Let’s take a look at one psychotropic drug and it’s side effects. Risperdal (risperidone) is an atypical antipsychotic, which may have contributed to the deaths of 31 children since its 1993 approval, according a New York Times article earlier this year. Of the 31 deaths 11 were treated for unapproved uses.
Risperdal is diagnosed for Schizophrenia, ADD and bi-polar disorder, Risperdal is used for “treatment”, but the side effects are putting people at serious risk. The major warning for elderly adults is increased mortality in elderly patients with dementia related psychosis. Hmm, Increased mortality now that is something that should indicate an alarm for the user. Some of the other side effects of this drug are anxiety somnolence, extrapyramidal symptoms(what?), dizziness, constipation, nausea, abdominal pain, rhinitis (nose irritation), rash, anxiety, diarrhea, weight gain, erectile dysfunction, ejaculatory dysfunction, diabetes, obesity, lactation in women, and breasts in men and boys.
Now nobody wants any of these side effects for any pill for treatment, but for a man and boy to get breasts must be confusing and quite mortifying. A report from CBS news indicates a four year old boy using risperdal grew one breast which lactated, and the breasts had to be surgically removed. I think we would all experience a psychological disorder if we had a breast forming on our chest.
The more and more patients become aware of these drugs and effects and that the drugs cause the more we expect them to be considered ancient technology. Doctors used leeching and blistering to “heal” patients hundreds of years ago. We know the true knowledge and effects of these drugs will be known, and their so called “treatment” will be exposed. Making the choice to not take these dangerous these psychotropic drugs and to embrace natural remedies will prove to be the best choice. Patients need to know what you are putting in your body. Just say no to psychotropic RX
Monday, June 1, 2009
Thursday, May 21, 2009
Florida-Court Case Regarding Psychiatrist Overmedicating a Disabled Boy
CAROL MARBIN MILLER of the Miami-Herald reported recently that the mother of a disabled boy who died in 2007 has filed a wrongful death suit in Miami-Dade County against Dr. Steven Kaplin for overmedicating Denis Maltez, 12. The mother is outraged after her son committed suicide after taking a lethal cocktail of four mental health drugs: Seroquel and Zyprexa, both anti-psychotic medications; Depakote, an anti-seizure drug sometimes , which is used to stabilize moods, and Clonazepam, a tranquilizer.
We at Stoprx.org recognize this as another case of psychiatrists only solution to control a teenager is drugs. They add one drug after another to hopefully control or restrain the teenager. The continued overmedication of teens in the US is astounding. The psychiatric community should be embarrassed that more and more of these wrongful death, suicides, and mass murders are all taking place while they are assisting these teens to improve. It's a case of the insane helping the depressed.
We don’t see the improvement coming anytime soon. We see teens being perscribed more and more drugs, and needing more and more assistance with no solution or end in sight. When do you think BigPharma, and psychiatry will get the message that they have no idea what they are doing? Unfortunately it will be never. These Psychiatrists are the same doctors who used electric shock treatment, straight jackets, and lobotomies. Today they use pills, which have side effects causing suicide, mass murder or at best a need for another pill. Now they have President Obama and the US Congress working more on their behalf. The Mothers Act has been introduced three times already and has failed twice. The Mothers Act will enforce all pregnant mothers to see a psychiatrist during her pregnancy, which will be administered by her hospital. This will essentially place all infant Americans on antidepressants. This is George Orwell’s 1984 worst nightmare coming true. All Americans are under threat to be on BigPharma’s drugs from cradle to grave. These drugs don’t do anything but put someone into apathy, or on the front page as a campus mass murderer. The next generation of Americans has become a “new normal” a medicated generation.
We applaud Martha Quesada, the mother of 12-year-old Denis Maltez, filing of the wrongful death suit. We hope more and more of these lawsuits come to light, and more and more of the West become aware of just what these drugs are and are not.
We at Stoprx.org recognize this as another case of psychiatrists only solution to control a teenager is drugs. They add one drug after another to hopefully control or restrain the teenager. The continued overmedication of teens in the US is astounding. The psychiatric community should be embarrassed that more and more of these wrongful death, suicides, and mass murders are all taking place while they are assisting these teens to improve. It's a case of the insane helping the depressed.
We don’t see the improvement coming anytime soon. We see teens being perscribed more and more drugs, and needing more and more assistance with no solution or end in sight. When do you think BigPharma, and psychiatry will get the message that they have no idea what they are doing? Unfortunately it will be never. These Psychiatrists are the same doctors who used electric shock treatment, straight jackets, and lobotomies. Today they use pills, which have side effects causing suicide, mass murder or at best a need for another pill. Now they have President Obama and the US Congress working more on their behalf. The Mothers Act has been introduced three times already and has failed twice. The Mothers Act will enforce all pregnant mothers to see a psychiatrist during her pregnancy, which will be administered by her hospital. This will essentially place all infant Americans on antidepressants. This is George Orwell’s 1984 worst nightmare coming true. All Americans are under threat to be on BigPharma’s drugs from cradle to grave. These drugs don’t do anything but put someone into apathy, or on the front page as a campus mass murderer. The next generation of Americans has become a “new normal” a medicated generation.
