Citizens Committee on Human Rights

The Mental Health Watchdog

Australian National Office

Psychiatric Labelling and Drugging of Australian Children: The Facts

Hand writing get the facts with a marker on a screen.There has been a dramatic increase in the psychiatric labelling and prescription of psychotropic drugs to Australian children. Parents have a right to know of all the alternatives and potential side effects of psychotropic drugs proposed for their children so they can give fully informed consent. Yet there are many facts about these drugs, including dangerous side effects, parents and others who are responsible for the welfare of these children are just not being told.

Graph and an arrow.The psychiatric Diagnostic and Statistical Manual of Mental Disorders (DSM) is the primary reference used in the diagnosis of ADHD and other psychiatric labels in Australia. It has no scientific basis. In 1987, American Psychiatric Association members simply “voted” on a list of behavioural symptoms, called this new “disorder” ADHD and inserted the symptoms into the DSM which Australia has since adopted. It created a false international epidemic. Our children’s lives are being placed at risk by an alliance which works like this: The American Psychiatric Association invents disorders and adds them into the DSM. Drug companies then make drugs to match the new disorder and then apply to Australia’s drug regulatory agency, the Therapeutic Goods Administration (TGA) for authority to use them in Australia.

ADHD & Stimulants

Pills and drugs.

  • The DSM entry for ADHD states “There are no laboratory tests, neurological assessments or attentional assessments that have been established as diagnostic in the clinical assessment of Attention Deficit/Hyperactivity Disorder.” 1
  • “The new DSM, DSM 5, states, “No biological marker is diagnostic of ADHD.” 2
  • Ritalin, Concerta, and dexamphetamine are Schedule 8 drugs in Australia. This means they are in the same category as cocaine, opium and morphine. This category is labelled “controlled drugs” to reduce misuse and dependence.3
  • A 2016 study done by researchers from Australia, Canada and South Korea of more than 100,000 children taking methylphenidate (brands include Ritalin and Concerta) found that there were 1,224 patients under 17 in South Korea experienced an “incident cardiovascular event.” These cardiovascular side effects included: 864 children with irregular heart rate, 67 with a stroke and 44 with heart failure.4
  • Other side effects linked to Ritalin reported in children to the TGA include: aggression, chest pain, heart palpitations, weight loss, psychotic disorders, and suicide attempts.5
  • By April 2014, the Australian TGA Adverse Drug Database reported the suicide of a 9 year old boy and the attempted suicides of an 11 year and 8 year old while taking the non-stimulant ADHD drug Strattera (an antidepressant). Other side effects reported include agitation, weight loss, chest pains and self-harm. Strattera has the strongest warning that can be placed on any drug in Australia, a “boxed warning” to warn of the risk of suicidal thoughts and behaviour in children.6
  • The 2010 Raine Study, conducted by the Telethon Institute in WA, was the first long-term outcomes stimulant study in the world. Researchers found that children receiving stimulants had significantly greater diastolic blood pressure (the pressure between heart beats) than children who have never received medication. This side effect can predispose children to the risk of heart attacks and stroke. They also found that “stimulant medication use increased the odds of below-age-level academic achievement by a factor of 10 times” which “strongly suggests that medication may not result in any long term academic gains (as rated by a classroom teacher).” 7
  • A 2007 Oregon Health and Science University Evidence-Based Practice Centre review of 2,287 studies – virtually every study ever conducted on ADHD drugs − determined that no trials had shown the effectiveness of stimulants and that there was a lack of evidence that they could affect “academic performance, risky behaviours, social achievements, etc.” 8
  • A 2014 Australian study reported that there has been a 72.9% increase in ADHD drug prescribing between 2000 and 2011. The study revealed a staggering 388,333 prescriptions were written for methylphenidate (Concerta, Ritalin and other brands) in 2012 for children aged 3 to 14, with methylphenidate the most dispensed psychotropic to Australian children aged 3 to 14.9
  • After Australian and international uproar on the Australian draft ADHD Clinical Practice Points (ADHD CPPs – used by doctors, teachers, justice system etc to asses and manage ADHD) which could have seen children removed from their parents if they refused to medicate their child, the final ADHD CPPs documents now state that parents will not be forced to medicate their child. This is a useful document for any parent who is being pressured to drug their child for ADHD.10

Antidepressants

The psychiatric theory that a “chemical imbalance” causes depression, requiring antidepressants to “balance it out” is fraudulent. As psychiatrist Dr. Ron Leifer states, “There’s no biological imbalance. When people come to me and they say, ‘I have a biological imbalance,’ I say, ‘Show me your lab tests.’ There are no lab tests. So what’s the biochemical imbalance?” Faced with media exposure of this in 2005, Dr. Steven Sharfstein, then President of the American Psychiatric Association, admitted that no “clean cut lab test” exists to determine such a chemical imbalance in the brain. Parents have the right to ask for scientific evidence of the “mental disorder” their child is said to have.

