User blogs
Paul Gionfriddo, CEO of non-profit Mental Health America (MHA), was among the witnesses called to testify. It should be noted that MHA, formerly known as National Mental Health Association or NMHA, has received millions of dollars of funding from the pharmaceutical industry.
Mr. Gionfriddo testified that two-thirds of individuals screened on MHA's website screen positively for mental illness. If true, this is an alarming percentage, and is less indicative of a mental illness epidemic than it is of the inaccuracy of screening tools used to diagnosis mental illness. Referring to the latest version of psychiatry's Diagnostic and Statistical Manual of Mental Disorders, National Institute of Mental Health Director Thomas Insel, M.D. wrote, "The weakness is its lack of validity... Patients with mental disorders deserve better... That is why NIMH will be re-orienting its research away from DSM categories."
With the unreliable and inaccurate diagnostic tools available today, increased early identification screening of children for mental disorders proposed in HR2646 would almost certainly exacerbate already out-of-control misdiagnosis and over-medication of children in our country. This is a decidedly American problem, with the rate of diagnosis of ADHD among children twenty times higher than in other developed countries. Geographic disparities in diagnosis rates are attributable to subjective, unscientific diagnostic tools. In the U.S., according to the CDC, children in Florida are almost twice as likely to be diagnosed with and medicated for ADHD than children in California, Nevada or Colorado.
Nowhere does the disturbing trend of misdiagnosis and wrongful medication of children seem more manifest than in Mr. Gionfriddo's own family story. In the Washington Post, Mr. Gionfriddo wrote, "The school’s evaluations suggested [my son Tim] had what was then called attention deficit disorder... And it turned out that Tim probably didn’t really have attention deficit disorder." Nonetheless, Mr. Gionfriddo also wrote in his book, "The pediatric neurologist started Tim on Ritalin... It turned out that neither Tim's teacher nor we could see any difference in his behavior, attention, or focus when he was on Ritalin. The reason, as we would discover later, was that ADHD wasn't really his problem."
In what has now become an all-too-familiar and sad refrain involving people put on perhaps unnecessary, the wrong or harmful psychotropic medications, Mr. Gionfroddo reported, "On Wednesday, November 20, 1996, my son Tim brought a gun to school." Like Mr. Gionfriddo's son who was put on the ADHD drug Ritalin, attorney Myron May was on the ADHD drug Vyvanse when he brought a gun to his alma mater and began shooting FSU students on November 20, 2014.
While fortunately neither Mr. Gionfriddo's son or other students at his school were harmed during that particular firearm at school incident, after starting on methylphenidate, Tim was later reportedly arrested in a meth lab bust. Like methamphetamine, methylphenidate (Ritalin) is also a Schedule II controlled substance. Methylphenidate carries an FDA-mandated Black Box warning - the strongest possible - for drug dependence.
Equally disturbing, years after Ritalin was approved and Mr. Gionfriddo's son was placed on the drug, the FDA released a post-marketing review, in 2006, of adverse event reports to the agency, warning that the data demonstrated children with no risk indicators, on regular doses of any of the stimulants approved for ADHD, experienced hallucinations, psychosis and mania. According to minutes of the March 22, 2006 FDA Pediatric Advisory Committee meeting, Dr. Andrew Mosholder of the FDA's Division of Drug Risk Evaluation noted that "symptoms of psychosis or mania were estimated to occur [on ADHD stimulants] at a rate of 2 to 5 per hundred person-years... This rate (greater than 1%) cannot be considered rare..." Like other children seemingly misdiagnosed with ADHD and put on psychosis-inducing stimulants, Mr. Gionfriddo's son would eventually be diagnosed with schizophrenia, a condition often involving hallucinations and psychosis.
It's time for America to step off the misdiagnosis and over-medication roller-coaster. Due to the profit motive of some and despite the good intentions of others, early mis-indentification of mental illness and wrongful interventions are worsening, not solving the problem. During a mental health forum sponsored by Rep. Gus Bilirakis on December 16, 2014 in Land O' Lakes, FL, the bill's author Rep. Murphy stated, "Forty percent of the time a person with psychiatric problem [sic] is on the wrong types or level of medication."
