Now, about those Guidelines Senator Grassley was referring to when talking about with Dr. Melissa Delbello‘s inconclusive study [big money for a freshman…]:
In his quest to peel back the curtain on the interplay between pharma and docs, Chuck Grassley offered an interesting example last week while speaking on the Senate floor. He noted that an ‘inconclusive’ 2002 study in the Journal of the American Academy of Child and Adolescent Psychiatry on AstraZeneca’s Seroquel was used to devise guidelines for treating bipolar disorder with antipsychotics…
The Guidelines for Children and Adolescents With Bipolar Disorder were initiated by the Child and Adolescent Bipolar Foundation, and has one of Senator Grassley’s targets as an author, Dr. Karen Wagner [see also the list of CABF scientific advisers – three ‘Grassleys’]:
Treatment Guidelines for Children and Adolescents With Bipolar Disorder: Child Psychiatric Workgroup on Bipolar Disorder
by ROBERT A. KOWATCH, M.D., MARY FRISTAD, PH.D., BORIS BIRMAHER, M.D., KAREN DINEEN WAGNER, M.D., ROBERT L. FINDLING, M.D., MARTHA HELLANDER, J.D., AND THE WORKGROUP MEMBERS
Journal of the American Academy of Child and Adolescent Psychiatry
2005;44(3):213–235.
ABSTRACT
Clinicians who treat children and adolescents with bipolar disorder desperately need current treatment guidelines. These guidelines were developed by expert consensus and a review of the extant literature about the diagnosis and treatment of pediatric bipolar disorders. The four sections of these guidelines include diagnosis, comorbidity, acute treatment, and maintenance treatment. These guidelines are not intended to serve as an absolute standard of medical or psychological care but rather to serve as clinically useful guidelines for evaluation and treatment that can be used in the care of children and adolescents with bipolar disorder. These guidelines are subject to change as our evidence base increases and practice patterns evolve.
This project was sponsored by the Child and Adolescent Bipolar Foundation and supported by unrestricted educational grants from Abbott Laboratories, AstraZeneca Pharmaceuticals, Eli Lilly and Company, Forest Pharmaceuticals, Janssen Pharmaceutical, Novartis, and Pfizer.
First off. I would question this assertion: "Clinicians who treat children and adolescents with bipolar disorder desperately need current treatment guidelines." I doubt that there were many people sitting on the edge of their seats desperately waiting for these Guidelines. Here they are:
I hardly know what to say about this algorithm [or the one not shown for patients with psychosis]. My candid reaction was experts shouldn’t be allowed to gather in groups. I actually read all the words, and could find no cogent explanation for the rationale used to arrive at this algorithm. It seems desperately arbitrary to me. Combination therapy seems to be the order of the day [even though only 11/135 references in the article are about multiple drug therapy]. Here’s their problem – nothing to go on [only two placebo controlled randomized trials] :
I’m going to resist the temptation to rant about having Expert Guidelines based on who-knows-what in the Age of Evidence-Based Medicine and let you reach your own conclusions.
My agenda with this post was simply to show that like everything else with Childhood Bipolar Disorder, there’s not much solid ground. Dr. Karen Wagner, one of the authors of these guidelines, was on Grassley’s list, but not because of Childhood Bipolar Disorder. She earned her place in a different enterprise, as a coauthor with Dr. Martin Keller on the infamous Paxil Study 329 – coming soon to a blog in your neighborhood.
GREAT post. What the guidelines did for CABF back then was give credence and wanted evidence based reason (in their minds) for drugging the kids and making the bipolar dx ‘real’ with such ‘experts’ The guidelines were sponsered by most ALL of the major pharma companies, and the CABF message boards for parents of kids who are bipolar etc are told these thought leaders are experts as are their recommendations. The parents are essentially brainwashed to believe their kids are SICK, forever and they often compare psych meds to cancer meds and parents who deny their kids psych meds are evil.
CABF has one of the most corrupt (Dollars for Docs) group Ive ever seen in one place and these ppl influence thousands of parents…. the bipolar child dx is alive and thriving on CABF and the parents believe, believe. Surely we will see one of them write a letter abt how great Biederman is, how his mistake (“mistake”) was just a little snafu… CABF loves to tout ‘world experts’ as their own, and frankly their advisory board is embarrassing, their members who pay to be a part of that place should KNOW the conflicted KOLs and what stands behind them, pharma, corruption, ghostwritten papers, it’s beyond belief. Having a child myself misdiagnosed bipolar at age 11 in 99….all I can say is those parents are being told the latest and greatest pills are out there and one year their Christmas mailer announced never a better time to be bipolar! to the kids! signed by Kay Jamison, author of the Unquiet Mind. Never a better time! for who?
$$$$$$ pharma and paid docs that’s who.