Girl leaning on a wall.

  • As early as December 2004 the Australian TGA warned there were indications in use by children and adolescents of the most common class of antidepressants (SSRIs) causing an increased risk of suicidality. This included suicidal ideation, suicide attempts and self-harm events. In 2005 this warning was extended to include adults and also stated anyone placed onto an SSRI antidepressant should be monitored for suicide.11
  • In December 2016, again the TGA issued a warning for the increased risk of suicidal thinking and behaviour with antidepressants, particular SSRI’s. They also warned that antidepressants should never be suddenly stopped and should be reduced gradually [always under a doctor’s supervision] to avoid potential discontinuation symptoms (also called withdrawal syndrome- worsening of current symptoms/ new never before experienced symptoms) such as nausea, sleep problems, dizziness, irritability, anxiety, numbness and ‘electric shock-like’ sensations.12
  • In 2010, the first ever long term study of antidepressants causing suicide in youths confirmed that while the risk of suicide is the same for all antidepressants, the risk is five times greater than for the general population. The Harvard study followed 20,906 British Columbian children aged 10 to 18 who were prescribed an antidepressant over 9 years. In the first year of antidepressant use, 266 attempted suicide and three suicided. This was about five times the rate of the general population of teens in British Columbia.13
  • By May 2011, documents obtained from the TGA laid out 119 adverse reactions reported for children under 10 linked to antidepressants. Reports showed these drugs have been linked to 5 deaths including 2 suicides in under 19 year olds. Other side effects reported linked to antidepressants include: convulsions, hallucinations and heart problems.14
  • A 2014 Australian study revealed that antidepressant prescribing increased by 95.3% between 2000 and 2011. Despite the fact that no antidepressant has been approved for use in children under the age of 18 in Australia for depression, this study also exposed there were 358,242 antidepressant prescriptions written for 3-19 year olds, 21,652 were for children aged between 3 and 9.15

Antipsychotics

By August 2011, there had already been 14,979 adverse reactions reported to the TGA linked to antipsychotics including 667 deaths. Of those, 1,094 involved children aged 0 to 19 years including 15 deaths. Between 2009 and 2012 there was a 45% increase in prescribing of antipsychotics to 3-9 year olds. Side effects of antipsychotics include, diabetes, drowsiness, drop of blood pressure, increased heart rate, headaches and stiffening and trembling of the muscles.16

  • Weight gain is a common side effect for antipsychotics and can be severe. An Australian 13 year girl put on 45kg over a 6 month period while on Zyprexa and a 15 year old boy went from 60kg to 100 kg. He was also taking Zyprexa.17

Mountain lake.ALTERNATIVES: There is no doubt that some children who are troubled require special care. But they should be given holistic, humane care that improves their condition. Institutions should be safe havens where children and adults voluntarily seek help for themselves or their child without fear of indefinite incarceration or harmful and terrifying treatment. They need a quiet and safe environment, good nutrition, rest, exercise and help with life’s problems. Extensive medical evidence proves that underlying and undiagnosed physical illnesses can manifest as psychiatric symptoms and therefore should be addressed with the correct medical treatment, not psychiatric techniques. Studies show that once the physical condition is addressed, the mental symptoms can disappear. With proper medical treatment and real help children can lead healthier, happier lives.

Actions you can take now

  1. You can responsibly report any side effect of a psychiatric drug to the TGA’s Australian Adverse Drug Reaction Reporting System by: A) Phoning the Consumer Adverse Medications Events Line: 1300 134 237. B) Electronically, by logging onto: http://www.ebs.tga.gov.au/ebs/ADRS/ADRSRepo.nsf and filling out a report. C) Ask your doctor or pharmacist who can make the report for you. This can force an investigation into the drug. Please also report the same effects to CCHR at: www.cchr.org.au
  2. Broadly distribute this fact sheet and its companion the Alternatives to Psychiatric Drugs for Children fact sheet to other parents, teachers, educators and those who you feel should have this information.

Download the fact sheet by clicking here.

WARNING: No one should stop taking any psychiatric drug without the advice and assistance of a competent medical doctor.


