- CCHR Australia - https://cchr.org.au -

79% Of Australian Children On Antipsychotics Are Prescribed Risperidone, A Drug At The Centre Of Multi-Billion Dollar Lawsuits

Blue pills in white cupGPs were trained with Pharmaceutical Company-Funded “Early Psychosis” Training Pack—Now they prescribe 72% of all antipsychotics

An extraordinary 79% of 2-16 year olds taking antipsychotics in 2009/10 were prescribed risperidone, a drug at the centre of multi-billion dollar lawsuits in the US and capable of causing irreversible damage to the nervous system and life-threatening diabetes. The number of children taking antipsychotics overall increased 69% between 2007/08 (5,727) and 2009/10 (9,683), 759 of them in 2010 aged 6 or under. The Citizens Committee on Human Rights (CCHR) said an investigation is needed into the potential conflicts of interest between pharmaceutical companies and psychiatrists writing treatment guidelines and the influence of these on prescription trends.

Concerns have escalated with federal government plans for GPs to screen 3-year-olds for highly subjective mental disorders when already this group has been heavily marketed to by the pharmaceutical-psychiatric consortium and prescribe 72% of antipsychotics, 86% of antidepressants and 94% of sedative-hypnotics.1 CCHR says Medicine Australia’s proposed Code of Conduct disclosing conflicts of interest with doctors and consumer groups is a whitewash, needing federal legislation similar to that in the US which names all doctors receiving more than $100 from pharmaceutical companies. CCHR national executive director Shelley Wilkins says the pharmaceutical-psychiatric industry needs to disclose any funding of psychiatric training manuals, treatment guidelines, and research.

Conflicts of Interest Hidden in Australia

A Texas lawsuit brought earlier this year by the state Attorney General against risperidone (Risperdal) manufacturer, Janssen-Cilag/Johnson & Johnson revealed the company had paid psychiatrists to develop treatment guidelines to boost sales and gave kickbacks to officials to ensure risperidone became a “preferred” drug on government medicine lists. http://www.pharmalot.com/2012/01/jj-pays-158m-to-settle-risperdal-lawsuit-in-texas/

In 1998 in Australia, Janssen-Cilag sponsored the development of a Resource Kit for General Practitioners aimed at integrating GPs into outpatient services for young people who were given psychiatric treatment for early psychosis.

A leading Australian researcher, Richard Gosden, Ph.D. said in the late 90s Janssen also provided an “unrestricted” grant to produce an “Early Psychosis Training Pack” for mental health workers. The principal authors were Prof. Patrick McGorry, Director, and Jane Edwards, Assistant Director of the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, which had also received Janssen funds to conduct research on risperidone. https://sites.google.com/site/richardgosden/ehss; https://sites.google.com/site/richardgosden/phd

The treatment algorithm in the Training Pack and subsequent Early Psychosis Treatment Guidelines is similar to that exposed in the recent Texas case against Janssen, which was developed by psychiatrists funded by Janssen around the same time as the Australian training pack and early psychosis guidelines were produced.

David J. Rothman, Ph.D., Professor of Social Medicine at the Columbia College of Physicians & Surgeons, Columbia University provided expert evidence for the Texas State prosecution of Janssen, detailing from the company’s records and emails the marketing strategies the company used to increase sales. http://media2.kxan.com/PDF/Daniel_Rothman_Expert_Report_300dpi.pdf

Rothman exposed how the company’s phrase “unrestricted educational grant” was misleading, aimed really at expanding Risperdal’s market. Treatment guidelines were turned into a powerful marketing tool, he said.2 Medical education and research were “thinly disguised marketing activities” and “funding of these activities created conflicts of interest that subverted scientific objectivity and professional medical integrity.”3 Psychiatrists were paid to develop treatment guidelines with a $65,000 bonus for completing on time. Government officials were given kickbacks to make Risperdal a preferred drug in insurance rebates.

Like the US Schizophrenia Guidelines, the Australian Early Psychosis Training Pack, Australian Clinical Guidelines for Early Psychosis and The Diagnosis and Management of Psychosis: A Booklet for General Practitioners, recommended risperidone, quetiapine and olanzapine as treatment for early psychosis/first episode psychosis.

