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BRITISH COLUMBIA: Babies on psychiatric drugs

[Fred A. Baughman Jr., MD:
This is a perversion of science and a monstous perversion of medicine.
Once a study has been completed, presented at meetings, published in journals,
no matter how devoid of scientific merit, it becomes 'cutting edge', OK and
everyone starts doing it. There is no word for this except 'criminal'. The
District or prosecuting attorney of the province should convene a grand jury or
it's equivalent and begin to take testimony from physicians interviewed for
this article who have expressed alarm or misgiving. Testimony should be taken,
as well from child neurologists, pediatricians, pharmacologists, pediatric
pathologists, toxicologists and the like, then indictments should follow.
Wherever preschoolers are being drugged (there is no justification for calling
this treatment), legal inquiries should be launched.]

  Babies on mood drugs
  Tender age of patients shocks physicians
  Ann Rees The Vancouver Province   18 December 2000

  Babies still young enough to be in diapers are being
  prescribed powerful adult tranquilizers.
  A Vancouver Province investigation found about 20 B.C. infants
  aged two and under last year were prescribed either a sedative called
  imipramine or anti-depressant drugs such as Prozac, Paxil and
  Zoloft, a class of drugs known as SSRIs. The five youngest were not
  even a year old, which shocked doctors.
  "Oh my goodness!" said Dr. Wendy Roberts, pediatrician and director of the
  Child Development Centre at Toronto's Hospital for Sick Children.  Dr.
  Marshall Korenblum, chief psychiatrist at the
  prestigious Hincks-Dellcrest Centre for Children in Toronto said: "I cannot
  see any indication for putting a pre-schooler on anti-depressants."
  The drugs have not been tested for safety and effectiveness in such young

[Fred A. Baughman Jr., MD:
Meaning there is no proof they are safe or effective, i.e.,
that there is no medical reason to prescribe them.]

  Dr. Jane Garland, head of the mood disorders clinic at B.C. Children's
  Hospital in Vancouver, said "systematic studies" have been done only on
  children six and up. But despite the lack of research, Garland said the
  drugs are appropriate in rare and extreme cases for children under three.
  "I have seen kids, for example, with sleep-terror disorders or extreme
  sleep disorders and anxiety problems who are younger than three who
  occasionally have been put on those medications," she said.

[Fred A. Baughman Jr., MD:
That someone
has done it is all they have to have to justify following suit. With no valid
research as to safety or efficacy it cannot be said their is a scientific basis
for using such drugs in children of this age. It cannot be said that that
benefit outweighs risks. This being the case, there is no justification for
their use.]

  "But that would be a treatment of last resort for under-threes. One would
  have wanted to try everything else."

  Garland is currently conducting a drug trial, paid for by the manufacturer
  of the anti-depressant Zoloft, to study safety and effectiveness in six-to

[Fred A. Baughman Jr., MD:
With the 'researcher' funded by the drug's maker, what is the
chance the drug will be found to be other than effective?]

  Meanwhile, there is widespread debate about whether popular
  anti-depressants could cause long-term side-effects, especially in young
  children. At the extreme end of the debate is a book called Prozac
  Backlash, in which Harvard psychiatrist Dr. Joseph Glenmullen documents
  serious long-term effects of popular anti-depressants such as Prozac, Paxil
  and Zoloft.

  Glenmullen reports several cases of neurological disorders, such as
  disfiguring facial and body tics, which he believes are indications of
  brain damage. Other prominent doctors have dismissed Glenmullen's concerns.
  But when it comes to children there is no certainty either way. "I think
  it's reasonable to be concerned," Julie Magno Zito, a University of
  Maryland pharmacy professor, said in a recent magazine interview. "We have
  no idea on how these drugs affect the developing brain, the heart, the
  kidney, the liver."

[Fred A. Baughman Jr., MD:
Which means there is no justification for giving
them--it simply is not known if they do more harm than good]

  What is certain is that the use of psychiatric drugs
  by young children is on the increase.

[Fred A. Baughman Jr., MD:
Not treatment having a scientific basis for a bona fide disease or diseases, it is big business of the
mental health/psychopharm industry]

  Zito recently published a study in which she found a three-fold increase in
  the prescription of psychotropic drugs in U.S. children aged two to four
  between 1991 and 1995.  "It's a growth market," said Dr. Larry Diller, an
  American pediatrician who is writing a book urging a more sensible approach
  to using drugs to treat
  childhood psychiatric disorders.
  Diller, who wrote the best selling book Running on Ritalin, believes
  widespread acceptance of drugs to treat Attention Deficit Hyperactivity
  Disorder has made doctors and parents less cautious about using other
  psychiatric drugs to treat children. "I think it is just basically the
  increasing acceptance of using psychiatric
  drugs in children."
  B.C. appears to be on the cutting edge of the trend.
  The 20 babies and tots were among almost 70 pre-schoolers four and
  younger who were prescribed sedatives and anti-depressants last year,
  according to data obtained through Freedom of Information from B.C.'s
  PharmaNet prescription record system.  The youngest anti-depressant
  patients were two baby girls and three baby boys, all under a year old. The
  two girls received Paxil. One baby boy was
  prescribed bupropion, a drug sold as Zyban and Wellbutrin, and the other
  two received Surmontil and Effexor.
  Three babies who turned one last year were also given Prozac, Paxil or
  trazodone.  A dozen tots who turned two last year were also given
  anti-depressants. Five of the two-year-olds were prescribed imipramine,
  which the American Heart Association warns could cause death from cardiac
  Toronto's Roberts said doctors at Sick Children's are very cautious about
  using the sedative and never prescribe it for babies. "Not at that age,
  never," she said. "There are major cardiac problems with
  In the past, the drug was commonly prescribed in school-aged children to
  control bed-wetting. But there is absolutely no excuse for using a drug to
  control bed-wetting in a two-year- old, said Toronto psychiatrist
  Korenblum. "They may not even be toilet-trained yet," he said. Neither of
  the Toronto child specialists could explain why infants would be prescribed
  anti-depressants or sedatives. Roberts said anti-depressants such as Paxil,
  Prozac and Zoloft are used to treat children old enough to speak but who
  have a rare form of mutism associated with social anxiety. "The incidence
  is very small," she said. "I wouldn't think there would be 10
  kids in B.C. with it."
  The same anti-depressants are used to treat autism, but usually not before
  age four or five. "Zoloft has been very helpful at night for a percentage
  of (autistic) kids because it has a sedating effect," Roberts said. "For
  some of our kids it is a lifesaver because they sleep two hours a night and
  the parents are just completely wiped out. It also helps the excessive
  anxious behaviour."
  Dr. Pratibha Reebye, infant psychiatrist at B.C.'s Children's Hospital,
  does not prescribe anti-depressants to kids under three.