References

  1. Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR, American Psychiatric Association, pps.86,87.
  2. Diagnostic and Statistical Manual of Mental Disorders, DSM-5, American Psychiatric Association, p.61
  3. Poisons Standard 2013, Australian Government, Department of Health and Ageing, Therapeutic Goods Administration, pps, iv, 209, 210,211, 22 July 2013.
  4. Ju-Young Shin, Elizabeth E Roughead, Byung-Joo Park, Nicole L Pratt, “Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self controlled case series study,” British Medical Journal, 31 May 2016: http://www.bmj.com/content/353/bmj.i2550 ; SBS News article available on this link: http://www.sbs.com.au/news/article/2016/06/01/ritalin-linked-higher-heart-disease-risk
  5. Therapeutic Goods Administration Database of Adverse Event Notifications: Generate reports for Ritalin on this link: http://www.tga.gov.au/safety/daen.htm
  6. Therapeutic Goods Administration Database of Adverse Event Notifications: Generate reports for Strattera on this link: http://www.tga.gov.au/safety/daen.htm ; Department of Health and Ageing Therapeutic Goods Administration, Medicines Safety Update, “Atomoxetine and suicidality in children and adolescents,” Volume 4, Number 5, October 2013; “Australian ADHD drug warnings are already in place: TGA,” AAP Newswire 22 Feb, 2007.
  7. Stephen Lunn, “Kids on ADHD drugs ‘poor at school,’” The Australian, 17 Feb, 2010; “Raine ADHD Study: Long-term outcomes associated with stimulant medication in the treatment of ADHD in children, Government of Western Australia Department of Health, p. 6, 2010.
  8. Drug Class Review on Pharmacologic Treatments for ADHD, Final Report December 2007 p.16
  9. E. A. Karanges, C.P. Stephenson, I.S. McGregor, “Longitudinal trends in the dispensing of psychotropic medications in Australia from 2009-2012:Focus on children, adolescents and prescriber speciality,” Australian and New Zealand Journal of Psychiatry, pps. 1,2,4,8.
  10. Draft Clinical Practice Points on Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents, National Health and Medical Research Council, p 15, October 2011; “Health Advice on Attention Deficit Hyperactivity Disorder (ADHD): Questions and Answers, Clinical Practice Points on the Diagnosis, Assessment and Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents (the CPPs), p.3, 3 Sept 2012.
  11. “Use of SSRI antidepressants in children and adolescents” The Australian Therapeutic Goods Administration, Adverse Drug Reactions Bulletin, Vol. 23, No. 6, August 2004; “Suicidality with SSRIs: adults and children,” The Australian Therapeutic Goods Administration, Adverse Drug Reactions Bulletin, Vol. 24, No. 4, August 2005.
  12. Department of Health and Ageing Therapeutic Goods Administration, Medicines Safety Update, “Antidepressants – Communicating risks and benefits to patients,” Volume 7, Number 5, October- December 2016.
  13. S. Schneeweiss, A. R. Patrick, D. H. Solomon, C. R. Dormuth, M. Miller, J. Hehta, J.C. Lee & P.S. Wang, “Comparative Safety of Antidepressant Agents for Children and Adolescents Regarding Suicidal Acts,” Pediatrics, Volume 125, Number 5, May 2010.
  14. Medicine Summary-antidepressants (22) (to date) ages 0 to 9, Cube updated: Apr 29, 2011, 7:18:03 AM, report from Therapeutic Goods Administration; Medicine Summary- antidepressants (22) (to date) ages 10 to 19, Cube updated: Apr 29, 2011, 7:18:03 AM, report from Therapeutic Goods Administration.
  15. E. A. Karanges, C.P. Stephenson, I.S. McGregor, “Longitudinal trends in the dispensing of psychotropic medications in Australia from 2009-2012: Focus on children, adolescents and prescriber speciality,” Australian and New Zealand Journal of Psychiatry, pps. 1,2,7.
  16. Medicine summary-antipsychotics (see list) to date, Cube updated: 21/07/2011, 7:21:10AM report from Therapeutic Goods Administration; Medicine summary- antipsychotics (to end January 2009) 0-9 year olds, Cube updated: 15/12/2009,7:30:39AM report from Therapeutic Goods Administration; Medicine summary- antipsychotics (to end January 2009) 10-19 year olds, Cube updated: 15/12/2009,7:30:39AM report from Therapeutic Goods Administration; E. A. Karanges, C.P. Stephenson, I.S. McGregor, “Longitudinal trends in the dispensing of psychotropic medications in Australia from 2009-2012:Focus on children, adolescents and prescriber speciality,” Australian and New Zealand Journal of Psychiatry, p.9.
  17. Therapeutic Goods Administration, Public Case Detail, Case Number: 220675; Therapeutic Goods Administration, Public Case Detail, Case Number: 321666.
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