We applaud Martha Quesada, the mother of 12-year-old Denis Maltez, filing of the wrongful death suit. We hope more and more of these lawsuits come to light, and more and more of the West become aware of just what these drugs are and are not.
Saturday, May 2, 2009
FDA Should Recall all Antidepressants for their Hand in Deaths to Users
"The FDA urges consumers to discontinue use of Hydroxycut products in order to avoid any undue risk. Adverse events are rare, but exist," said Dr. Linda Katz, interim chief medical officer in the FDA's Center for Food Safety and Applied Nutrition. The FDA has received 23 reports of liver problems ranging from jaundice to damage that required a liver transplant, Katz said. One person died.
Hydroxycut is a diet supplement used by many to cut appetite and lose weight. Now the FDA recalls Hydroycut products because of one death from the product, yet thousands died from suicide and mass murder from the use of psychotropic antidepressants like Prozac, Paxal, Zoloft, and Exfexor yet these drugs are not recalled.
Perhaps cases like the probe in Plymouth County will shed more light the effects of these drugs. Lane Lambert of the Patriot Ledger wrote on Friday May, 1, 2009. The Plymouth County grand jury probe of Dr. Kayoko Kifuji came to light on Thursday, in court documents from the Suffolk County civil case. This is the case in the death of Rebecca Riley.
It’s not clear how long the grand jury has been examining Kifuji’s action. A spokeswoman for District Attorney Tim Cruz declined to confirm or deny whether a grand jury is investigating Kifuji. The former Tufts-New England Medical Center psychiatrist criminally liable for Rebecca Riley’s death, she could face involuntary-manslaughter charges. Rebecca’s parents, Michael and Carolyn Riley, will go on trial later this year on first-degree murder charges in the little girl’s overdose death at their Hull home in December 2006.
Conviction for involuntary manslaughter carries a sentence of up to 20 years in prison, though Massachusetts sentences typically are 3 to 5 years. But legal experts say a criminal conviction would be highly unlikely for Kifuji. They indicate it will be a very hard case to make. Kifuji diagnosed Rebecca as bipolar with attention deficit disorder when she was 2½. Kifuji prescribed the powerful blood pressure medication Clonidine and anti-seizure drug Depakote. A medical examiner ruled that Rebecca died from an overdose of those drugs and over-the-counter cold medicine. Carolyn Riley says her daughter died of pneumonia, not the drugs. Kifuji voluntarily gave up her medical license in February 2007, after Rebecca’s parents were charged.
Court evidence of the grand jury investigation surfaced amid fresh legal action in both the civil and criminal cases. Recently, Kifuji’s lawyers asked a Suffolk County judge to postpone her deposition in the civil case indefinitely, and close the entire court record to the public. Kifuji’s attorney, Bruce Singal, said a deposition would force the doctor to claim her Fifth Amendment right not to incriminate herself while the grand jury was looking at the case. But the judge denied both motions.
Ben Novotny, an attorney for Rebecca Riley’s estate, says Kifuji is scheduled to give her deposition on July 6, after the grand jury is finished. She was to have given the deposition May 1, 2009. For the deposition Novotny said Kifuji will be asked about “pretty much all her (medical) conduct,” starting with explaining the bipolar diagnosis. In the court document that mentions the grand jury, Singal says Kifuji “strenuously denies any allegations that her treatment of Rebecca was negligent, let alone criminal.”
We at Stop Foundation Inc are perplexed to find how any parent can condone the use of psychotropic drugs on a child who is 21/2 years old. It is also a wonder how the FDA chooses to recall Hydroxycut for one death when there are numerous deaths like that of Rebecca Riley for malpractice, and FDA malpractice in keeping dangerous drugs out of circulation. The three headed monster of BigPharma, the FDA and Psychiatry continues to march down Main Street like Godzilla reeking havoc wherever they roam.
Hydroxycut is a diet supplement used by many to cut appetite and lose weight. Now the FDA recalls Hydroycut products because of one death from the product, yet thousands died from suicide and mass murder from the use of psychotropic antidepressants like Prozac, Paxal, Zoloft, and Exfexor yet these drugs are not recalled.
Perhaps cases like the probe in Plymouth County will shed more light the effects of these drugs. Lane Lambert of the Patriot Ledger wrote on Friday May, 1, 2009. The Plymouth County grand jury probe of Dr. Kayoko Kifuji came to light on Thursday, in court documents from the Suffolk County civil case. This is the case in the death of Rebecca Riley.
It’s not clear how long the grand jury has been examining Kifuji’s action. A spokeswoman for District Attorney Tim Cruz declined to confirm or deny whether a grand jury is investigating Kifuji. The former Tufts-New England Medical Center psychiatrist criminally liable for Rebecca Riley’s death, she could face involuntary-manslaughter charges. Rebecca’s parents, Michael and Carolyn Riley, will go on trial later this year on first-degree murder charges in the little girl’s overdose death at their Hull home in December 2006.
