Monday, June 9, 2008

Biederman, Pharma and Bipolar Disorder

This was a little scary:
" A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators."
New York Times, June 8, 2008

Why does this matter?  Because, in the 1990s, Dr. Biederman was one of the leading voices of those who argued that many children who had been diagnosed with ADHD actually had bipolar disorder, a disease that had previously been considered rare in prepubertal children.  Changing the diagnostic paradigm changes the medications recommended;  Dr. Biederman's reanalysis led many psychiatrists to recommend changing from stimulant medications to SSRIs, mood stabilizers and antipsychotic medications.  This change resulted in huge profits for the makers of these medications;  it appears that the pharmaceutical companies were not shy about sharing a little of the wealth.
In fairness to Dr. Biederman, his views were pretty clear before he started receiving this personal windfall, and I doubt that the payoff was a simple tit-for-tat.  By accepting the money and not disclosing this to Harvard or the NIH, however, he has reduced of his credibility as a researcher, and helped to convince the public that we are all in thrall to drug companies.  This is small potatoes to big Pharma, a rounding error.  Yet it made us sit up and take notice on the front page of the Sunday New York Times, making it all a little harder to explain science to the public.
Are there really lots of kids with bipolar disorder?  I am not sure.  I am sure, however that I am a bit less likely to take Dr. Biederman's word for it.

PS.  Nice little article about the distinguishing of the two disorders here.

FEEDJIT Live Traffic Map