Dr. Joseph Biederman plays god with ADHD meds

World-renowned Harvard child psychiatrist Joseph Biederman, whose work has helped fuel an explosion in the use of powerful antipsychotic drugs in children, has been caught up in controversy since a Congressional inquiry by Senator Charles Grassley (R-Iowa) in 2008.
Biederman has been criticized for being an advocate of diagnosing Attention Deficit Hyperactivity Disorder (ADHD) and bipolar disorder in even the youngest of children, and using antipsychotic medicines to treat them. Pharmaceutical companies are continuing to profit from the sale of these powerful and sometimes unnecessary drugs. The problem was that much of Biederman's work was underwritten by drug makers for whom he was a private consultant. He was caught with his hand in the cookie jar.
The Congressional inquiry revealed last year that Biederman earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007, but failed to report all but $200,000 to Harvard officials. This constituted a major conflict of interest.
Biederman appeared at a deposition on February 26, 2009, and was questioned by several lawyers for the states, who were claiming that makers of antipsychotic drugs defrauded state Medicaid programs by marketing their medicines improperly.
At the deposition, Biederman was asked what rank he held at Harvard.
"Full professor," he answered.
"What's after that?" asked Fletch Trammell, one of the attorneys.
"God," Biederman responded.
"Did you say God?" Trammell asked.
"Yeah," said Biederman, after which there was a moment of stunned silence.

» more at: www.paulsolomon.blogspot.com

Posted By Paul Solomon at 2010-02-23 21:01:55 permalink | comments

Tags: Adderall ADHD CDC Cocaine FDA Harvard NPD Pediatrics Ritalin UCLA Unibomber

» More ways to bookmark this page

killerM. : 2011-05-13 11:34:37

what a narcissistic piece of intellectual fucking trash. who gives a shit about full professorships and child psychology powerfullness, theys all a bunch of fucking douche bag jokes.

David. : 2010-03-15 18:51:30

"Well, in something like Parkinson's disease it really isn't much of an issue. The symptoms of and criteria for diagnosing Parkinson's are pretty clear"

Nonsense. Parkinson's disease is diagnosed based on observed behaviors. If I recall correctly, it's not a black and white diagnosis at all; rather a holistic analysis of how someone is doing on certain scales and measurements.

ADHD is diagnosed based off observed behaviors. It's not a black and white diagnosis; rather a holistic analysis of how someone is doing on certain scales and measurements.

jamesk : 2010-03-04 11:50:44

Yay, we reach consensus. Now let's all dance!

Anonymous. : 2010-03-04 07:44:31

James: I don't disagree and don't mean to imply that all cases are like my friend's. The right medication to the right person at the right time can be a lifesaver, both literally and figuratively. Not just for things like ADHD, but even for some things which were considered previously by many to be intractable (such as schizophrenia).

I guess I'm just saying that we always need to be careful when evaluating our options. [And I do happen to think that that, in general, these medications are horribly over-prescribed!]

jamesk : 2010-03-03 16:31:57

I agree with what anonymous is saying here, but it is wrong to assume every case of ADHD is like the one described in this post. There are often non-medical ways to cope with ADHD, and that is fine, but there are also people who cannot properly focus on simple tasks like reading to the end of a paragraph without some kind of chemical assistance. ADHD people may function quite well in creative indulgent exploratory learning situations, and finding those alternatives is great, but in typical classroom settings, like trying to get through an advanced degree, ADHD people are at a serious disadvantage. Medication sometimes helps these people accomplish things that would otherwise be impossible.

Anonymous. : 2010-03-03 15:51:49

"ADHD is not a gray area if you meet 10 out of 10 of the behavioral criteria. If you meet 5 out of 10 then it becomes a gray area. That is why you have a DSM and MDs to make the call in the case of gray areas. The system may be rigged, but that's the system."

But I think it is a grey area, for precisely the reasons that James gives: those "10 criteria" can--and do--change over time.

Don't get my wrong: I'm not saying there is anything wrong with this. But I think we should keep in mind just how disease is a mental designation or categorization.

Why is this important to remember? Well, in something like Parkinson's disease it really isn't much of an issue. The symptoms of and criteria for diagnosing Parkinson's are pretty clear, and in general they will be clear for a disease/syndrome/condition that exhibits clear organic dysfunction in well-defined ways. Making a diagnosis of Parkinson's is relatively easy. What's more, is is relatively useful because that diagnosis is consonant with etiology of the condition as we know it, and is useful for treating and/or researching that dysfunction.

But in cases of behavioral conditions for which there are no clear lines of organic dysfunction yet determined more caution is warranted, especially considering the frank and stark fact that the treatment of these conditions is big business and there are many vested interests in that business. I'm sorry if that sounds a little tin-foil-hat wearing, but I think that's the situation we're in. The more ambiguity that exists for just what constitutes a treatable condition, the more opportunity there is for people to exploit that ambiguity for their own benefit.

And just what constitutes "normal behavior" is a very complex issue, for it is very closely tied to cultural and societal norms, biases, and opinions. If my leg stops working cultural biases and norms don't come into very strong play when it comes to seeking treatment. But if I, for example, am acting up in an elementary school class, those norms matter greatly.

Here's a little anecdote, and as it is an anecdote it may not have very wide applicability, but it is interesting none-the-less. Make of it what you will.

I have a friend who started a few Waldorf schools, and I once asked him how he got involved. It seems that his son had been diagnosed as having ADHD, and for a variety of reasons (which aren't particularly germane to the discussion) he didn't want to medicate him at that point.