Dr. Gosden stated: “In the end one may propose the working hypothesis argued presently, that early psychosis research and intervention programs are driven by funding and lobbying from the pharmaceutical companies that have recently launched atypical neuroleptics [antipsychotics] onto the market.” https://sites.google.com/site/richardgosden/ehss; https://sites.google.com/site/richardgosden/phd

Antipsychotic Drug Use Soaring

The elderly are also a target for antipsychotic prescriptions. According to PBS 2009/10 figures, of the 87,911 elderly aged 72 and over taking antipsychotics, 48% (42,478) were prescribed risperidone, 24% olanzapine and 11.6% quetiapine. [See Janssen/Johnson and Johnson marketing off label to treat the elderly in the U.S. http://americanfraud.blogspot.com/2012/01/marketing-risperdal-part-iii-marketing.html

PBS expenditure on antipsychotics has soared 3,700% since 1992/93. Expenditure on just three brand-name antipsychotics Risperdal (risperidone), Zyprexa (olanzapine) and Seroquel (quetiapine) year-ending 30 June 2011 reached $343,121,352; total costs with co-payments were $362,728,613.4 Between April 2010 and March 2011, Janssen in Australia spent over $1 million on 563 events attended by psychiatrists, representing 36% of all their sponsored medical events.

The manufacturers of Risperdal, Zyprexa and Seroquel have paid almost $4.5 billion in fines and penalties over illegal marketing of and covering up serious adverse effects of their antipsychotics in the US Janssen-Cilag has been fined over $1.9 billion since 2010. http://www.nytimes.com/2012/04/12/business/drug-giant-is-fined-1-2-billion-in-arkansas.html

Parallel Between US and Australian Conflicts Regarding Risperidone: Big Pharma Tactics

David J. Rothman, Ph.D. wrote an 86 page expert statement regarding Janssen/J& J’s egregious marketing strategies to increase sales, subverting scientific objectivity and buying off psychiatric researchers and government officials. In part:


Like the US Schizophrenia Guidelines, between the Australian Early Psychosis Training Pack, Australian Clinical Guidelines for Early Psychosis (including updated 2010 version) and The Diagnosis and Management of Psychosis: A Booklet for General Practitioners, the atypical antipsychotics risperidone, quetiapine and olanzapine are recommended as treatment for early psychosis/first episode psychosis.

To reiterate Dr. Gosden: “In the end one may propose the working hypothesis argued presently, that early psychosis research and intervention programs are driven by funding and lobbying from the pharmaceutical companies that have recently launched atypical neuroleptics onto the market.”



Individual or Class Action lawsuits may be the only way for Australians to learn the truth about all adverse drug events and potential collusion between pharmaceutical companies and psychiatrists conducting industry-funded studies and/or writing treatment guidelines that could influence prescription sales in the country.

Associate Professor Ian Kerridge, head of the Centre for Values, Ethics and Law in Medicine at the University of Sydney says class actions may deter companies tempted not to fully disclose their product’s risks. And court action could have a political impact.14


Mental Health Minister Mark Butler does not appear to monitor conflicts of interest within the mental health system. An investigation should be conducted into whether pharmaceutical company-funding of antipsychotic research and treatment guidelines or potential influence over government preference of prescription psychiatric drugs.


  1. How does the Minister account for the 69% increase in 2-16 year olds prescribed antipsychotics between 2007/08 and 2009/10?
  2. How does the Minister account for the fact that of 2-16 year olds taking antipsychotics in 2009/10 (9,683) 79% were prescribed risperidone, a drug which is the subject of lawsuits in the U.S. against one of its manufacturers, Janssen-Cilag?
  3. What statistics are collected annually on number of children/teens prescribed antipsychotics, antidepressants and psychostimulants through federally-funded youth mental health programs, such as headspace and Orygen Youth Mental Health?
  4. If statistics in (3) are not collected, what will the Minister do to obtain such information and make it publicly accessible and accountable?
  5. What investigation(s) have been initiated or will be initiated to determine what, if any, conflicts of interest may be influencing government treatment guidelines for psychosis, schizophrenia and depression in children, youths and the elderly?
  6. How does the Minister explain the over-representation of risperidone use in the elderly [of all elderly aged 72 and above in 2009/10 taking antipsychotics (87,911), 48% were taking risperidone (42,478), 24% were taking Zyprexa (21,099), and 11% Seroquel (10,203)]?
  7. Is the Minister aware of the recent lawsuits in the U.S. against Janssen-Cilag, the maker of Risperdal (risperidone) resulting in $1.9 billion in fines and settlements over misleading promotion and concealing adverse effects risperidone? Does the government have guidelines or any policy that makes Risperdal (risperidone), Seroquel (quetiapine) or Zyprexa (olanzapine) “preferred” drugs to be prescribed in mental health facilities?
  8. Does the Minister intend implementing a regulation/law where any government-subsidised healthcare facility, organisation, and or researcher and doctor must disclose complete past and present pharmaceutical company or medical device financial support or affiliation?
  9. Can the Minister provide a current breakdown of the number of Australians prescribed antipsychotics, antidepressants and psychostimulants, by age, gender, state and by itemized drug in these classes?


