Thanks to Tsara Shelton for help with transcript editing.

Rob: Welcome to the Rob Kall Radio Show, WNJC 1360 AM Washington Township. This is another one of those shows that'll probably be aired both on the Rob Kall Bottom UP Radio Show and on the Rob Kall Future Health Radio Show because it's got angles that make it appropriate for both.

My guest tonight is Robert Whitaker. He's the author of a new book, Anatomy of an Epidemic, and also the author of Mad in America. He's a writer who has covered articles on the mentally ill and pharmaceutical industry, he's garnered national awards including a George Polk award for medical writing and a National Association of Science Writer Award for best magazine article. He's written for the Boston Globe, and he was named a finalists for the Pulitzer Prize in 1998. Welcome to the show Robert.

RW: Thanks you for having Rob. It's a pleasure to be here.

Rob: I'll tell you...I learned about this book from an interview with another one of my guests, Ray Tattenbaum, and I have to tell you I delved into this and within moments I was transfixed by it because this is a book that should get you a Pulitzer...I have to say it -- this is just an incredible, uncovering of information that's been readily available that you've tied together that's just mind blowing and...well let's start. I'd like start off taking care of you -- so what's your website?

RW: My website is...I have two websites. You can go to madinamerica.com, M-A-D-I-N-A-M-E-R-I-C-A.com or you can go to robertwhitaker.org, and I think the important things about the website, in addition you can contact me through there, but I have a lot of documents up there as well so if you want to see some of the source documents -- say, for Anatomy of an Epidemic -- you can go to madinamerica.com and that way you can...if your curiosity is as such, you can read the original source documentation for a lot of what I write about in the book.

Rob: Okay now, I'm going to give my overall impression of what this book does. This book basically tells us that the research in looking at the efficacy of the use of psychiatric drugs since their inception in 1955 with the beginning of the use of Thorazine, has pretty much showed that not only do they not in the long run not work, but they hurt people. And the model that was developed to sell this approach, biological psychiatry, has been damaging to probably millions of Americans and it has also created a way to sell drugs and to pathologize and label children in ways that didn't exist before; and this model seems to suggest that psychiatry is better and smarter now so that they can identify and come up with new diagnoses. But in a sense that's really got to be considered with the other consideration -- that psychiatry has done a devil's bargain with pharmaceutical companies, partnering them in an incredibly incestuous way.

RW: Yeah, you've raised a lot of themes there and they're all pretty accurate. I mean, we could start with the first theme, and the first theme that you mentioned was, you know, what is the efficacy of these medications? What does the science show? And what you...and when you start to get into that first question, what you do find is you find when they do short term trials of psychiatric drugs whether they be antipsychotics or antianxiety agents or antidepressants, there may be...

Rob: Or stimulants for children, right?

RW: Or stimulants for children, that's right....there may be some benefit on a target symptom over the short term, say 6 weeks...so you'll see the reduction a little bit better than a placebo on -- let's say the target symptom of psychosis...whatever that may be -- and even on the short term, often the efficacy is much smaller than you might expect. So, for example, with the antidepressants, even over the short term there's just...there's a very small benefit over a placebo, even in the 6 week studies. And in fact, just one small aside, when they test presence against an active placebo (an active placebo is some chemical agent that'll cause some small side effect like dry mouth so you think you're getting a magic pill)...when they do antidepressants against active placebos, there's basically no difference even over the short term.

But what I'm really interested in in this book is looking at what are the long term effects, and in the aggregate. In other words, does this paradigm of care...do these medications...do they shift the long term outcome for schizophrenia for the better? The long term of depression for the better, etcetera? And what you find when you start digging into the research literature, well you find many, many, many surprises. But the one constant you find is that, in fact, this paradigm of care is worsening long term disorders -- I mean, people become much more chronically symptomatic than they used to be, it lowers recovery rates, it lowers, sort of, employment rates for people who end up with, say, a bipolar diagnosis or a schizophrenia diagnosis, and you see other problems...yeah go ahead Rob.