Conviction for involuntary manslaughter carries a sentence of up to 20 years in prison, though Massachusetts sentences typically are 3 to 5 years. But legal experts say a criminal conviction would be highly unlikely for Kifuji. They indicate it will be a very hard case to make. Kifuji diagnosed Rebecca as bipolar with attention deficit disorder when she was 2½. Kifuji prescribed the powerful blood pressure medication Clonidine and anti-seizure drug Depakote. A medical examiner ruled that Rebecca died from an overdose of those drugs and over-the-counter cold medicine. Carolyn Riley says her daughter died of pneumonia, not the drugs. Kifuji voluntarily gave up her medical license in February 2007, after Rebecca’s parents were charged.
Court evidence of the grand jury investigation surfaced amid fresh legal action in both the civil and criminal cases. Recently, Kifuji’s lawyers asked a Suffolk County judge to postpone her deposition in the civil case indefinitely, and close the entire court record to the public. Kifuji’s attorney, Bruce Singal, said a deposition would force the doctor to claim her Fifth Amendment right not to incriminate herself while the grand jury was looking at the case. But the judge denied both motions.
Ben Novotny, an attorney for Rebecca Riley’s estate, says Kifuji is scheduled to give her deposition on July 6, after the grand jury is finished. She was to have given the deposition May 1, 2009. For the deposition Novotny said Kifuji will be asked about “pretty much all her (medical) conduct,” starting with explaining the bipolar diagnosis. In the court document that mentions the grand jury, Singal says Kifuji “strenuously denies any allegations that her treatment of Rebecca was negligent, let alone criminal.”
We at Stop Foundation Inc are perplexed to find how any parent can condone the use of psychotropic drugs on a child who is 21/2 years old. It is also a wonder how the FDA chooses to recall Hydroxycut for one death when there are numerous deaths like that of Rebecca Riley for malpractice, and FDA malpractice in keeping dangerous drugs out of circulation. The three headed monster of BigPharma, the FDA and Psychiatry continues to march down Main Street like Godzilla reeking havoc wherever they roam.
Thursday, April 23, 2009
An Alternative to Psychotropic Drugs
Virtually every campus or company mass shooting involves the shooter taking an SSRI(selective re-uptake inhibitor) like Prozac, Zoloft, Exfexor, and Paxal among others. A lot of these shooters report that they feel like zombies and they want to get "off their meds". There is a book Prozac Backlash by Joseph Glenmullen which he talks about an aggressive effect when a person is taken "off their meds" abruptly. But the Columbine killers Klebold and Harris were clearly on medication.
These drugs, the huge pharmaceutical companies that make them, the doctor who prescribe them, and the government agencies who support questionable research but are suppose to be the "watchdog" are all guilty of creating a health and legal menace.
The effects of these drugs are well chronicled and are advertised as potentially causing adverse effects such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, mania, and thoughts of suicide. We are certain nobody wishes to feel any of these effects, and what mother wishes to have their child feel this way.
Chiropractors have been studying and addressing the neurotransmitters of the body since the 50's when Dr. Palmer discovered that Chiropractors can correct abnormalities of the intellect as well as the body. During that period Judges would commit mental patients to Chiropractic Sanitarium, and they produces and much higher cure and discharge rate of release then their rival sanitariums.
Chiropractor practice is a drug free alternative solution to the mass murder effects of pharmaceutical. Before you even think of putting your child on a mind altering drug you should take the safe step and see a chiropractor and exercise a natural cure
These drugs, the huge pharmaceutical companies that make them, the doctor who prescribe them, and the government agencies who support questionable research but are suppose to be the "watchdog" are all guilty of creating a health and legal menace.
The effects of these drugs are well chronicled and are advertised as potentially causing adverse effects such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, mania, and thoughts of suicide. We are certain nobody wishes to feel any of these effects, and what mother wishes to have their child feel this way.
Chiropractors have been studying and addressing the neurotransmitters of the body since the 50's when Dr. Palmer discovered that Chiropractors can correct abnormalities of the intellect as well as the body. During that period Judges would commit mental patients to Chiropractic Sanitarium, and they produces and much higher cure and discharge rate of release then their rival sanitariums.
Chiropractor practice is a drug free alternative solution to the mass murder effects of pharmaceutical. Before you even think of putting your child on a mind altering drug you should take the safe step and see a chiropractor and exercise a natural cure
Saturday, April 4, 2009
To Move More Prescription Drugs, Sales Reps Sling Swag
This is an article from the St. Petersburg Times which says it all. Doctors continually on the BigPharma take, and unethical sales representatives risking other peoples lives for a dollar. The end result is push the drugs and dosage even if the patient doesn’t need it. Do you still trust your doctor?
By Kris Hundley
St. Petersburg Times Sunday, April 5, 2009
A busy Panama City Fla. Physician had no problem leaving patients to stew in the waiting room while he listened to a pitch about Seroquel from a persistent saleswoman.
"Dr had 3 pat (patients) waiting and did sit down w (with) me," the rep wrote after a series of snubs at the front desk. "You never know what you will get w/dr b."
Every day, legions of drug reps troop into doctors' offices, then scoot back to their cars and enter notes about their encounters onto laptops or handheld devices. They include reminders about everything from medical questions to the doctor's new Nissan 350Z or his kid's Eagle Scout badge.
The notes are uploaded to a secure database at company headquarters and used by the drug rep, her partners and managers as the company refines its sales spiel.