[Fred A. Baughman Jr., MD:
It is absurd of psychiatry to pretend it can diagnose psychologic symptom
complexes in infancy
that are akin to those diagnosed and treated in children K-12, and in adults.
Moreover, once diagnosed, they presume as through all biological psychiatry,
that they have diagnosed a 'disease', a 'chemical imbalance', one needing
medical therapy--a 'chemical balancer', a pill.]

  "But occasionally you may have a child who is three and a half years or
  four years old who is clinically so depressed and having phobic reactions,
  not sleeping, not settling down and you may want to try some
  anti-depressants. But that would be a very rare."

  Dr. Derryck Smith, chief psychiatrist at Children's Hospital does not know
  why a baby would be prescribed an anti-depressant. "There is no reason I
  could think of personally, but that is not to say there isn't one," said

  What the doc ordered
  Ann Rees
  Vancouver Province  18 December 2000

  Paxil is the leading anti-depressant for kids in B.C.  Doctors turn to
  Zoloft and Prozac as their second and third choices to treat depression,
  anxiety, obsessive-compulsive disorders and other mental
  disorders, according to 1999 data obtained through Freedom of
  Information from the provincial PharmaNet prescription drug records. The
  data does not show the diagnosis. About 3,326 teens and children were
  prescribed Zoloft which, like Paxil, is one of a new group of mood-altering
  anti-depressants called serotonin reuptake inhibitors (SSRIs). Two dozen
  Zoloft patients were six or younger, and about 420 were 12 or younger.

  Prozac, perhaps the best known of the SSRIs, was the third most popular
  tranquilizer for kids, with 2,498 patients under 19. About 464 of the
  patients were pre-teens. Fifty-five were six or younger.

  About 2,285 teens and children were prescribed imipramine, an old-style
  tricyclic anti-depressant. The drug, which is sold under the brand names
  Tofranil, Impril and Novo-Pramine, is used primarily to treat long-term
  depression.  It was previously widely used to control bed-wetting.  "We
  have stopped using it altogether unless you are completely desperate," said
  Dr. Wendy Roberts, director of the Child Development Clinic at Toronto's
  Hospital for Sick Children.

  In B.C., 42 of the patients were under five, and five of those turned two
  last year. Thousands of B.C. children and teenagers were prescribed other
  powerful anti-depressants which are not tested or recommended for use in
  young patients. The PharmaNet records show:

  - 1,966 patients 19 or younger received prescriptions for amitriptyline,
  which is sold under the brand names Elavil, Apo-Amitriptyline and
  Novo-Tryptin. The youngest patient was two years old, with 40 aged six
  years or younger and 171 aged 10 or younger.

  - 1,409 patients received fluvoxamine, sold as Luvox, which is used to
  treat depression and obsessive-compulsive disorder. The youngest patients
  were four years old, with 198 aged 10 or younger -- 30 were aged six or

  - 1,380 patients aged 19 or younger received venlafaxine, an
  anti-depressant sold as Effexor. The youngest patient on the drug was under
  one year of age. Forty- nine patients were 10 or younger.

  - 1,310 received trazodone, which is sold as Desyrel. The youngest patient
  was a one-year-old infant; 17 were six or younger and there were 106
  patients 10 or younger.

  - 946 received bupropion, which is sold as Zyban and Wellbutrin. The
  youngest patient was under one year, with 65 aged 10 years or younger --
  five were six or younger.
  - 533 received citalopram hydrobromide, sold as Celexa. The youngest
  was seven.
  - 351 received clomipramine, sold as Apo-clomipramine and Anafranil.
  The youngest turned seven last year.
  - 275 received desipramine, sold as Norpramin and Pertofane. The
  anti-depressant is not recommended for children under 12. The data
  shows 91 children under 12 were prescribed the drug in 1999. The
  youngest was four last year.
  - 243 received Lithium, an anti-manic drug which carries a high overdose
  risk as well as side-effects of nausea and trembling. Only 12 patients were
  10 or older. The youngest was six.
  - 200 received doxepin, an anti-depressant with strong sedative effects.
  The youngest patient was four. A child who turned five and two who were six
  last year were also on the drug.
  - 321 received nefazodone, an anti-depressant. Only nine patients were
  under 10, with the youngest aged four.
  - 159 received nortriptyline, an old-style tricyclic anti-depressant sold
  as Aventyl. There were 23 patients aged 10 or under on the drug, with the
  youngest patient turning five last year.
  - 91 patients received moclobemide, an anti-depressant sold as Manerix. The
  youngest three patients were eight in 1999.
  - 67 patients received trimipramine, which is an anti-depressant sold as
  Surmontil. Two of the patients were infants younger than a year.

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