Rob: Well, actually you're...when you say it lowers....it massively lowers them or it massively increases symptoms, and it also kills people. One thing I like about your book is you do a chapter that kind of goes through the history of the use of...the treatment of...the diagnosis, the treatment, the development of the drugs, the authorizations and approvals of them by the FDA, the marketing of them by both the American Psychiatric Association and the pharmaceutical companies; and then you'll have a chapter on how people suffered -- the victims of the use of these prescription medications...and people die -- people develop all kinds of diseases, chronic debilitating deadly diseases, because of these things, right?

RW: Yeah, I know that's...certainly when you long term, yeah, you see a lot of physical disability begin to arise, you think....say, with the atypical antipsychotics you see...let's just stop and start with the antipsychotics which you're talking about. You'll see all sorts of physical problems associated with it. You do see early death, no question...sometimes you'll see even rapid death, but more commonly you'll just see people becoming so physically unwell that you'll see...they're dying now 25 years earlier than normal. You do see when you really start digging into this...

Rob: See I take that really serious...

RW: ...and you'll see brain damage, you'll see cognitive decline with the antipsychotics, but you'll see cognitive decline a little bit with the antidepressants; you'll definitely see a lot with the benzodiazepines. So really I guess, you know, Rob...to sort of...one...in a sense what you see with these medications is this, in a big picture way...and actually what I do do is what you say -- I first try to flush out what's the natural spectrum of these disorders, and it turns out the people often...they would more flu like -- people might have a bout of mania, a bout of depression, they'd get better and they'd -- I'm talking about in the pre-drug era days, and they'd get better -- now they get stuck much more in this sort of chronic condition. But really what you have to see is...if you really look at the science is that these are agents that are, sort of, perturb normal functioning in the brain -- they're not fixing any chemical imbalance. And once you understand that they're perturbing normal function and the brain is trying to compensate and adapt to this sort of interruption in normal functioning, you begin to understand why the side effects are bad, the psychiatric side effects can be bad, and you know, you are talking...what happens is when you pull yourself back and let's say manic depressive illness, which is now known as bipolar illness -- so we...50 years ago, 40 years ago that was a rare disease...okay, a rare disorder, right? In other words it was like 1 in 5,000 people and the outcomes were pretty good. There was no long term cognitive decline, 70 to 85 percent of people worked, they might have an episode of mania or an episode of depression, but then it would pass and they'd go back to sort of what they call euthymia, an absence of symptoms, then go back to, you know, functioning well. Well what happens to bipolar patients today? Well now, what you see, is often they're on a cocktail of drugs, often they have poor physical health, they're much more symptomatic, they have...they're much more likely to be rapid cyclers, suffer from a lot of depression, suffer some physical problems, after about 5 years they start showing cognitive decline, only about 33 percent are working as opposed to 85 percent, and you do see the early death...and by the way, the early death thing that is really appearing now, which showed up with the atypical antipsychotics in big form -- we're just at the first wave of this. So there was a report saying -- Oh my goodness, these people are now dying at age 56; well I know a new study that's being done and they're finding among people who've died the average age is 46...and what's going to happen to these kids being put on these drugs? How long are they going to live? So you've sort of opened up a...you've really jumped into, with your opening questions here, a really big fundamental question and that is...do we have this form of care...so-called care...but anyway, do we have these medications that are, you know, making people disabled and, you know, poor physical health leading to early death? And if so, it is one of the...and that's in fact what the facts do show...that their own...the science done by the NIMH and all shows, and as such it's really a...it's an extraordinary medical misadventure that is harming many, many, many, many people -- and we're talking millions of people.

Rob: Extraordinary medical misadventure.

RW: I'm putting it kindly, but yes.

Rob: Now, I want to...

RW: And by the way we can talk about the kids a second, but once you get into kids it's even beyond the medical misadventure, but go ahead.

Rob: We're going. First I want to say what I was trying to say that I didn't...I failed to interrupt you is I take this personal because my ex-wife died this summer at 56 from the diseases that you describe in your book at the kind of things that appear from taking these medications -- diabetes, heart disease, liver problems -- she had all of them. And she went through a horrible death.

RW: How long had she...right. How long had she been on psychiatric medications?

Rob: Oh, probably 15 years.

