Tag Archives: big pharma

Incomprehensibly Irresponsible: Brain Drugs and Babies

Laurie and Debbie say:

In 2008, we wrote “The Medicalization of Human Variety,” about how concerned we (and much of the medical establishment) were about the increase in prescribing Ritalin and other psychoactive drugs to schoolchildren.  We are shocked and saddened to find out how much worse things have gotten in the last seven years.

risperdal-600

Alan Schwarz, writing in the New York Times, details much nastier drugs than Ritalin, such as the antipsychotic risperidone (Risperdal) given to babies and toddlers. Schwarz reports “almost 20,000” such prescriptions were written in 2014,  a 50% jump from 2013. Prozac prescriptions for children that young are rising almost as fast.

We can’t even count the number of ways that this is horrible.

Brain science is itself in its infancy. Virtually all of the psychoactive medications prescribed today work by guesswork and hypothesis. We might know that a drug raises serotonin levels or reduces cortisol, but no one really understands why or how those chemical changes affect mood, behavior, resilience, et cetera. And no one understands what else these chemicals might be doing to the brain.

Whatever we do know about brains we know about adult brains. Children’s brains are incredibly plastic, growing at phenomenal speeds, and very little studied. In the case of Ritalin, it took medical scientists decades to understand that it affects children exactly the opposite way it affects adults. With newer drugs like Risperdal and even Prozac, the effects are unpredictable and could certainly be the opposite of what the prescribing doctor intends. Since we can’t ethically, morally, or as human beings experiment on living children to find out what works, this study has to proceed extraordinarily slowly and carefully.

… Dr. [Mary Margaret] Gleason, [a pediatrician and child psychiatrist at Tulane University] said that children with ages measured in months had brains whose neurological inner workings were developing too rapidly, and in still unknown ways, to risk using medications that can profoundly influence that growth. She said the medications had never been subject to formal clinical trials in infants and toddlers largely because of those dangers.

“There are not studies,” Dr. Gleason said, “and I’m not pushing for them.”

Perhaps most important, while some percentage of the children receiving these drugs have some kind of medical need that the drug at least might address, many of them are just behaving like children their age.  Schwarz uses the phrase “tempering chronically disruptive behavior,” which is easy-to-read code for “This kid is hard to manage.”

“There are behavioral ways of working with the problems rather than medication,” said Dr. [Ed] Tronick, [a professor of developmental and brain sciences at the University of Massachusetts Boston], who runs a program that teaches health care providers to assist families with troubled children. “What is generating such fear and anger and withdrawal in the child? What is frustrating or causing stress in the parent? These are the things that have to be explored. But that takes time and money.”

He also said something we said back in that 2008 post:

There’s this very narrow range of what people think the prototype child should look like. Deviations from that lead them to seek out interventions like these.

These kinds of “interventions,” these drug-based “solutions” to behavior that can almost certainly be addressed with patience, creativity, love, and (when appropriate) therapy, can destroy a child’s life, destroy a family’s life, and damage everyone who cares about that child and family.

It’s bad enough that these drugs are officially available to children in the 8-10 range depending on the drug. It’s bad enough (though completely not surprising) that the pharmaceutical companies getting rich off the drugs have stories of “positive effects among suffering young people” they can tell to line their pockets. Some of those stories are probably true, but you can bet your last dollar that they are cherry-picked from a set of mostly miserable-to-neutral stories. What’s worse is that too many people don’t care about our society’s children enough to protect them from harmful chemical intervention; we just want them to shut up, behave right, and not bother anybody.

Children are a global treasure; they’re the hope we have. They have a right to grow up whole and complete and uninvaded.

 

Sex-Linked Links

Debbie says:

Last time I set out to do a links round-up, I wound up with a themed post on penises. This time, I’m finding a set of themed links on human sexuality. One day, we’ll have a real wide-ranging links round-up … but not today.

299px-Sperm-egg

Diane Kelly at Throb shares an interesting insight into why more babies are boys than girls … and why what we’ve always believed about that is wrong.

For nearly two centuries, experts have assumed that the skew came from a higher rate of male conceptions. In an article at Nautilus, David Steinsaltz, J. W. Stubblefield, and J. E. Zuckerman explain that an early, 19th-century guess that more males were conceived to compensate for greater losses in utero–the so-called “fragile male” hypothesis–snowballed into a rarely-questioned “truth. …

In fact, new methods of looking at the sex ratio during development have shown that … X and Y sperm are equally likely to fertilize any given egg. The skew comes instead from differences in survival rates during embryonic development. There’s a complex shift in miscarriage ratios over time, from more males to more females at different moments in gestation. In the end, more female embryos are lost to miscarriage, skewing the birth ratio slightly to males.

I will forbear from making jokes about the “fragile male” hypothesis. Really I will.

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In other news, the FDA has approved Addyi, a libido-enhancing drug for women. This sounds like good news, but Sarah Boseley at The Guardian is viewing it with alarm, and I think she makes sense.