Based on PBS figures, there’s been a 69% increase in 2-15/16 year olds prescribed antipsychotics between 2007/08 (5,727) and 2009/10 (9,683).

Of the total number of 2-16 year olds taking antipsychotics in 2009/10 (9,683) 79% were prescribed risperidone, towering over quietapine at 9% and alonazapine at 7%.

NSW tops the list of 2-16 years old on antipsychotics, representing nearly a third (3,448) of the nationwide consumption of them in this age group. Queensland ranks second (2,777) and Victoria third (1,881).


Of all elderly aged 72 and above in 2009/10, 48% were taking risperidone, 24% were taking olanzapine, and 11% quietapine.
In 2007/08, the number of elderly prescribed risperidone at age 80 was 1,688 and soared an inexplicable 1,433% (to 25,893) among those aged 81 and older.

Federal reporting of these statistics changed in subsequent years, showing aged groups broken down more generally to 72-76 and 77 plus. Even then, in 2009/10, 5,220 72-76 year olds were taking risperidone, increasing 613% in the age group 77 plus (37,258).
Olanzapine was taken by 4,915 elderly aged 72-76 in 2009/10 and 16,184 aged 77 and over.
Quetiapine was taken by 2,577 elderly aged 72-76 in 2009/10 and 7,629 aged 77 and over.


The Australian Therapeutic Goods Administration clearly warns of the increased risk of strokes and death in elderly dementia patients, seizures, major weight gain, onset of diabetes and potentially fatal high blood sugar.15

The FDA also warns that the death rate in the elderly taking antipsychotics is nearly double (1.6 – 1.7 times) that in those taking placebo.16 The Australian National Prescriber Service (NPS) reports an increased death rate was found in an analysis of placebo-controlled trials of aripiprazole, olanzapine, quetiapine and risperidone in dementia patients, mostly due to cardiovascular events (e.g. heart failure, sudden death) or infections (e.g. pneumonia) One death was associated with antipsychotic use for every 100 patients treated over 10–12 weeks.17

A Canadian study found that 5.2% of the nursing homes residents studied died within a month of being given one of the newer classes of antipsychotic drugs, compared to 3.3% of residents who did not take the drugs who died within a month. Among community-dwelling patients, nearly 14% taking the drugs suffered a “serious health event” within 30 days, compared to about 4% not on the drugs.18


Based on Adverse Drug Reports to the TGA

Up to 2007 Up To 2011 (includes earlier figure)
TOTAL 440 629 (22 suicides) – 43% increase
Clozapine – 248 433 (13 suicides) – 74% increase
Olanzapine 40 62 (2 suicides) – 5% increase
Risperdone – 27 38 (3 suicides) – 41% increase
Quetiapine – 10 27 (2 suicides) – 63% increase

“Patients ages 30 to 74 who took atypical antipsychotics such as risperidone (sold as Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa) and clozapine (Clozaril) had a significantly higher risk of sudden death from cardiac arrhythmias and other cardiac causes than patients who did not take these medications, according to a study funded by the US Department of Health & Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) in 2009. The risk of death increased with higher doses of the drugs taken. Especially among children and demented elderly patients for whom there is little evidence of the drugs’ efficacy, their use “should be reduced sharply.”19

NB: The total number of people PBS reports take clozapine is low: 894 in 2007/08, 952 in 2008/09 and 1003 in 2009/10, compared to olanzapine for the same period, 101,012; 105,337 and 104,407 respectively. That means the risk of death could be 87,000 or greater for those taking Clozapine.