RW: Well, Rob, first of all I'm sorry for your loss and it is a horrible death, and that's the amazing thing -- 15, 20 years...the poor physical health that you see set in...and by the way sometimes it doesn't take 15 or 20 years for the physical health to set in -- you'll see people sometimes within a year or two just really having health problems. But long term you'll see people stop...you know, they gain so much weight, they have the diabetes, you'll see them using canes earlier ages...

Rob: All that.

RW: Yeah, it's really remarkable.

Rob: All of that, yes. Now you talk about this new kind of medication...what's the word? The atypical antipsychotics -- what are they?

RW: Well yeah, so they're sort of a marketing invention but here's what I mean by this. There was what's called the first generation of antipsychotic medications, and that was Thorazine and Haldol and the old "standard neuroleptics." And those drugs were known by the psychiatric community, by the medical community to be really, sort of, problematic drugs that you, supposedly, were only supposed to use them when people were severely ill, etcetera, with psychotic symptoms; and it was understood that these drugs could cause Tardive Dyskinesia. Tardive Dyskinesia is when your basal ganglia is basically damaged so you can no longer control motor movements...that sort of thing.

Rob: And that would include drooling and ticks and things like that.

RW: That's right, you might see...yeah, all those. And you might see a person's tongue darting out real regularly as if they can't stop their tongue, and it's more than just ticks -- with severe Tardive Dyskinesia you might have trouble walking, you might have trouble eating, you might have trouble holding pens...I mean it just depends on the severity of the Tardive Dyskinesia, but it's a sign that your basal ganglia is being damaged and you're losing motor control.

It's also, by the way, associated with some other things including worsening psychosis, etcetera. And by the way, that set in at the rate with these old drugs at about 5 percent per year. So after one year on the drugs, 5 percent had Tardive Dyskinesia; after 2 years, 10 percent; and after 10 years maybe 40, 50 percent; and that means that once you got on the old standard neuroleptics, you were really on a path towards having your basal ganglia damaged and this physical disability. Well the thought was that when the atypical antipsychotics came in -- this was a new class of antipsychotics, drugs like Risperdal and Zyprexa -- and what happened is when they were brought in, the academic psychiatrists, who were being paid by the pharmaceutical companies to act as speakers and advisers...in other words they really were paid spokesmen -- they painted this story (and this is in the mid-1990s in the Wall Street Journal, The New York Times) of how these drugs were so safe and effective....so much more effective than the old drugs, so much safer than the old drugs, they didn't cause Tardive Dyskinesia, and, in fact, if you go back to the stories that appeared in the newspaper, it almost sounds like they didn't cause problems at all. Well it was complete nonsense. I mean, if you actually looked at the trials, there were a number of people who had died in the trials. There were...diabetes showed up in the trials. Weight gain showed up in the trials. I'm talking about in the short term trials. And they weren't really any better than the old drugs even in those trials -- so we just heard this false story. Now because of that false story the drugs began to be prescribed for all sorts of things -- kids, people "with bipolar illness" and we can talk about how that became so popular; we even have...you can go and watch your TV now and they'll say if you're antidepressant doesn't work add Abilify -- well Abilify is an antipsychotic. So because of this false story about how safe and effective the atypicals were, the use of these drugs exploded and in 2000...I think it was 2008, antipsychotics -- now these are problematic drugs, these are drugs that can...you go on Zyprexa and you can gain 60 pounds in, you know, 4 months...you're at risk for diabetes...all sorts of things -- they were the leading generator of revenue in the United States of any class of medications...antipsychotics. It's extraordinary. And these are the...these are drugs that are so, so problematic and by the way, I did an initial study of Zyprexa in the clinical trials and it was something like -- I don't know 1 out of every 145 people in the trials died. I mean, it's just...the idea that these are very safe and effective drugs is just extraordinary that such an idea could have taken hold, I mean, especially on the safety part of the thing...that they're so extraordinarily safe without side effects; and yet because of that we give these antipsychotics....the atypical antipsychotics to kids, including 2 year olds, 4 year olds...and now that you've already got me warmed up, you know, a recent study came out and said that within a year on Zyprexa you have some sort of notable shrinkage of the frontal lobes -- well, why would you give that drug to a kid? So that's what atypical antipsychotics are -- they were advertised to the public as very safe and effective when in fact if you look at the clinical trials they were...the adverse events with these drugs was pretty extraordinary.

