaxoSmithKline to comply with federal rules. But on that day, he was at the Four Seasons Resort in Jackson Hole, Wyoming, earning $3,000 of what would become $170,000 in income that year from the British drug giant — 17 times the figure he had agreed on.” Pending the ongoing U.S. Senate Finance Committee investigation into his and other psychiatrists’ undisclosed conflicts of interest with pharmaceutical companies, Nemeroff stepped down from his position as Emory Psychiatry Chair. From 2000 through 2006, Dr. Nemeroff earned more than $960,000 from GlaxoSmithKline but listed earnings of less than $35,000 for the period on his university disclosure forms, according to Congressional documents.
Alan F. Schatzberg, professor and chair of psychiatry and behavioral sciences at Stanford University School of Medicine, he was voted in March 2008 as the president-elect of the APA. At the APA annual meeting he was also announced as candidate for the APA’s Board of Trustees. He is the co-editor, along with Nemeroff above, of The Textbook of Psychopharmacology. In June 2008, the Senate Finance Committee disclosed that Schatzberg had failed to fully disclose his conflicts of interest to Stanford. Schatzberg is the co-founder of Corcept Therapeutics, which had applied for approval from the FDA to market the drug mifepristone—currently used to induce abortions—for treatment of “psychotic depression.” He holds more than $6 million of Corcept stock. Stanford requires researchers to specify whether they own more than $100,000 in stock. The Senate Finance Committee chair said that Schatzberg sold nearly $110,000 of Corcept stock in 2005, just months after beginning clinical trials of the drug. In 2002, he also received $22,000 from Johnson and Johnson. As a result of the exposure, he stepped down from his position as principal investigator on a federal research grant.
Steven Sharfstein, A former APA president who sat on the Board of Directors of the American Psychiatric Foundation (APF), an organization formed by the APA that lists 17 major pharmaceutical companies as its corporate adviser. Since 1992, he has been President and CEO of Sheppard Pratt Health System and in 2002, he signed on 6 pharmaceutical companies to test their products at Sheppard Pratt. He signed contracts with Eli Lilly & Co., Merck and Janssen pharmaceuticals. Sharfstein’s 2003 testimony to the U.S. “Freedom Commission on Mental Health” gave an insight into his modus operandi: “In order to survive, we must go where the money is.” Sharfstein responded to the exposure of key psychiatrists being exposed for their conflicts of interest, telling The New York Times in 2008: “With every new revelation, our credibility with patients has been damaged….”
WORLD PSYCHIATRIC CONGRESS
The XIV Congress of Psychiatry was held in Prague in September 2008, where more psychiatrists with financial interests in pharmaceutical companies spoke as well as Joseph Biederman, Steven Sharfstein, David Shaffer and David Kupfer above. The conflicts prompted one Czech child psychiatrist attending the congress to write an article in a national newspaper, stating, “The practice, when famous researchers or clinical professionals praise the effectiveness of a drug depending on what company pays them, is common, as doctors prescribing drugs are ‘motivated’ – bribed – by pharmaceutical companies….this psychiatric [Congress] looked a little bit like a marketing event for big pharmaceutical companies.”
Dilip V. Jeste, APA Trustee and Member of the DSM-V Task Force is a consultant to Bristol-Myers Squibb, Lilly, Janssen, Solvay/Wyeth and Otsuka; honoraria from Bristol-Myers Squibb, Janssen and Otsuka; received “supplemental support to NIMH-funded grants” from Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, and Janssen in the form of donated medication for the study, “Metabolic Effects of Newer Antipsychotics in Older Patients.” Jeste’s 2008 APA disclosure for the DSM-V Task Force stated he received honorarium from Abbott, AstraZeneca and Pfizer-Eisai. He also received consulting fees from four pharmaceutical companies.
Jan Fawcett, Professor of Psychiatry, Chair, Mood Disorders Work Group Member, DSM-V Task Force. He has received grants and research support from Abbott, Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly, Organon, Pfizer, SmithKline Beecham, Wyeth-Ayerst, and Zeneca; was a consultant to Abbott, Bristol-Myers Squibb, Eli Lilly, EM Industries, Forest Laboratories, Glaxo Wellcome, Pfizer, Pharmacia-Upjohn, and SmithKline Beecham; was a member of speakers’ bureaus sponsored by Abbott, Bristol-Myers Squibb, Eli Lilly, Pfizer/Roerig, Pharmacia-Upjohn, SmithKline Beecham and Wyeth-Ayerst.
Nada Stotland, former APA President who serves on the Board of the pharmaceutical company that funds the U.S. National Mental Health Association (NMHA) that received over $2 million in pharmaceutical company funding in one year alone. Stotland is on the speakers’ bureau for Pfizer and GlaxoSmithKline, both makers of antidepressants. In a published article in 2008, Stotland said that “black box” warnings about psychiatric drug risks, that include antidepressants, are “unwarranted.”
Steven Sharfstein, a former APA president, Sharfstein sat on the Board of Directors of the American Psychiatric Foundation (APF), an organization formed by the APA that lists 17 major pharmaceutical companies as its corporate advisers. Since 1992, he has been President and CEO of Sheppard Pratt Health System and in 2002, he signed on 6 pharmaceutical companies to test their products at Sheppard Pratt. He has signed contracts with Eli Lilly & Co., Merck and Janssen pharmaceuticals.
In July 2008, the Senate Finance Committee requested that the APA hand over all its financial records showing pharmaceutical company funding.
CCHR released psychconflicts.org to raise awareness about how the APA’s DSM medicalizes all human troubles as “mental disorders” in order to sell psychiatric drugs. It will continue to update this to ensure that people get the facts about the conflicts of interests driving up drug sales, often at the risk of patients’ lives. Read the history of articles exposing these conflicts by clicking here.