Thanks to thousands of lawsuits pending against Seroquel, AstraZeneca's best-selling antipsychotic, hundreds of pages of call notes concerning several Florida doctors recently were made public. Though specific to Seroquel, the salespeople's notes reflect industry-wide practices. They give insights into what happens behind closed doors while patients cool their heels.
It's not a pretty picture, with sales reps laying on the swag and doctors complaining about late honoraria and angling to get on the AstraZeneca's "advisory board."
Company spokesman Tony Jewell said the drug maker's philosophy is that "any interaction with health care providers should be about providing information that helps them decide on the right medicines, for the right patients, at the right time."
But notes from pharma's emissaries reflect two different goals: Get the doctor to prescribe the drug. Then push him to boost the dosage.
A sales rep in Jacksonville was ecstatic when a nurse practitioner prescribed Seroquel at twice the dosage used by the psychiatrist in the same practice.
"Gave him goodies," the rep wrote. "Biggest user of Seroquel in the office!"
•
AstraZeneca's sales reps have worked wonders. Though approved only for schizophrenia and bipolar disorder, relatively rare mental illnesses, Seroquel has been one of the world's best sellers. Last year sales reached $4.5 billion.
But Seroquel's widespread use for everything from insomnia to anxiety has also triggered lawsuits alleging the drug caused weight gain, diabetes and other health problems. AstraZeneca, a U.K.-based company, denies the charges, noting that the FDA has repeatedly upheld the safety of Seroquel.
It also has denied that its salespeople illegally promoted unapproved, or off-label, uses of the drugs to doctors. Reps "are trained to ensure that every product promotion discussion with (a) health care provider conforms to the FDA-approved prescribing information," Jewell said.
Company lawyers vigorously opposed unsealing sales reps' notes, saying they contained confidential, proprietary information. But at a recent hearing in Orlando's federal court, AstraZeneca agreed to release call notes from before January 2004, when Seroquel received FDA approval for bipolar mania.
Heavily redacted, the notes comprise what the company's commercial brand leader, Alfred Paulson, described as sales reps' "continuous conversation" with a half-dozen Florida health care providers who prescribed Seroquel to plaintiffs in pending lawsuits.
Depicting sales pitches, on which millions of dollars of revenue hinge, as simple "conversations" is an apt description for what, in the end, comes down to the chemistry between two people. Shahram Ahari, a drug rep for competitor Eli Lilly & Co. in 1999 and 2000, now lectures physicians on how to avoid being manipulated by well-trained marketing reps.
"As much as doctors want to think the relationship with a sales person is about the transfer of knowledge, it's the affinity between two people that's the big money-maker for the drug company," said Ahari, who is part of Pharmedout.org, a physician-education group in Washington, D.C. "That's why drug companies hire former cheerleaders and athletes as drug reps instead of scientists. It's a question of how gregarious and engaging you can be."
While AstraZeneca declined to comment on its employees' compensation, industry data shows drug reps earn an average of nearly $100,000 a year, including bonuses based on sales.
They learn sales techniques more often associated with door-to-door soliciting than medical offices. Doc too busy to see you? Send in several sales people, daily if necessary, until you get a sit-down. Show up on rainy days when patients cancel. And even highly paid physicians find it hard to resist a free lunch.
In 1999, Seroquel reps tried to waylay Dr. Maria Carmen Wilson, the Tampa neurologist, four times before hitting gold.
"We were able to speak to her at lunch that we brought for the office," a rep wrote.
Wilson moved from free food to free trips to medical meetings in Spain and Scotland. By early 2002, a drug rep noted that Wilson was using a "ton of Seroquel" for patients with migraines.
Wilson, who says she was surprised to learn that drug reps recorded their interactions with her, denies that she was ever a big Seroquel prescriber. Despite her initial hopes, she says the drug did not turn out to be effective against chronic headaches.
"I still use it in low doses for people with intractable insomnia," said Wilson, an associate professor at the University of South Florida. "But I make sure patients are acutely aware of the potential for weight gain, especially if they have a predisposition to diabetes."
Wilson says the industry-funded jaunts to Europe did not unduly influence her.
"I went because I want to be up-to-date and learn," she said of the seminars, which she did not report, as required, to USF officials. "But frankly, I'd prefer they were in Orlando."
•
The call notes show that massaging doctors' egos consumed an inordinate amount of a drug rep's time.
Saleswomen in Miami quickly honed in on psychiatrist Dr. Heriberto Cabada's need for extra schmoozing. "Would not pay attention, all about him," wrote one frustrated sales rep in 2001. So the line worker pulled in a "customer solutions" specialist who offered to redo the doc's patient history forms with a personalized logo.
She agreed to Cabada's demands for multiple revisions, "one side only and ... marbled type paper." More attention was funneled his way through a "preceptorship," in which a sales rep shadows the doctor for the day and pays for the honor.
In a few months, Cabada went from prescribing what he called "chicken dosages" of Seroquel to higher doses. Soon after his conversion, however, Cabada closed his practice and moved to Spain, where he now lives. He did not respond to an e-mail seeking comment.