Rob: Now I want to take a step back for a second because you're very tough on the pharmaceutical companies here, and on modern psychiatry; and in your book, you write a history of modern psychiatry that looks like they're monsters in many ways. And you point out something very interesting that probably the biggest group that has opposed the use of psychiatric medications is the scientologists.

RW: Right.

Rob: And that actually this has helped the psychiatrists and the pharmaceutical companies. How's that?

RW: Okay, so what you're talking about here is the storytelling forces within our society, and that's one of the things that I do do in the last part of the book. So, and just sort of to set the stage for why we're so interested in the storytelling forces -- our society now believes, for example, that these drugs fix a chemical imbalance in the brain, that they are antidotes to known diseases. So you can read things like, well why would you give your kid a stimulant? Well because wouldn't you give your kid insulin for diabetes? -- that sort of metaphor is said. And of course we believe, and you can see the extraordinary embrace of these medications, that, you know, how helpful they are; and there has been an extraordinary success in marketing these medications.

But what you have to go back to is how did we as a society come to believe this story? Because it's false in so many dimensions. When you look at the chemical imbalance theory of mental disorders that arose in the 60s and 70s, it was investigated...really in the 70s and early 80s, and found not to be true. So in other words, Prozac comes to market in 1987...we start hearing about how people with depression have low serotonin and the drugs...Prozac, by upping serotonin is fixing that much like insulin for diabetes. Well 3 years earlier the NIMH had concluded after investigating the serotonin theory of depression and it wasn't so. So that's an example of how, in essence, a false story was told.

So what happens? How did we get to this false storytelling? You've got to go back to 1980. Prior to that time, in the 1970s, psychiatry as a profession felt that it was fighting for its survival, and really fighting for its survival in the marketplace, and in 2 ways -- one, the use of psychiatric drugs was actually declining in the 1970s and that was because the first generation of drugs was being found to be so problematic...so you had Tardive Dyskinesia showing up with the first generation antipsychotics, you had a lot of addiction showing up with the use of Valium and the Benzodiazepines, the Tricylics -- there was a big problem with those drugs inducing mania; so actually, use of psychiatric drugs was declining in the 1970s.

At the same time, there were a lot of other therapists springing up so psychiatrists found themselves in competition with social workers, counselors, psychologists, etcetera, and they basically started having meetings and saying -- How are we going to revitalize our discipline? How are we going to save our discipline? How are we going to save psychiatry? And what they said is, we need to wrap ourselves in the white coat -- we need to present ourselves as people like internal medicine doctors...and, what do internal medicine doctors do? They prescribe pills more regularly for known diseases. So they...as a financial point of view, as a way to save their image, they set forth DSM-III -- this is the Diagnostic and Statistical Manual in 1980, and under a medical model; they said these are known diseases in essence, and the drugs are, sort of, specific treatments for those diseases. But that wasn't a scientific story, that was a marketing story to (a) revitalize the image of psychiatrists as physicians who are treating known diseases just like their brethren in the internal medicine, and (2) it was to also provide a value to the medications in the marketplace because what separated psychiatrists from psychologists or psychiatrists from social workers is they could prescribe drugs and the others could not....so that was their competitive position in the marketplace, so they needed to have drugs that were seen as quite helpful and drugs for diseases, so to speak. And as they -- and this is real interesting -- in 1980, as they launched this new manual, DSM-III, they also launch an internal...not an internal, they launch a PR campaign and basically...in other words, they set up the American Psychiatric Association Press to start promoting those notions. They start running training schools for psychiatrists, sort of, leading psychiatrist around the country, on how to tell this story to the press. They began holding press conferences to say -- Ah, we're making these great leaps and understanding the brain and now we understand that these drugs are like....we now have drugs that are, sort of, fixing these problems in the brain -- and it was all this story of great medical progress, and frankly it wasn't true.

