What Happens to a Misdiagnosed Patient in the Mental Health Care System?
I recently learned that Jansen, the pharmaceutical company which manufactures Risperdal was sued by a number of states for their deceptive marketing practices. Apparently Jansen's sales representatives were encouraging child psychiatrists to use Risperdal on "unmanageable" children. There is a mental health condition the psychiatric community calls "oppositional defiant disorder." Here are the criteria for diagnosing this so-called mental illness (This was taken from Wikipedia):
Some signs and symptoms that must be perpetuated for longer than 6 months and must be considered beyond normal child behavior to fit the diagnosis are:
"The child must exhibit 4 out of the 8 signs and symptoms listed below in order to meet the DSM-IV-TR diagnostic threshold for oppositional defiant disorder
- Actively refuses to comply with majority's requests or consensus-supported rules
- Performs actions deliberately to annoy others
- Angry and resentful of others
- Argues often
- Blames others for his or her own mistakes
- Often loses temper
- Spiteful or seeks revenge
- Touchy or easily annoyed
Generally, these patterns of behavior will lead to problems at school and other social venues."
Essentially, any child in America could be diagnosed with oppositional defiant disorder as defined in the Diagnostic Statistical Manual. For this reason, any child could potentially be prescribed anti-psychotic medication.
Interestingly, the Jansen sales reps also walked into nursing homes encouraging the doctors to prescribe Risperdal to their dementia patients. It wasn't until elderly nursing home residents started dying from Neuroleptic Malignant Syndrome that people started complaining about this drug. The lawsuits filed against Jansen resulted in a billion dollar settlement. This money went to state coffers to recover the health care costs involved in treating the victims. At least that is their claim. This landmark settlement is one the largest in pharmaceutical history.
I have a particular issue with atypical anti-psychotic medications such as Zyprexa, Seroquel, Abilify, and Risperdal. After taking Risperdal for over fifteen years for bipolar manic-psychosis, I was told by my prescriber that I no longer need it. My psychiatrist told me that she "believes my patients should experience their emotions. I was thinking "You mean human beings should experience emotion? What a marvelous idea!" In a follow-up appointment, I asked her about the memories and emotions I was experiencing with such great intensity. She told me that Risperdal has a blunting effect on emotion. It actually suppresses one's feelings. I wish my last four or five treaters had mentioned this terrible effect. Since emotions do not go away, but rather pile up, I recommend that people process their emotions while they occur rather than putting aside for a later time. Anti-psychotic medications should be used as a treatment of last resort, and only in cases where a patient is not responding to milder therapeutic treatments.
When Zyprexa first entered the prescription drug market, I was prescribed to me for anxiety. I remember at that time I was taking classes at my local hospital for frustration with the mental health care system (I realize that now). I met a person who was serving time in an inpatient unit for bipolar disorder. I knew him from years before. This man was anxiously pacing on the floor. His restlessness was making me nervous. I noticed he was popping a pill every fifteen minutes. I asked him what he was taking. He said Zyprexa. I was troubled by this, so I expressed my concern to a nurse. She said, "He has a PRN for it, but even that has its limitations. For those of you who are not familiar with medical terminology, PRN means "as needed." Thinking back on this, I am wondering if this man is still alive.
I use to hear psychiatric patients complain about how their doctors experimented on them. I thought this statement was a little far-fetched (especially coming from a psych patient). I realize now that this is exactly what they were doing to me. I believe the term the medical community gives to this dangerous experimenting is "off label use." I do not know if off label drug use is unique to psychiatry or if it is common practice in all medical specialties. I am under the impression that medications proposed to treat a certain condition, must undergo medical trials before entering the prescription drug market. I have found myself in the emergency room more than once because of this off label use practice.
I'll bet most of you reading this article were not aware of the failings of our behavioral health care system. I have not personally had the experience I just described, but I have been in the psychiatric system long enough to have learned how business is carried out.
Some signs and symptoms that must be perpetuated for longer than 6 months and must be considered beyond normal child behavior to fit the diagnosis are:
"The child must exhibit 4 out of the 8 signs and symptoms listed below in order to meet the DSM-IV-TR diagnostic threshold for oppositional defiant disorder
- Actively refuses to comply with majority's requests or consensus-supported rules
- Performs actions deliberately to annoy others
- Angry and resentful of others
- Argues often
- Blames others for his or her own mistakes
- Often loses temper
- Spiteful or seeks revenge
- Touchy or easily annoyed
Generally, these patterns of behavior will lead to problems at school and other social venues."
Essentially, any child in America could be diagnosed with oppositional defiant disorder as defined in the Diagnostic Statistical Manual. For this reason, any child could potentially be prescribed anti-psychotic medication.
Interestingly, the Jansen sales reps also walked into nursing homes encouraging the doctors to prescribe Risperdal to their dementia patients. It wasn't until elderly nursing home residents started dying from Neuroleptic Malignant Syndrome that people started complaining about this drug. The lawsuits filed against Jansen resulted in a billion dollar settlement. This money went to state coffers to recover the health care costs involved in treating the victims. At least that is their claim. This landmark settlement is one the largest in pharmaceutical history.
I have a particular issue with atypical anti-psychotic medications such as Zyprexa, Seroquel, Abilify, and Risperdal. After taking Risperdal for over fifteen years for bipolar manic-psychosis, I was told by my prescriber that I no longer need it. My psychiatrist told me that she "believes my patients should experience their emotions. I was thinking "You mean human beings should experience emotion? What a marvelous idea!" In a follow-up appointment, I asked her about the memories and emotions I was experiencing with such great intensity. She told me that Risperdal has a blunting effect on emotion. It actually suppresses one's feelings. I wish my last four or five treaters had mentioned this terrible effect. Since emotions do not go away, but rather pile up, I recommend that people process their emotions while they occur rather than putting aside for a later time. Anti-psychotic medications should be used as a treatment of last resort, and only in cases where a patient is not responding to milder therapeutic treatments.
When Zyprexa first entered the prescription drug market, I was prescribed to me for anxiety. I remember at that time I was taking classes at my local hospital for frustration with the mental health care system (I realize that now). I met a person who was serving time in an inpatient unit for bipolar disorder. I knew him from years before. This man was anxiously pacing on the floor. His restlessness was making me nervous. I noticed he was popping a pill every fifteen minutes. I asked him what he was taking. He said Zyprexa. I was troubled by this, so I expressed my concern to a nurse. She said, "He has a PRN for it, but even that has its limitations. For those of you who are not familiar with medical terminology, PRN means "as needed." Thinking back on this, I am wondering if this man is still alive.
I use to hear psychiatric patients complain about how their doctors experimented on them. I thought this statement was a little far-fetched (especially coming from a psych patient). I realize now that this is exactly what they were doing to me. I believe the term the medical community gives to this dangerous experimenting is "off label use." I do not know if off label drug use is unique to psychiatry or if it is common practice in all medical specialties. I am under the impression that medications proposed to treat a certain condition, must undergo medical trials before entering the prescription drug market. I have found myself in the emergency room more than once because of this off label use practice.
I'll bet most of you reading this article were not aware of the failings of our behavioral health care system. I have not personally had the experience I just described, but I have been in the psychiatric system long enough to have learned how business is carried out.