Drug reps are taught to use free samples as a strategic weapon: Parcel them out sparingly, even if there are box loads in the trunk.
"It makes the doctor even more grateful," said former Lilly rep Ahari. "And when he gives a freebie to the patient, the doctor feels like a hero."
Dribbling samples out in small caches, and requiring the doctor's signature each time, also gives the rep another chance at valuable face time.
"Samples are key to access," wrote a sales rep who was routinely brushed off by Dr. John Roy Billingsley in Panama City.
AstraZeneca said it has voluntarily banned many of its "reminder" giveaways to docs — free pens, pads and hand wash emblazoned with drug names. But the company declined to say how such changes have affected its spending on physicians.
Ahari said he doubts drug companies have pared back their marketing budgets. "The money going to influence physicians is exactly the same,'' he said.
"There's absolutely no enforcement of these voluntary guidelines. All the incentives are still in place to wine and dine doctors at Hooters if he needs to."
The reason: it works.
Case in point: Dr. Mohamed O. Saleh, a Jacksonville psychiatrist who was involved in early clinical studies of Seroquel. In 1998, he was telling AstraZeneca reps that their product wasn't effective and two years later he was still dodging salesmen.
By 2003, however, the rep was crowing that Saleh "really loves seroquel for elderly... said that he would — dose of 800 (mg) and even higher if necessary!"
Saleh and his nurse practitioner, Richard Daniel Malcolm, were wooed with everything from holiday treats ("Left pumpkin candy baskets ... put seroquel labels on them") to a video of Saleh for his use during a visit to Africa in 2002.
AstraZeneca also furnished Saleh with freebies for the trip. The payoff: the doctor told the drug rep he would put a picture on his Web site showing "African healthcare workers holding the Seroquel bags filled with (a text book) and pens/etc. Appreciated our support."
Saleh, who said in July that he is still receiving $10,000 to $15,000 a year as a speaker for Seroquel, seemed aware of the persuasive power of drug company payola. In October 2003, he told AstraZeneca reps that he was concerned about his nurse practitioner, who had taken a fishing trip with the Seroquel rep and was pushing for his own speaking gigs.
"Concerned about payments to Dan (Malcolm) and can be inducement for scripts b/c paying so much," wrote one of the two reps assigned to Saleh's office.
Malcolm joined Saleh's office in June 2001, four months after he was disciplined by the Florida Board of Medicine for pleading guilty to charges of domestic battery, driving with a suspended license and fraud in obtaining a medicinal drug.
Neither Saleh nor Malcolm returned calls or e-mails seeking comment.
•
When doctors complained that patients were ballooning up on Seroquel, sales reps often handed them a study by Chicago psychiatrist Dr. Michael J. Reinstein. Its startling message: "Use of S (Seroquel) to reduce weight and reduce risk," according to a salesman who visited Panama City's Billingsley.
Back at headquarters, however, company executives had serious questions about the validity of Reinstein's findings. "Our clinical colleagues have significant and numerous issues in the past with the quality of research that this group has produced," a note from Seroquel's brand manager said in 2001.
While sales reps were not allowed to explicitly promote Seroquel for anything other than schizophrenia prior to 2004, the notes reflect a not-so-subtle, broad-based push.
In early 2000, Billingsley's sales rep wrote, "S best in new Schizo's, kids, adolescents, bi-pols, blacks and asians."
Dr. Guido Nodal, Jr., a psychiatrist in Hialeah, at first was cautious about Seroquel, fearing potential links to cataracts. In late 2001, he told a male sales rep he would keep the drug in mind only for "smoking sciz pts."
Two months later, however, a female rep wrote that Nodal "LOVES SER. FOR ELDERLY." By year's end he had 15 nursing home patients on the drug. (Later the FDA made all antipsychotics warn that use in elderly with dementia could cause death.)
"Claims that he is switching patients from Risperdal to Seroquel at the nursing homes," a sales rep wrote in 2003. "Writing as much as he can to all patients."
Notes show that in the interim, Nodal received a textbook, mug, penlights ("Using lots"), payment for a preceptorship and dinner at Ruth's Chris Steak House. He denies the giveaways influenced his prescribing.
"If drug companies stopped marketing, I think prescribing (patterns) would be more or less the same as they are now,'' said Nodal, who said he tried to become a Seroquel speaker but was not accepted. "It didn't affect me at all."
Nodal closed his private practice last year and now works for the state's Department of Corrections in Florida City. The agency does not allow drug reps to lobby its physicians.
By Kris Hundley
St. Petersburg Times Sunday, April 5, 2009
A busy Panama City Fla. Physician had no problem leaving patients to stew in the waiting room while he listened to a pitch about Seroquel from a persistent saleswoman.
"Dr had 3 pat (patients) waiting and did sit down w (with) me," the rep wrote after a series of snubs at the front desk. "You never know what you will get w/dr b."
Every day, legions of drug reps troop into doctors' offices, then scoot back to their cars and enter notes about their encounters onto laptops or handheld devices. They include reminders about everything from medical questions to the doctor's new Nissan 350Z or his kid's Eagle Scout badge.
The notes are uploaded to a secure database at company headquarters and used by the drug rep, her partners and managers as the company refines its sales spiel.