And then when they...in going forward with the storytelling, let's say with Prozac...when Prozac comes to market, you get this extraordinary story about how the drug is so safe, so much more efficacious -- it can make you better than well, and you even start getting this story about how psychiatrists have learned the inner workings of the brain so finely they can almost give you a designer personality -- whatever you want, and it was like this sort of magical time, etcetera. Well, if you actually look at the Prozac trials, they were having so many problems when they...they first tested it in large trial in Germany -- the German authorities said this is not a safe nor effective drug, and so the German authorities weren't even going to allow Prozac to even come to market. You were also seeing people going psychotic on Prozac; you were seeing people...there was an increased risk of suicide, and all of that got hidden -- it got washed out...it got hidden from the public -- and that's what I'm talking about in, sort of, psychiatry's extraordinary betrayal of the American public in terms of -- and I'm talking not at maybe...I'm not talking about individual psychiatrists, I'm talking about the profession as a whole -- it presented a known false story to the American public, it hid dangers from the drugs, and that's just not how we believe medicine is supposed to operate.

Now you raised Scientology -- why is Scientology...why has it been so helpful to psychiatry in order to tell this story? Well we can go back to the Prozac story. So actually it was Scientologists who began complaining about the fact that Prozac was causing, you know, some people to become suicidal, homicidal, etcetera. Now scientifically that was true...okay...that was indeed showing up in the clinical trials. But because it was being brought to the public by Scientologists -- and most people see Scientology as this sort of odd cult, weird cult, and you know, who the hell are these people?...and they are seen as a group with an agenda -- they have their own way to treat psychological distress -- so they were seen as, basically, they have their own competing form of therapy, they're seen as this crazy cult, so psychiatry and the pharmaceutical industry together said -- Aha, this is fantastic, thank God for the Scientologists because now what we can say, and we can say to the media...and you see this -- what's really interesting...if you get the documentation...so when the Prozac thing happens and this worry about this drug happens, what does Eli Lilly do? It begins coming up with a strategy to tell the press. Oh, they'll say -- this is a problem being sort of...this is a fantasy being brought to the public by Scientologists, okay, it's not real. These drugs actually prevent suicide. And they would bring their fancy doctors in and these doctors/psychiatrists came from places like Harvard Medical School, etcetera, and they would bring them in for training sessions and they would say -- here's the message we want you to say to the Wall Street Journal -- we want you to say is that these drugs reduce suicide and that Prozac reduces suicide, and the real risk is that they won't be treated with Prozac; and we want you to say, oh, and this whole thing is being brought up by Scientologists...so blame the Scientologists. So they would have these PR sessions -- and you can even see at one point the Eli Lilly people complaining that the doctors aren't getting the message that they're supposed to say exactly down. In other words, they're not being the exact spokespeople they're supposed to be and we're going to have to have more training sessions to get them to, sort of, hue to the message...stay tuned to the message -- anyway, then what happens? The Wall Street Journal articles come out, other articles come out, and it's exactly what they plotted in these PR campaigns and the pharmaceutical companies/the doctors say -- Ah, this is not a real problem; we've looked at the data -- the data actually reduces the suicide risk; this whole thing is being brought up by those crazy Scientologists....and, so that became a way for the public...in the public mind to go 'Aha, this isn't the real issue; these drugs are very safe and effective; there's no increased risk of suicide when you go on Prozac; and this whole thing where you question American psychiatric drugs...that's a Scientology thing'....and so it became a way, thanks to Scientology, to diffuse any sort of real critical look about what was happening to people on these drugs long term -- what was the science really showing. And even really, what was the data in the short term.

Rob: So actually in a sense this is kind of like what politician are doing nowadays. If somebody...if a politician gets attacked they'll go out and they'll ask for contributions, and they'll get a half a million or a million dollars in contributions because the other side attacked them. The pharmaceutical companies used this to beef up their promotion of the efficacy of the drug when they were attacked by a group that was not trusted by the American public.

RW: Yeah, yeah, even more than not trusted -- mistrusted. So it became a way to continue to maintain the false story and to keep the press convinced that to write critically of psychiatric drugs was to, sort of, throw your lot in with the Scientologists -- God knows no one wants to do that -- so it became a way, really to, not only maintain a story, but prevent even, sort of, any critical look at what the data might actually show and to completely delegitimize those who would look critically at the medications.

Rob: Now you don't have any connection with Scientology do you?

RW: Good God no, man.