HR2646 is old wine (HR3717) in a new bottle. It's bad for America, and it's bad for our kids. Parents are intelligent enough to make the right mental health decisions and seek the right mental health care if needed for their children. They do not need more intrusive, wildly inaccurate and unscientific diagnostic screening thrust upon them or their children.
Our nation's over-reliance on pharmacological answers to life's challenges is manifestly not working for our veterans and military personnel, either. The Army's report on the 2 April 2014 Fort Hood shootings concluded that the mental health care Spc Ivan Lopez received did not deviate from the standard of care. Time to rethink the standard of care, which included in Lopez's case an untested polypharmacy cocktail of the psychotropic medications Celexa, Wellbutrin, Ambien and Lunesta. Our service personnel and veterans deserve better than being treated as guinea pigs, experimented upon with risky, ineffective psychotropic polypharmacy.
On the topic of Evidence-Based Treatment (EBT), can we agree that four dead and twelve others shot is not evidence of a good outcome of medication management? It should be noted that Army records indicate that Spc Lopez attended at least ten counseling sessions dutifully over ten months prior to the shooting; met with a social worker therapist, four psychiatrists, and a nurse practitioner; sought multiple medication refills voluntarily on a walk-in basis (Jan 14, 2014; March 6, 2014; March 10, 2014), had psychotropic medications in his blood stream at the time of death per his autopsy, and had even scheduled a follow up mental health appointment prior to his death during a walk-in visit seeking medication.
The problem is not a lack of access to mental health care, a lack of access to medications, anosognosia, medication non-compliance or treatment non-compliance. The nature of the problem is American psychiatry's fascination with an as yet unproven chemical imbalance theory whereby mental illness is genetically hardwired into individuals. Dr. Jeffrey Lieberman's exuberant hearing testimony espousing the benefits of psychotropic medications, suggesting they can prevent or eliminate mental illness, should be tempered by his comments that his faith in pharmacologic manipulations is rooted in his first LSD trip. Patrick Kennedy's impassioned testimony eschewing any moral component of mental illness ignores man's soul, argues fatalistically that we're all just chemical soup, and removes the element of free will. It's no wonder depression can turn into despair, when psychiatrists tell patients fate has dealt them a hopeless genetic hand.
Harvey Rosenthal testified in the hearing that people need to be offered a promise of hope and recovery, and that Assisted Outpatient Treatment (AOT) is synonymous with medication. Nowhere is this more evident than in the push to erode the privacy rights of patients. Undermining confidentiality, so long a foundational tenet of mental health care, is a chilling indicator that the page is indeed being turned, some would say forcibly, away from proven yet more time-consuming psychotherapeutic and recovery modalities, in favor of quick but ineffective medication management. In light of Rep. Murphy's stunning admission that doctors are wrong about psychiatric medications forty percent of the time, we're now going to take away patient privacy in the name of medication compliance? To comply with the wrong medications? So that caregivers - often parents who previously forced their children to take the wrong medications under poor medical advice - can continue to harm their kids well into adulthood?
Let parents parent their minor children without intrusion. Let adults make mental health care decisions for themselves. We need less, not more, government intrusion into mental health care.
In his determination to erode privacy rights as well as the centuries-old legal protection against false imprisonment afforded by habeas corpus - based upon shaky psychiatric diagnoses and worrisome doctor prescribing habits - Rep. Tim Murphy claims with great dramatic effect that the mentally ill are dying with their rights on.
Actually, they're dying with psychotropic medications in their corpses, and often taking others with them. Spc Ivan Lopez died with antidepressants and sedatives in his body, and took three others with him. Elliot Rodgers died with Xanax (alprazolam) in his body, and took six others with him. Myron May died with Vyvanse in his veins, almost taking six others with him. Andreas Lubitz, Germanwings co-pilot, took 149 other souls with him when, according to the BEA's preliminary report, he committed suicide by intentionally crashing a plane into the Alps, after being prescribed antidepressants.