He went around to several schools, and none of them would accept his son as a student unless he was medicated. But then he came to a Waldorf school who would accept him, but on one condition: that they wouldn't medicate him. "We need his energy in this class" was the comment the teacher made. So he enrolled him in that school.

So, attitudes do matter when it comes to these things. In one case his behavior was seen as a problem to be medicated; in the other case as an energy that was needed to balance the class.

(By the way, my friend's son did very well in school and "got over" is ADHD.)

jamesk : 2010-03-02 18:19:23

And, the DSM is not written is stone. It has errors, it can be changed, views of disorders are modified, it grows with culture. The article on the DSM which set this off [link] was from Psychotrophic. I had heard this story on the radio and had not thought to post it, it was fairly generic news. The DSM is like an old buddy to anyone who has been through med school or advanced psychiatric study. Everyone knows it is flawed in some ways, but it is like WikiPedia or the dictionary, if you don't like something you can lobby to have it changed in the next edition.

jamesk : 2010-03-02 18:07:31

@guest - How those gray areas between normal irregularity and pathological irregularity are defined change constantly. Obviously the drug companies want more people taking their drugs, but there is also a consumer market for people who seek drugs to make them feel better. ADHD is not a gray area if you meet 10 out of 10 of the behavioral criteria. If you meet 5 out of 10 then it becomes a gray area. That is why you have a DSM and MDs to make the call in the case of gray areas. The system may be rigged, but that's the system.

guest : 2010-03-02 16:21:00

In case you didn't know "James Kent" is really a nomme de plume of Pfizer's CEO, but don't tell anyone, as it may adversely affect value to shareholders.

On a different issue, it is true that the Pharma companies didn't invent depression or Parkinson's, but the categorization (and "creation") of disease isn't always as black and white as this, so I think it is a reasonable discussion to have (despite the fact that the poster below didn't fire off a very reasonable first salvo in that discussion).

As far as I can tell--and I make no claim to be an expert--one can reasonable argue that ADD is one of those things that in that grey area. Human behavior occupies a distribution along a continuum, and just where you draw the lines of demarcation on those distribution (which is to say, just how you define "normal" and "diseased") does matter.

I am reminded of a commercial I saw once (this was years ago in a hotel, and I don't have TV, so I don't know if it is still on or not).

"Everyone feels blue from time to time, but if you're depressed for a week or longer you should consider speaking to your doctor about X." (X was an SSRI of some kind, the specific brand of which I can't remember.)

[Emphasis added to show where I choked on bad room-service food.]

It is just wrong to define "in need of chemical help" at the one week mark.

Not surprisingly, this was just a pharmaceutical company trying to immorally drum up business at the expense of "customers." But what if "Major Depressive Illness" began to be defined in the diagnostic manuals as feeling sad for longer than a week. This actually could have some pretty serious (and horrifying, IMO) consequences.

jamesk : 2010-03-02 14:16:17

This article was posted in response to the recent thread on ADHD. It is an article by Paul Solomon posted by Paul Solomon. It is over a year old. I don't disagree that big pharma pushes meds on people who don't need them, this is obvious in their marketing strategies. But sometimes, gasp, medication does actually improve lives. There are other avenues for ADD therapy than big pharma, they just have the market cornered with their designer stimulants. So what? They didn't invent ADD and Parkinson's disease, they are just good capitalists trying to push drugs. Crack dealers did not invent poverty, they just exploit it. Big pharma did not event ADD and depression, they just exploit it. People who are wrongly diagnosed and exploited are right to be mad, but don't take it out on me because the DSM is being updated(?) Do I really have to defend that as being newsworthy on DoseNation without being a pawn of some pharma-mind control conspiracy? Some rationality please people. Sometimes drugs are good, sometimes they are bad. Always question the motivation of people who are selling them. Geez.

guest : 2010-03-02 13:42:58

"There is an excellent article in the current New Yorker about how psychiatry is on it's last legs in terms of credibility. This will counter much of the willful delusion in cheerleaders for the DSM like jamesk et al."

Yep, that's what me and my Scientologist buddies have been saying all along!

Smiley. : 2010-03-02 07:55:35

There is an excellent article in the current New Yorker about how psychiatry is on it's last legs in terms of credibility. This will counter much of the willful delusion in cheerleaders for the DSM like jamesk et al.
[link]

Anonymous. : 2010-02-26 13:44:03

I mean, they guy might be a jerk (and I suspect he is), but:

"At the deposition, Biederman was asked what rank he held at Harvard.
"Full professor," he answered.
"What's after that?" asked Fletch Trammell, one of the attorneys.
"God," Biederman responded."

at least he's honest. This is a fairly accurate and succinct summary of academia.

maxwell. : 2010-02-26 09:03:55

i knew it all along. bunch of bullshit. its jackasses like this guy that are ruining my country. biederman should burn in hell.

smorg34. : 2010-02-24 10:10:54

Wow. Did the jamesk tirade about ADHD in the recent DSM article he posted here have anything to do with this one? We were talking about how ADHD was invented out of thin air, and even posted a link to paper by a child neurologist who stated just that, but what a strange coincidence! or is jamesk pulling everyone's leg? I mean, is this really shocking news?

The comments posted here do not reflect the views of the owners of this site.

Follow DoseNation

» More subscription options

Dr. Joseph Biederman plays god with ADHD meds

Posted By Paul Solomon at 2010-02-23 21:01:55 permalink | comments

Tags: Adderall ADHD CDC Cocaine FDA Harvard NPD Pediatrics Ritalin UCLA Unibomber

Follow DoseNation

Recently @ DoseNation