Rob: Okay. I...because you know, you're very strong on attacking and I now, having read the book, I know that. But I just want to make it really clear that what you're talking about is a problem here where this history is that the American Psychiatric Association and the pharmaceutical companies tend to vilify and in character attack people who show them for what they are and what they're doing, and what their drugs do.

RW: Yeah, and this is....

Rob: So I'm going to ask you...I'm going to do a station ID and when I get back I'm going to ask you about any effects that this has had on you.

RW: Okay.

Rob: Now, this is the Rob Kall Radio Show WNJC 1360 AM Washington Township. We're sponsored by futurehealth.org and opednews.com. If you want to go to listen to other podcasts or interviews that I've done, or you can't listen to all of this one, go to futurehealth.org/podcasts or opednews.com/podcasts and you'll see scores of other interviews that cover everything from health to politics to what's happening on the internet.

I'm interviewing now Robert Whitaker, he's the author of Anatomy of an Epidemic. The subtitle is Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. And it's a book, as I described earlier, that basically reports that long term findings show that psychiatric medications in the long run not only don't work, but they can kill you. Now I have to say, Robert, that I'm preparing to do another interview on a book called American Taliban by Markos Moulitsas, and he's basically there as describing how some people in the United States act like the Taliban act in Afghanistan -- and it crossed my mind that what we have here is a kind of a psychiatric Taliban when you have people saying...defending a drug that we now know increases the risk of suicide, saying if you don't take that drug you're going to increase a person's risk of suicide. If you have people saying 'people need to take this drug - it's like somebody who has diabetes needing insulin', when in effect, taking this drug is going to probably make them much more likely to be, for the rest of their lives disabled, decrease their life span by 15, 20 years -- this is a very scary, dangerous thing. In a sense you've got a group of people who have, in a sense, either massively maimed or killed -- directly or indirectly -- hundreds of thousands, if not millions of people. Am I going too far?

RW: Well, let me (laughs)...you know, one of the things I've been trying to do as I've been talking about this is just say, here are the facts and people can make the conclusions as to the moral judgment of this whole thing, but two things -- and just in terms of the disability numbers, okay...we have something like 850 people per day in the United States -- adults -- going on disability now due to mental illness, and that's...let me go back to put this in context. From 1987...in 1987 we had 1.25 million people on government disability due to mental disorders/mental illness; then Prozac comes in and today we have more than 4 million people -- so the number of people on disability has tripled as we have embraced this paradigm of care in this use of drugs. So something is going horribly wrong. We're now getting the early deaths, as you say. Outcomes for bipolar illness have deteriorated dramatically. You will see for example, many people that use antidepressants now they'll have, sort of, eventually a bad reaction to the antidepressants and they'll move from the depression to the bipolar category -- that's the story of an iatrogenic, a drug cause deterioration.

So what I try to do is just say: Here are the facts, here's their science, and then you can sort of make the moral calculations as to, you know, how to describe this behavior. But what I think is important to make a distinction of -- you can have many psychiatrists working at a local level that are as betrayed by everybody else because they don't really know what the research shows -- it's really at these upper levels by people -- by doctors, psychiatrists, at the academic medical schools -- that have allowed themselves to be bought and once they've allowed themselves to be bought they tell false stories, and stories that do cover up harm done, and that is a betrayal of a remarkable sort.