The Medical Observer reported in February 2012 that Australia’s monitoring requirements for clozapine are some of the least stringent in the world and have not changed since

1992. The TGA noted that the rate of moderate leukopenia [decrease in white blood cells which places individuals at risk of infection] was “very significant” at 11.8 per 1,000 between weeks 19 to 52, and 6.1 per 1,000 after one year’s use. A psychiatrist and member of the RANZCP complained to the TGA that the monitoring requirements were “unnecessarily onerous.”20

The expenditure on Clozapine increased steadily over the 2004-05 – 2008-09 period—from $30.1 to $39.4 million.21


In Australia, obtaining statistics on psychiatric drug usage, especially by age group and drug is a lengthy and costly affair—upwards of $4,000 per request.

Medicare has informed those seeking such statistics that they now must provide a detailed explanation for wanting the information and how it will be used. This is information that should be provided annually in health care statistics as a matter of transparency.


See near bottom of this page for statistics references.


2007/08: 288,701
2008/09: 312,467
2009/10 329,920

14% increase from 2007/08 – 2009/10



Olanzapine (Patent drug Zyprexa by Eli Lilly) 101,012
Risperidone (Patent drug Risperdal by Janssen- Cilag) 89,955
Quetiapine (Patent drug, Seroquel) Astra Zeneca) 52,782
Haloperidol, older antipsychotic 25,399
Aripiprazole (Abilify–Bristol-Myers Squibb) 14,257


Olanzapine 105,337
Risperidone 98,422
Quetiapine 69,093
Haloperidol 25,001
Aripiprazole 15,604


Olanzapine 104,407
Risperidone 100,410
Quetiapine 87,036
Haloperidol 23,872
Aripiprazole 16,340



Aged 2 – 16

2007/08: 5,727
2008/09: 8,433
2009/10: 9,683 – 69% increase

Aged 2-6

2007/08: 528
2008/09: 660
2009/10: 759

Aged 7-11

2007/08: 1,694 (aged 7-10 – not possible to work out 7-11 for this year)
2008/09: 2,952
2009/10: 3,481

Aged 12 – 16

2007/08: 3,505 (aged 11-15 – not possible to work out 12-16 for this year)
2008/09: 4,821
2009/10: 5,443

Aged 17 – 21

2007/08: 3,642 (16-18 years only reported)
2008/09: 9,463
2009/10: 10,547

Aged 72 – 77 Plus

2007/08: 14,672 – 72-76
67,305 – 77 plus
 Total: 81,977
 (Age 80 – 3,987 – Age 81 plus – 52,303)
2008/09: 15,353 – 72-76
71,079 – 77 plus
 Total: 86,432
2009/10: 15,869 – 72-76
72,042 – 77 plus
 Total: 87,911

7% increase in elderly on antipsychotics since 2007/08


2007-08 2-15 2-18
NSW 2,033 3,351
VIC 1,090 1,963
QLD 1,679 2,433
SA 469 738
WA 287 559
ACT 80 150
TAS 73 146
NT 16 29
2008-09 2-16 2-21
NSW 2,986 6,198
QLD 2,457 4,340
VIC 1,595 4,021
SA 731 1,485
WA 426 1,190
TAS 112 315
ACT 103 288
NT 23 59
2009-10 2-16 2-21
NSW 3,448 7,039 13% increase over 2008/09
QLD 2,777 4,937 13%
VIC 1,881 4,574 14%
SA 820 1,624 9%
WA 496 1,376 15%
TAS 115 321 2%
ACT 105 278 -3%
NT 41 81 37%






(Patent: Risperdal)
Total 2 -16 4,464 (2-15) 6,597 7,640
Total 2- 21 6,022 9,705 10,906
Ages 2-6 425 559 675
Ages 7-11 1,459 (7-10yrs) 2,654 3,147
Ages 12-16 2,580 (11-15 yrs) 3,384 3,818
Ages 17-21 1,558 (16-18 yrs) 3,108 3,266





(Patent: Seroquel)
Total 2 -16 245 (2-15) 660 908
Total 2- 21 1,196 3,816 4,994
Ages 2 -6 4 15
Ages 7-11 30 (7-10 yrs) 53 72
Ages 12-16 256 (11-15 yrs) 592 836
Ages 17-21 906 (16-18 yrs) 3,156 4,086