[Cynthia] Graham, [professor in sexual and reproductive health at the University of Southampton] and other critics believe the FDA was pressured and half-shamed into approving Addyi (generic name flibanserin) by a campaign headed by a vocal group called Even the Score, which pitched the absence of drugs to help women with low libido as a gender inequality issue. It describes itself as a campaign for women’s sexual health equality which was “created to serve as a voice for American women who believe that it’s time to level the playing field when it comes to the treatment of women’s sexual dysfunction”. On the front page of its website now runs a banner saying “Thank you, FDA”. Sprout Pharmaceuticals, which owns Addyi, is one of the funders, as is Trimel, another company in the same field.

Nothing makes me more nervous than “grassroots” political groups which turn out to be funded by corporations with a financial interest in their activism. And learning that Addyi is “only moderately effective, should not be taken with alcohol, and has potentially serious side-effects” doesn’t calm my nerves.  I also appreciate the comments by Dr. Petra Boynton, an extremely smart and sensible analyst of sexual issues, who said:

“People have a perception that everybody else is having fantastic sex all the time with exotic positions.” There is, Boynton said, “anxiety brought about by misinformation about sex”, which is perpetuated by the media and especially men’s and women’s magazines. “The cultural wallpaper is telling you that to keep someone and be desirable and not left alone, which is a huge fear, you must be having and providing frequent sex.”

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In a related vein, Mona Chalabi at 538 is talking about “the gender orgasm gap” from her point of view as a data analyst:

In 2009, the National Survey of Sexual Health and Behavior (NSSHB) asked 1,931 U.S. adults ages 18 to 59 about their most recent sexual experience. The topline findings show that men are more likely to orgasm than women — 91 percent of men said they climaxed during their last sexual encounter, compared with 64 percent of women.

But there seems to be a perception gap, too — at least among men. Eighty-five percent of men said their partners in that recent sexual encounter had reached climax, far higher than the percentage of women who said they orgasmed. That can’t simply be explained away by saying that the men were referring to different sexual partners. Most of these sexual encounters were heterosexual — 92 percent of men and 98 percent of women said their last sexual encounter was with someone of the opposite sex. So it seems like some of those men were wrong when they said their partners had orgasmed — either their egos are causing them to overestimate, or some of those women are faking it.

Nothing surprising here (and it’s six-year-old data); nonetheless, 538 is always refreshing because of its focus on data. Chalabi has a lot more to say about which sexual acts, done with whom (including alone), etc.  And who can resist a chart about what acts lead to orgasm entitled “How Come?”

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Finally, Liz Prato at Hippocampus has a rich, nuanced article about female masseuses, male clients, and erections.

Massage school was the first to teach me that there were two types of erections: hostile and benign. My instructors taught me how to deal with each erectile happenstance, ranging from saying nothing at all, to having a clinical discussion with the engorged client about what’s appropriate behavior during a massage. I was confident that, by the time I graduated from massage school, I would have no problems dealing with erections, hostile or otherwise. After all, I’d seen a few in my private life without eliciting trauma, and (thought) I had a clear concept of professional boundaries. This would be no big deal.

My first encounter with a hostile erection popped up a lot sooner than I expected. … My school was a blond brick office building with bleached linoleum floors and industrial-grade carpet (in other words, not a bordello), and my student uniform was khaki pants and a green polo shirt (not a mini skirt and knee-high fuck me boots). My client was in his mid-twenties, with dark hair and a cheesy mustache. The massage began with him lying on his stomach, so if there was an erection, I didn’t see it. Sure, he moaned and groaned a little, but, Hey, some people are expressive, I reasoned. But when he turned over, there it was, pitching a tent under the thin white sheet.

Okay, ignore it, was my tactic. I figured bringing attention to the erection was always the wrong way to go, and just massaged his shoulders. That’s when his moaning turning into loud groaning. “Oh, God, oh, yes! It feels so good!”

Prato goes on to discuss the relationship between massage and sexuality, between touch and sexuality, and the complexities this entails. She looks at the issues with directness and compassion:

I used to have a forty-something client named Tom who saw me weekly. He was referred by a psychotherapist who treats sex addicts. It’s not as creepy as it sounds. I’ve worked with several recovering sex addicts, and they’re no more interested in a Happy Ending than anyone else who lies on my table. These folks have a pretty good idea of where to go for sex and don’t want to waste my time and theirs if that’s what they’re looking for. What they are looking for is touch that’s not a futile attempt to mask their emotional pain. See, for them, sex isn’t about pleasure, and it sure as hell isn’t about intimacy. It’s usually about trying to cover up some horrible wound inside of them, but that’s like trying to douse a flame with kerosene. All it does is create a firestorm of emptiness and shame. When they come to me they want touch that isn’t sexual. They want intimacy with boundaries. They want – and they get – no self-hatred.

When I lay my hands against their skin, it might very well be the first time that touch hasn’t been manipulative or degrading. So they come back. Each time I touch them, they relax a bit more. They feel a little more pleasure. They get a little less scared. It reminds me of how we all walk around carrying fear and self-doubt and weeping wounds, and we’re just doing the best we can to dance around all that pain. I wish I didn’t need to be reminded of that, but I’m so glad I am.

Read the rest; Prato is a fascinating writer.

Thanks to oursin for the Addyi link; the others are from my regular reading