World-renowned Harvard child psychiatrist Joseph Biederman, whose work has helped fuel an explosion in the use of powerful antipsychotic drugs in children, has been caught up in controversy since a Congressional inquiry by Senator Charles Grassley (R-Iowa) in 2008.
Biederman has been criticized for being an advocate of diagnosing Attention Deficit Hyperactivity Disorder (ADHD) and bipolar disorder in even the youngest of children, and using antipsychotic medicines to treat them. Pharmaceutical companies are continuing to profit from the sale of these powerful and sometimes unnecessary drugs. The problem was that much of Biederman's work was underwritten by drug makers for whom he was a private consultant. He was caught with his hand in the cookie jar.
The Congressional inquiry revealed last year that Biederman earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007, but failed to report all but $200,000 to Harvard officials. This constituted a major conflict of interest.
Biederman appeared at a deposition on February 26, 2009, and was questioned by several lawyers for the states, who were claiming that makers of antipsychotic drugs defrauded state Medicaid programs by marketing their medicines improperly.
At the deposition, Biederman was asked what rank he held at Harvard.
"Full professor," he answered.
"What's after that?" asked Fletch Trammell, one of the attorneys.
"God," Biederman responded.
"Did you say God?" Trammell asked.
"Yeah," said Biederman, after which there was a moment of stunned silence.
The transcripts of this deposition call into question the mental state of the psychiatrist himself. It seems the good doctor is showing symptoms of Narcissistic Personality Disorder (NPD), which, according to the Mayo Clinic, is a mental disorder in which people have an inflated sense of their own importance. They believe they are superior to others, but in reality, they are masking their own fragile self-esteem, and are vulnerable to the slightest criticism.
For decades, according to Bruce Levine in an article Friday in the Web site AlterNet.org, "the majority of American doctors, mental health professionals, the media, and the general public have yielded to the dissemination's of Harvard psychiatrist Joseph Biederman who successfully evangelized for more children - and younger children - to be medicated with powerful psychiatric drugs."
The "blowback," according to Levine, can be found in the July 2009 Scientific Mind article "Do ADHD Drugs Take a Toll on the Brain?" The article, by Edmund S. Higgins, clinical associate professor of family medicine and psychiatry at the Medical University of South Carolina, is a sobering report of the long-term dangers associated with ADHD drugs such as Ritalin, Concerta, Vyvanse, and Adderall.
In his article, Higgins cites the Centers for Disease Control. In a recent survey, the CDC found that ADHD afflicts about 5 percent of children in the U.S. - twice as many boys as girls - age 6 to 17. In 2005, according to the CDC, an estimated 9 percent of boys and 4 percent of girls were taking stimulant medications as part of their ADHD therapy. The majority of patients take Ritalin and Concerta, a methylphenidate, and the most of the rest are prescribed Adderall, an amphetamine.
In his article, Higgins writes "although it sounds counterintuitive to give stimulants to a person who is hyperactive, these drugs are thought to boost activity in the parts of the brain responsible for attention and self-control".
Higgins acknowledges that the ADHD medication can indeed improve attention, concentration and productivity and also suppress impulsive behavior. Significant improvements have been found in some people's lives.
Severe inattention and impulsive behavior can indeed put individuals at risk for crime and substance abuse, and adults can face unemployment and be susceptible to car accidents. In these instances, appropriate medication might keep a person out of prison, away from addictive drugs, or in a job. But over the last 15 years, doctors have been prescribing stimulants for people with moderate to mild inattention, and even some with a normal ability to focus.
Patients are no longer just taking medications in childhood, but are encouraged to stay on them when they become adults. Vyvanse, an amphetamine, and Concerta were introduced in 2008 by the FDA for treating adults, and pharmaceutical companies are pushing awareness of adult forms of ADHD. Students are taking the drugs to increase academic performance, and professionals such as doctors and lawyers are taking stimulants in hopes of boosting their productivity. These drugs have therefore become increasingly popular. According to a 2007 study, prescriptions for ADHD drugs in the methalphenidate and amphetamine categories rose by almost 12 percent per year between 2000 and 2005.
The increased usage of stimulants is causing questions to be raised about their long-term use. There is a growing concern that the drugs might take a toll on the brain in the long run. Methylphenidates such as Ritalin and Concerta have a chemical structure "similar to cocaine," according to Higgins, and they act on the brain in a similar way as cocaine.
According to Higgins: "Indeed, a smattering of recent studies, most of them involving animals, hint that stimulants would alter the structure and function of the brain in ways that may depress mood, boost anxiety, and, contrary to their short-term effects, lead to cognitive deficits. Human studies already indicate the medications can adversely affect areas of the brain that govern growth in children." He goes on to speculate as to what additional harmful side-effects have yet to be found.
In February 2007, the FDA did indeed issue warnings about the side-effects of ADHD drugs, such as stunted growth and psychosis, among other mental disorders. The possibility exists that stimulant treatment during childhood might contribute to high rates of accompanying diagnoses for other mental health problems, according to Higgins. But having ADHD is itself a risk factor for other mental health problems.