Thanks to thousands of lawsuits pending against Seroquel, AstraZeneca's best-selling antipsychotic, hundreds of pages of call notes concerning several Florida doctors recently were made public. Though specific to Seroquel, the salespeople's notes reflect industry-wide practices. They give insights into what happens behind closed doors while patients cool their heels.
It's not a pretty picture, with sales reps laying on the swag and doctors complaining about late honoraria and angling to get on the AstraZeneca's "advisory board."
Company spokesman Tony Jewell said the drug maker's philosophy is that "any interaction with health care providers should be about providing information that helps them decide on the right medicines, for the right patients, at the right time."
But notes from pharma's emissaries reflect two different goals: Get the doctor to prescribe the drug. Then push him to boost the dosage.
A sales rep in Jacksonville was ecstatic when a nurse practitioner prescribed Seroquel at twice the dosage used by the psychiatrist in the same practice.
"Gave him goodies," the rep wrote. "Biggest user of Seroquel in the office!"
•
AstraZeneca's sales reps have worked wonders. Though approved only for schizophrenia and bipolar disorder, relatively rare mental illnesses, Seroquel has been one of the world's best sellers. Last year sales reached $4.5 billion.
But Seroquel's widespread use for everything from insomnia to anxiety has also triggered lawsuits alleging the drug caused weight gain, diabetes and other health problems. AstraZeneca, a U.K.-based company, denies the charges, noting that the FDA has repeatedly upheld the safety of Seroquel.
It also has denied that its salespeople illegally promoted unapproved, or off-label, uses of the drugs to doctors. Reps "are trained to ensure that every product promotion discussion with (a) health care provider conforms to the FDA-approved prescribing information," Jewell said.
Company lawyers vigorously opposed unsealing sales reps' notes, saying they contained confidential, proprietary information. But at a recent hearing in Orlando's federal court, AstraZeneca agreed to release call notes from before January 2004, when Seroquel received FDA approval for bipolar mania.
Heavily redacted, the notes comprise what the company's commercial brand leader, Alfred Paulson, described as sales reps' "continuous conversation" with a half-dozen Florida health care providers who prescribed Seroquel to plaintiffs in pending lawsuits.
Depicting sales pitches, on which millions of dollars of revenue hinge, as simple "conversations" is an apt description for what, in the end, comes down to the chemistry between two people. Shahram Ahari, a drug rep for competitor Eli Lilly & Co. in 1999 and 2000, now lectures physicians on how to avoid being manipulated by well-trained marketing reps.
"As much as doctors want to think the relationship with a sales person is about the transfer of knowledge, it's the affinity between two people that's the big money-maker for the drug company," said Ahari, who is part of Pharmedout.org, a physician-education group in Washington, D.C. "That's why drug companies hire former cheerleaders and athletes as drug reps instead of scientists. It's a question of how gregarious and engaging you can be."
While AstraZeneca declined to comment on its employees' compensation, industry data shows drug reps earn an average of nearly $100,000 a year, including bonuses based on sales.
They learn sales techniques more often associated with door-to-door soliciting than medical offices. Doc too busy to see you? Send in several sales people, daily if necessary, until you get a sit-down. Show up on rainy days when patients cancel. And even highly paid physicians find it hard to resist a free lunch.
In 1999, Seroquel reps tried to waylay Dr. Maria Carmen Wilson, the Tampa neurologist, four times before hitting gold.
"We were able to speak to her at lunch that we brought for the office," a rep wrote.
Wilson moved from free food to free trips to medical meetings in Spain and Scotland. By early 2002, a drug rep noted that Wilson was using a "ton of Seroquel" for patients with migraines.
Wilson, who says she was surprised to learn that drug reps recorded their interactions with her, denies that she was ever a big Seroquel prescriber. Despite her initial hopes, she says the drug did not turn out to be effective against chronic headaches.
"I still use it in low doses for people with intractable insomnia," said Wilson, an associate professor at the University of South Florida. "But I make sure patients are acutely aware of the potential for weight gain, especially if they have a predisposition to diabetes."
Wilson says the industry-funded jaunts to Europe did not unduly influence her.
"I went because I want to be up-to-date and learn," she said of the seminars, which she did not report, as required, to USF officials. "But frankly, I'd prefer they were in Orlando."
•
The call notes show that massaging doctors' egos consumed an inordinate amount of a drug rep's time.
Saleswomen in Miami quickly honed in on psychiatrist Dr. Heriberto Cabada's need for extra schmoozing. "Would not pay attention, all about him," wrote one frustrated sales rep in 2001. So the line worker pulled in a "customer solutions" specialist who offered to redo the doc's patient history forms with a personalized logo.
She agreed to Cabada's demands for multiple revisions, "one side only and ... marbled type paper." More attention was funneled his way through a "preceptorship," in which a sales rep shadows the doctor for the day and pays for the honor.
In a few months, Cabada went from prescribing what he called "chicken dosages" of Seroquel to higher doses. Soon after his conversion, however, Cabada closed his practice and moved to Spain, where he now lives. He did not respond to an e-mail seeking comment.
Drug reps are taught to use free samples as a strategic weapon: Parcel them out sparingly, even if there are box loads in the trunk.