(Patent: Zyprexa)      
Total 2 -16 390 (2-15) 659 646
Total 2- 21 1,391 3,803 3,774
Ages 2-6 14 13
Ages 7-11 41 (7-10 yrs) 61 66
Ages 12-16 349 (11-15 yrs) 584 567
Ages 17-21 1,001 (16-18 yrs) 3,144 3,128






Ages 72-76 14,672 15,353 15,869
Ages 77 + 67,305 71,079 72,042
81,977 86,432 87,911 – 7% increase

Of all elderly aged 72 and above in 2009/10, 48% were taking risperidone, 24% were taking olanzapine, and 11% quetiapine.





Ages 72-76 4,646 5,063 5,220
Ages 77 + 31,870 35,927 37,258
36,5I6 40,990 42,478





Ages 72-76 4,656 4,880 4,915
Ages 77 + 16,380 16,674 16,184
21,036 21,554 21,099





Ages 72-76 1,712 2,170 2,577
Ages 77 + 5,196 6,320 7,626
6,908 8,490 10,203


[See alerts re: antipsychotics] http://au.mediguard.org/alerts/alert/1329.html

Click here to see the 2007/08 antipsychotics statistics
Click here to see the 2008/09 and 2009/10 antipsychotics statistics

Click here to see the TGA report for the number of deaths linked to …

Click here to see the numbers of deaths linked to risperidone
Click here to see the numbers of deaths linked to quetiapine
Click here to see the numbers of deaths linked to clozapine
Click here to see the numbers of deaths linked to olanzapine

  1. Mental health services in Australia, 2007-08, Australian Institute of Health and Welfare, Aug. 2010, p. 131.
  2. http://www.omsj.org/cases/2011/rothman-report-1-20.pdf, pp. 16-17
  3. http://www.omsj.org/cases/2011/rothman-report-1-20.pdf, p. 12-13
  4. “Expenditure and prescriptions twelve months to 30 June 2011,” Data and Modelling Section, Pharmaceutical Policy and Analysis Branch, PBS, p. 11.
  5. http://www.omsj.org/cases/2011/rothman-report-1-20.pdf, p. 18
  6. Randomised Control Trial http://www.meb.uni-bonn.de/psychiatrie/zebb/literatur/mcgorry.pdf
  7. http://www.iepa.org.au/ContentPage.aspx?pageID=10
  8. http://books.google.com/books/about/Early_psychosis.html?id=ntYCSQAACAAJ
  9. Early Psychosis Training Pack, Module, 4, p. 6.
  10. Early Psychosis Training Pack, Module, 4, pp. 15-16.
  11. The Australian Early Psychosis Treatment Guidelines, pp. 28,30.
  12. Richard Gosden, Ph.D., Chapter 10, Schismatic Mind: Early Psychosis, pp. 298-299.
  13. Early Diagnosis and Management of Psychosis: A Booklet for General Practitioners, 2002, pp. 15,17,20.
  14. “See you in court,” SMH.com, 22 Nov. 2007, http://www.smh.com.au/news/national/see-you-in-court/2007/11/21/1195321867047.html
  15. ”Johnson & Johnson fined $1.1bn in Risperdal case”, Herald Sun, 12 April 2012.
  17. NPS Prescribing Practice Review 37: “Role of antipsychotics in managing behavioural and psychological symptoms of dementia”, http://www.nps.org.au/health_professionals/publications/prescribing_practice_review/current/role_of_antipsychotics_in_managing_behavioural_and_psychological_symptoms_of_dementia
  18. ”Antipsychotic drugs dangerous for the elderly”,Agedcarecrisis.com, 27 May 2008, http://www.agedcarecrisis.com/dementia/dementia-and-antipsychotics-medication-or-management/2773-antipsychotic-drugs-dangerous-for-the-elderly
  19. “Antipsychotics Increase Risks for Sudden Cardiac Death,” Pharmacology Corner, Jan 2009, http://pharmacologycorner.com/atypical-antipsychotics-and-sudden-cardiac-death-medical-media-coverage/
  20. ”Clozapine monitoring least stringent in Australia,” Medical Observer, 28 Feb 2012.
  21. Mental Health Services in Australia, 2007-08 (August 2010), Aust. Institute of Health and Welfare, Mental Health Series 12, p. 189.