The evidence that ADHD drugs cause adverse reactions such as stunted growth in children are in direct contradiction to Biederman's findings. Alternet.org's Levine, himself a clinical psychologist, reports on a 2007 National Institute of Mental Health study of ADHD treatments involving 579 children. Over a three year period, the children, between seven and ten years old, were involved in a growth rate study. In the study, the growth rates of unmedicated children were compared to the growth rates of children who took ADHD stimulants throughout that period. Compared to the children who were unmedicated, the ADHD drug-treated children showed a decrease in growth rate of, on average, two fewer centimeters in height, and 2.7 kilograms less in weight. By the third year, there was no noticeable stunting of growth, but the damage had been done. The ADHD children never caught up to their counterparts.
According to Levine, "there are many children whose only problem in life is not doing their homework but are medicated with ADHD drugs; and the majority of their parents had no idea that they were giving their children amphetamines or amphetamine-like substances. Unfortunately, too many Americans are willing to surrender their own authority to damn near every pompous authoritarian rather than question the legitimacy of exploitive industrial complexes and the predatory people at the top of them."
The pharmaceutical-industrial complex, according to Levine, is part of a "wave of evil" that "washes not only the financial-industrial complex, the military-industrial complex, the energy-industrial complex, and predatory executives at AIG, Citibank, Halliburton, Blackwater/Xe, Enron, and Exxon."
Levine was quoting Ralph Waldo Emerson, who wrote: "The wave of evil washes all our institutions alike."
According to Levine, the pharmaceutical-industrial complex has "virtually annexed the mental health profession, whose all-star opportunist team is captained by Harvard psychiatrist Joseph Biederman."
Biederman, as I pointed out earlier, may be suffering from Narcissistic Personality Disorder. He has a "God complex" not unlike another well-known person associated with Harvard University, Theodore Kaczynski.
According to Wikipedia, Kaczynski, also known as the Unibomber, "is an American murderer, mathematician, and neo-Luddite social critic who carried out a campaign of mail bombings. He was born in Chicago, Illinois, where, as an intellectual child prodigy, he excelled academically from an early age. Kaczynski received an undergraduate degree from Harvard University and earned a PhD in mathematics from the University of Michigan. He became an assistant professor at the University of California, Berkeley at age 25 but resigned two years later." His occupation is listed as "prisoner, former assistant professor of mathematics." They left out "bomber".
While Wikipedia can sometimes be comical in its descriptions and anecdotes, the esteemed Psychology Today has referred to Kaczynski's acts of terror as being "narcissistic." It should be noted that Kaczynski suffers from a variety of other mental illnesses.
Joseph Biederman cannot be compared to Theodore Kaczynski, other than that they are both associated with Harvard, and both have a background in academics. Oh, and they both are suffering from Narcissistic Personality Disorder.
The problem with Biederman is that he has been held in such high regard for so long. His theories on mental illness have been disputed and shown to be dangerous. How many Ted Kaczynskis could have been stopped as children?
The June 22, 2009 issue of Time Magazine includes an article titled "Staying Sane," by John Cloud. He takes a look at the work of Dr. William McFarlane, who is one of the world's top authorities on preventing mental illness. He has long felt that forms of mental illness such as schizophrenia, from which Ted Kaszynski suffered, were preventable.
A team of UCLA researchers in the late 1970's began to publish the results of a long-term study called the UCLA Family Project. The study found that you could predict, with remarkable accuracy, which 16-year-old children would develop schizophrenia later in life.
The UCLA study found, after studying the kids for more than a decade, that those who became schizophrenic were most often from families that displayed "communication deviance," described as "unclear, unintelligible or fragmented speech." They also found the parenting to be "critical and intrusive."
Dr. McFarlane and others began working with some of the families to teach them to communicate better, with "less anger and intrusion". McFarlane was working on the assumption that schizophrenia could be prevented in asymptomatic kids who were at risk for the disease.
"Once a patient's perception of reality has cracked the first time, it becomes very hard to walk back to normality," Time Magazine's Cloud says of McFarlane's theory. Early detection is crucial, according to McFarlane.
McFarlane's schizophrenia-prevention ideas have given other researchers hope in more routine conditions, such as ADHD. Mental illness has long been linked to genes, over which we simply have no control. But according to many mental health experts like McFarlane, your environment and experiences have powerful effects on the way those genes are expressed. This is exactly the opposite of Harvard's Joseph Biederman.
If McFarlane is to be believed, and he has a large following, people like Ted Kaczynski are as much a product of their environment as they are their genes. Could Kaczynski have been stopped before he became ill? Probably not. But what about the millions of children who are having trouble focusing on their homework? Are drugs the answer? According to Biederman, yes. But after the February 2009 deposition when he compared himself to God (to be fair, he didn't say he was God, only that he was next in line), Biederman has lost all credibility. The fact that he failed to report $1.6 million in pharmaceutical consulting fees has been the subject of an ongoing Congressional investigation. His Harvard credentials are about as meaningful as the Unibomber's.
And one more thing: If you got through this article, you don't have ADHD.