"It makes the doctor even more grateful," said former Lilly rep Ahari. "And when he gives a freebie to the patient, the doctor feels like a hero."
Dribbling samples out in small caches, and requiring the doctor's signature each time, also gives the rep another chance at valuable face time.
"Samples are key to access," wrote a sales rep who was routinely brushed off by Dr. John Roy Billingsley in Panama City.
AstraZeneca said it has voluntarily banned many of its "reminder" giveaways to docs — free pens, pads and hand wash emblazoned with drug names. But the company declined to say how such changes have affected its spending on physicians.
Ahari said he doubts drug companies have pared back their marketing budgets. "The money going to influence physicians is exactly the same,'' he said.
"There's absolutely no enforcement of these voluntary guidelines. All the incentives are still in place to wine and dine doctors at Hooters if he needs to."
The reason: it works.
Case in point: Dr. Mohamed O. Saleh, a Jacksonville psychiatrist who was involved in early clinical studies of Seroquel. In 1998, he was telling AstraZeneca reps that their product wasn't effective and two years later he was still dodging salesmen.
By 2003, however, the rep was crowing that Saleh "really loves seroquel for elderly... said that he would — dose of 800 (mg) and even higher if necessary!"
Saleh and his nurse practitioner, Richard Daniel Malcolm, were wooed with everything from holiday treats ("Left pumpkin candy baskets ... put seroquel labels on them") to a video of Saleh for his use during a visit to Africa in 2002.
AstraZeneca also furnished Saleh with freebies for the trip. The payoff: the doctor told the drug rep he would put a picture on his Web site showing "African healthcare workers holding the Seroquel bags filled with (a text book) and pens/etc. Appreciated our support."
Saleh, who said in July that he is still receiving $10,000 to $15,000 a year as a speaker for Seroquel, seemed aware of the persuasive power of drug company payola. In October 2003, he told AstraZeneca reps that he was concerned about his nurse practitioner, who had taken a fishing trip with the Seroquel rep and was pushing for his own speaking gigs.
"Concerned about payments to Dan (Malcolm) and can be inducement for scripts b/c paying so much," wrote one of the two reps assigned to Saleh's office.
Malcolm joined Saleh's office in June 2001, four months after he was disciplined by the Florida Board of Medicine for pleading guilty to charges of domestic battery, driving with a suspended license and fraud in obtaining a medicinal drug.
Neither Saleh nor Malcolm returned calls or e-mails seeking comment.
•
When doctors complained that patients were ballooning up on Seroquel, sales reps often handed them a study by Chicago psychiatrist Dr. Michael J. Reinstein. Its startling message: "Use of S (Seroquel) to reduce weight and reduce risk," according to a salesman who visited Panama City's Billingsley.
Back at headquarters, however, company executives had serious questions about the validity of Reinstein's findings. "Our clinical colleagues have significant and numerous issues in the past with the quality of research that this group has produced," a note from Seroquel's brand manager said in 2001.
While sales reps were not allowed to explicitly promote Seroquel for anything other than schizophrenia prior to 2004, the notes reflect a not-so-subtle, broad-based push.
In early 2000, Billingsley's sales rep wrote, "S best in new Schizo's, kids, adolescents, bi-pols, blacks and asians."
Dr. Guido Nodal, Jr., a psychiatrist in Hialeah, at first was cautious about Seroquel, fearing potential links to cataracts. In late 2001, he told a male sales rep he would keep the drug in mind only for "smoking sciz pts."
Two months later, however, a female rep wrote that Nodal "LOVES SER. FOR ELDERLY." By year's end he had 15 nursing home patients on the drug. (Later the FDA made all antipsychotics warn that use in elderly with dementia could cause death.)
"Claims that he is switching patients from Risperdal to Seroquel at the nursing homes," a sales rep wrote in 2003. "Writing as much as he can to all patients."
Notes show that in the interim, Nodal received a textbook, mug, penlights ("Using lots"), payment for a preceptorship and dinner at Ruth's Chris Steak House. He denies the giveaways influenced his prescribing.
"If drug companies stopped marketing, I think prescribing (patterns) would be more or less the same as they are now,'' said Nodal, who said he tried to become a Seroquel speaker but was not accepted. "It didn't affect me at all."
Nodal closed his private practice last year and now works for the state's Department of Corrections in Florida City. The agency does not allow drug reps to lobby its physicians.
Friday, March 20, 2009
Harvard Psychiatrist thinks his senior is God
Harvard professor Joseph Biederman an apparently deranged Psychiatrist, among other coacademics are part of a lawsuit in New Jersey for failing to report consulting fees. He allegedly failed to fully report approximately $1.6 million in fees from a number of drugmakers from 2000 and 2007. The litigation in the Superior Court of New Jersey involves three drugmakers AstraZeneca, Eli Lilly and Johnson and Johnson's who are being sued in connection with risks associated with their antipsychotic medications.
"Full Professor" Beiderman's deposition contained a bizarre exchange. (From Informed Consent newsrelease)On page 47 of the deposition , Biederman is quizzed about his professional ranking at Harvard. He notes that his resume is used for academic promotions.
