http://www.thejournalnews.com/rtc/27part7.htmManufacturers push their psychotropics(This is part of a Journal News report on the widespread use of drugs at residential treatment centers. The story was reported and written by staff writers Jorge Fitz-Gibbon and Dwight R. Worley. Links to other parts of the article can be found at the end of this section. )At the heart of the debate over psychotropic drug use in children is the pharmaceutical industry, a $250 billion business that Fortune magazine called the world's most profitable in its 2000 review of corporate earnings. Fortune listed two psychotropic drugs manufactured by Eli Lilly among the top-selling "blockbuster" drugs: Prozac, with $2.7 billion in sales, and Zyprexa, with $1.9 billion.
Marketing has been instrumental in bolstering sales. Advocacy groups like the Child and Adolescent Bipolar Foundation, which promote bipolar awareness, education and treatment, are funded in large part by pharmaceutical manufacturers. Four of the group's top five corporate donors are drug makers.
Since 1997, pharmaceutical companies have also been allowed to advertise directly to consumers, a rarity in the developed world.
The pharmaceutical consulting and marketing firm IMS Health reported that drug manufacturers spent $19 billion in advertising last year alone.
Pharmaceutical companies are also active lobbyists in Washington, with well over 600 registered lobbyists — more than the oil industry. Mitch Daniels, director of President Bush's Office of Management and Budget, is a former Eli Lilly vice president.
Drug makers made $26.5 million in campaign contributions in 2000, up from $3.1 million a decade earlier, according to the campaign finance watchdog group Open Secrets.
Critics have charged that pharmaceutical influence has seeped into the medical profession as well. Dr. Loren Mosher, clinical professor of psychiatry at the University of California, is one of the leading critics.
In 1998, he resigned his membership in the American Psychiatric Association, charging that the association "reflects and reinforces, in word and deed, our drug-dependent society."
"The problem is, psychiatry all depends on grants and contracts," Mosher said. "The big ones, the ones who are doing research, depend a lot on grants from the pharmaceutical companies for staying in business, so to speak. So it's really pervasive. It's all over the place. You can't get away from it."
In 1999, Eli Lilly stopped making annual contributions of $25,000 to The Hastings Center in Garrison, a medical ethics think tank, after it published an article by Dr. David Healey, a noted psychiatrist.
Healey had been an expert witness against Lilly in court and did a study at the University of Wales that found healthy adults became belligerent, fearful and suicidal when using Prozac.
For its part, the pharmaceutical industry rebuts criticism of its influence. Jeff Trewhitt, spokesman for the Pharmaceutical Researchers and Manufacturers of America, or PHARMA, the national trade association for the industry, said drug makers simply produce the medications. They don't prescribe them.
"We have, at great expense, researched, developed and produced these medicines," he said. "There are medicines that are helping a large number of patients, and we certainly make sure that doctors have information about these medicines. It's up to them to make a basic, fundamental decision as to whether or not to use it.
"It strikes us that the system is working very well, and we would be a lot worse off without these medicines."
Drug companies, including Eli Lilly, refer doctors to outside literature or reports on using the medications on children, including the antipsychotic Zyprexa, one of the company's newer products. Marni Lemons, an Eli Lilly spokeswoman, said Zyprexa is not marketed for children.
At St. Agatha Home, Small insists that the days of the hard sell, when companies lavished expensive gifts and trips on doctors, are over.
Yet, he concedes that pharmaceutical representatives still visit about three times a week. A small purple clock with a white Zyprexa logo sits on his desk — a gift from a pharmaceutical representative.
Yes, Small said, Zyprexa is used, both on some of the retarded adults in his care as well as in the children.
Most RTCs use it as well, primarily for diagnoses of schizophrenia and acute mania. For critics, that is a troubling fact.
"It's a very suppressive drug," said Breggin, the director of the International Center for the Study of Psychology and Psychiatry. "This drug is like putting cement in the brain of a child."A good series...
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