In the U.S., antidepressants carry an FDA-mandated Black Box warning for increased risk of depression and suicidal thoughts. Again, on the topic of EBT, can we agree that 150 lost souls is not evidence of a positive outcome of antidepressants? Can we agree that the aforementioned deadly mass shootings are not evidence of positive outcomes of psychotropic medications?
Ironically, as the HR2646 hearing was closing, testimony of Aurora theater shooter James Holmes' psychiatrist Dr. Lynne Fenton was just getting underway in Colorado. She testified that Holmes was on a psychotropic cocktail of 150 mg of Sertraline (Zoloft), .5 mg of Klonopin (Clonazepam), and 10 mg of Propanolol. DA: "Did he ever tell you that he wanted to stop Sertraline?" Dr. Fenton: "No."
The assertion that medication non-compliance is the reason people with a mental illness become violent is simply not true. Medications are not the panacea that Rep. Murphy portrays them to be, and in fact there is credible scientific evidence to suggest that they may be doing more harm than good.
Perhaps Murphy's bill would be more aptly named the Helping Big Pharma and Mental Health Industry Act.
Parents who want alternatives to mental
health drugs, suggested by teachers, mental health professionals, doctors or
ex-spouses, may be relieved to know that there is a medical test that can be
performed to evidence whether your child can even metabolize the drug that is
being proposed.
This test has been around for a long
while, yet the medical community has not used it nor made it broadly known as
it may cut into pharma spending. The test is a genomic test, meaning it tests
the DNA function and structure and through this, can determine if the
individual can break down the drug and move it through the body or will the
liver become overwhelmed and the individual become toxic, and therefore
experience the adverse effects of the mental health drugs, such as psychosis,
worsening depression, anxiety, mania, delusions, suicidal thoughts, homicidal
thoughts and more.
Like all things in our culture and in our
society that revolves around money, the test is currently being used and
promoted for use to the psychiatric community.
Now, if the use of it were as healthful as what has been suggested above,
in order to test the individual to see if they will be able to metabolize the
drug, therefore they would most definitely be wise to learn of the alternative,
non pharmaceutical treatment, then we would live in an ideal world. Yet, that is
not the intention, nor the purpose for promoting this test to the psychiatric
community. Mental health professionals
are using the test in order to find the drug that rates “best” in their
estimation. (Please refer to the FDA warnings on mental health drugs to
understand the risks they carry, www.fda.gov). Mental Health drugs cannot rate "best" in any estimation.
In a highly scientific article regarding
this genomic testing, the facts relayed are as follows. “drug-metabolizing enzyme genes, such as
cytochrome P 4 5 0 2D6 gene (CYPD6), were identified.” That’s the good news. The genes that partake in metabolizing drugs
were identified through genomic research.
The article continues, with the benefit
of this news as it “provides clinicians with the opportunity to identify both
poor metabolizers and ultrarapid metabolizers…”
The article does point out that “In
recent years, the potential iatrogenic harm (illness caused by the drug)
associated with psychotropic medications has become increasingly obvious, with
“black-box warnings” being attached to antidepressants, antipsychotic
medications, stimulants, and mood stabilizers.”
Again, this is not necessarily new
technology, this is new to the public, “The identification of specific gene
variants associated with idiosyncratic responses is about 50 years old, and the
recognition that some psychiatric patients metabolize antidepressants at
dramatically different rates has been documented for several decades.”
Some information for those parents who
want to approach their doctors to do this testing and assert their right to
alternative treatment for their child:
“CYP2D6 was the first drug-metabolizing
enzyme gene that was genotyped to identify psychiatric patients with increased
or decreased metabolic capacity. It is
located on chromosome 22 and consists of 4382 nucloetides…
The CYP2DC enzyme plays a primary role in
the metabolism of more than 70 substrate medications, including twelve
psychotropic medications…
The most important CYP2D6 phenotype to
identify is the poor 2D6 sustrate metabolizer phenotype. Patients who are poor
metabolizers are at increased risk of adverse events when they are prescribed
2D^ substrate medications, because of their low metabolic capacity.”
For more factual information that helps
to get you fully informed on your rights in the field of mental health, visit www.mentalhealthrights.org
Source:
Psychiatric pharmacogenomics testing in
clinical practice, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181940/