Lawyer: "What does that mean?"
Biederman: "To move in the ranks from one rank, for example, at Harvard, there is instructor, from instructor you move to assistant professor, from assistant professor you move to associate professor, from associate professsor you move to full professor."
Lawyer: "Full professor?"
Biederman: "Hm...mmm."
Lawyer: "What rank are you?"
Biederman: "Full professor."
Lawyer: "What's after that?"
Biederman: "God"
Lawyer: "Did you say God?"
Biederman: "Yeah."
It appears full professors of psychiatry at Harvard are next to God? According to Joseph Biederman he gets his orders from God and God is in agreement of drugging children with psychotropics? Hmm, What ever happened to we are made pure in God image? Then why would a child need a drug? We think "Full Professor" Joseph Biederman is more like "Son of Sam" and he is talking to the devil.
"Full Professor" Beiderman's deposition contained a bizarre exchange. (From Informed Consent newsrelease)On page 47 of the deposition , Biederman is quizzed about his professional ranking at Harvard. He notes that his resume is used for academic promotions.
Lawyer: "What does that mean?"
Biederman: "To move in the ranks from one rank, for example, at Harvard, there is instructor, from instructor you move to assistant professor, from assistant professor you move to associate professor, from associate professsor you move to full professor."
Lawyer: "Full professor?"
Biederman: "Hm...mmm."
Lawyer: "What rank are you?"
Biederman: "Full professor."
Lawyer: "What's after that?"
Biederman: "God"
Lawyer: "Did you say God?"
Biederman: "Yeah."
It appears full professors of psychiatry at Harvard are next to God? According to Joseph Biederman he gets his orders from God and God is in agreement of drugging children with psychotropics? Hmm, What ever happened to we are made pure in God image? Then why would a child need a drug? We think "Full Professor" Joseph Biederman is more like "Son of Sam" and he is talking to the devil.
Friday, March 13, 2009
German Teen Prescribed Antidepressants Kills Fifteen in a Drug Rage
The Associated Press confirms that Tim Kretschmer, 17 killed 16 people in Germany last week. In a story published across the Internet. Police investigator Siegfried Mahler states on the record that the shooter (Tim Kretschmer) "underwent several treatment sessions for depression at a psychiatric clinic" and was "prescribed a session of outpatient therapy, which he never began." Once again Antidepressants are at the base of a school shooting.
Thus, the shooter was on psychiatric medications and then quit using them. This created a classic antidepressant withdrawal crisis which is exactly what leads to extreme acts of violence against self or others. As Stoprx.org has reported in a previous story, virtually every school shooter that has taken place in the last two decades was carried out by those who either take psychiatric medications or are attempting to quit them. The deaths of the people killed in these school shootings rests solely on the shoulders of psychiatry, and the drug pushers of BigPharma.
"If we had known this in advance, we would have called him a prototype of a rampager," said Erwin Hetger, the chief of police in Baden-Württemberg, the southwestern German state where the crimes took place.
The fact of the matter is that psychotropic drugs create a prototype for mass murder. This is clearly evident from past cases where Eric Harris and Dylan Klebold of Columbine High School killed 12, Cho Seung-Hui of Virginia Tech University killed 32 fellow students and faculty, Jeffrey Weise of Red lake Minnesota, and Pekka-Eric Auvinen of Finland both killed nine classmates.
Do you see a pattern here? While many in the media do not? The media will not report this since they are complicit in the crime of the murderous effects of these drugs, or they are benefiting in advertising revenue and sales. You will hear the guns are to blame, or parents, or video games. The truth is that antidepressants are the cause of these violent rampages, and suicide that occur worldwide. How many more of these incidents need to occur until people wake up to what is widely known about these deadly drugs. You can find more information on the effects of antidepressants at stoprx.org.
Thus, the shooter was on psychiatric medications and then quit using them. This created a classic antidepressant withdrawal crisis which is exactly what leads to extreme acts of violence against self or others. As Stoprx.org has reported in a previous story, virtually every school shooter that has taken place in the last two decades was carried out by those who either take psychiatric medications or are attempting to quit them. The deaths of the people killed in these school shootings rests solely on the shoulders of psychiatry, and the drug pushers of BigPharma.
"If we had known this in advance, we would have called him a prototype of a rampager," said Erwin Hetger, the chief of police in Baden-Württemberg, the southwestern German state where the crimes took place.
The fact of the matter is that psychotropic drugs create a prototype for mass murder. This is clearly evident from past cases where Eric Harris and Dylan Klebold of Columbine High School killed 12, Cho Seung-Hui of Virginia Tech University killed 32 fellow students and faculty, Jeffrey Weise of Red lake Minnesota, and Pekka-Eric Auvinen of Finland both killed nine classmates.
Do you see a pattern here? While many in the media do not? The media will not report this since they are complicit in the crime of the murderous effects of these drugs, or they are benefiting in advertising revenue and sales. You will hear the guns are to blame, or parents, or video games. The truth is that antidepressants are the cause of these violent rampages, and suicide that occur worldwide. How many more of these incidents need to occur until people wake up to what is widely known about these deadly drugs. You can find more information on the effects of antidepressants at stoprx.org.
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