And now let's jump, in a sense, into a moral dimension here -- we can talk about the moral quality...the moral act of medicating children that was done -- and you can trace this real clearly -- that what happens, starting in the early 1990s, is the pharmaceutical industry -- first they had their SSRI drugs, that's the antidepressants, and they start saying -- we need to expand the market, the use of these drugs into kids...okay, they were seen as a market; and they basically got together with academic psychiatrists to say this story -- Oh we are now discovering that children can, in fact, experience severe depressive episodes, or depressive episodes, and they need to be helped -- they need to be put on antidepressants. Well that was being done to sell the drug, and in fact, when they tested antidepressants in pediatric populations, they found the drug didn't even work over the short term...but did they tell that to the public? Did they publish that data in scientific journals? No, they hid that, and instead they kept saying these drugs are very safe and effective for kids -- that's a betrayal, okay...that's a big time betrayal. And now why are so many kids on atypical antipsychotics? Because once they came to market, the pharmaceutical companies said -- Aha, we need to expand our use of these drugs into the kids market...and basically then you had certain doctors being paid to expand that market, and I will give you an example. Joseph Biederman was the guy in 1995 who "discovers" juvenile bipolar illness. In other words, before, the thought was kids, say, under 14 years of age, they just couldn't develop bipolar illness. And so what...Biederman says -- Ah no, in fact I have discovered that you develop bipolar illness at about...when you're 3 or 4 years old. Now what happens when you find some of the documents that are being...going between Biederman and Jansen subsequently (Jansen is the maker of one of the atypical antipsychotics)? Well one, you see a lot of money flowing to Biederman, and we're talking in the millions of dollars; you'll see Biederman promising Jansen that (a) he will prove that his drug is safe and effective in kids, Risperdal; he actually promises to trash another atypical, Zyprexa -- in other words he's saying, 'I'll make it seem that we should only be prescribing Risperdal to these kids,' and he says, 'and I'll also do studies showing that these kids are going to be chronically ill and are going to need these drugs for life.' So what you really see here, if you really break this down, you see a process of expanding atypical antipsychotics into children with the thought that now (a) that will create a market for these drugs immediately, but will also put these kids on these drugs for life, okay? In other words, creating a lifelong user of psychiatric medication.

Rob: Wow.

RW: Yes, and...

Rob: This is documented...these correspondences are document?

RW: Yeah, I have this correspondence, and so...

Rob: But what's the website...is it on your website?

RW: No that part is not, but in fact it's even referred to in the book -- if you go through...I don't know what page it is...there's an excerpt from it in somewhat...I forget where it, what exactly...what page it's on, but you'll find at least a reference to it -- and he's basically saying I will create these patients for life for you. And then what happens later, Biederman is being questioned by a state attorney general relating to, sort of, the illegal marketing of these drugs and the state attorney general says to Biederman, 'So how did you come up with this new diagnosis? And Biederman says...and I could put up this documentation -- it's a lot -- but he says, 'I reconceptualized it -- I took what used to be called oppositional defiant disorder,' which means a kid who's like throwing a temper tantrum, 'and I said that was bipolar illness; and so I reconceptualized this old behavior into this new illness, which then got marketed as a brain disease that then became, of course, a reason for prescribing Risperdal.' And then the guy goes to him, the state attorney general goes to Biederman -- you know, what's your title at Harvard Medical School? He goes -- I'm a professor of psychiatry or whatever at Harvard Medical School. And then the state attorney general goes -- well what's above that? And he goes, 'God.' And the state attorney general said, 'Did you say God?' And Biederman says, 'Yes, I said God.' And actually what Biederman is doing there...he's playing God, because what he is doing is changing the lives of many, many, many, many, many, many, many, many, hundreds of thousands of kids, and he's putting them on a path -- as long as we talk about the moral dimensions of this -- well (a) their frontal lobes will shrink within a course of the next...the first year on the medication. What the data show is that as you're on...

Rob: Wait, let's just point out that the frontal lobes are the part of the brain that handle the executive functions, the part where people mature and turn into responsible adults.

RW: That's right, and it's also the part of the brain that separates us from, you know, primates. I mean, it's a part that makes us most human, that enables us to be really fully conscious of ourselves and worry about the future, etcetera. So yeah, it is the part of the brain we most want to protect.

But you'll get some shrinkage there. Research done by Nancy Andreasen has shown that this shrinkage continues as you're on the brain...on the drugs. She has shown that by 5 years on the brain...as the shrinkage begins to correlate with a significant decline in cognitive function. You do see Tardive Dyskinesia in kids on these atypical antipsychotics...I think the rate is something like 4 percent a year. That means that their basal ganglia is being damaged, and often it means that it's being permanently damaged -- so we're talking about permanent damage to the part of the brain that controls motor movements. Then you've got to ask -- and you'll get these kids that'll have diabetes, they'll have cholesterol problems, they'll become obese, they'll become lethargic, they can't feel the world as much -- and then you've got to ask how long can we expect that kid -- who is age 4 or 5 and put on an atypical antipsychotic -- well, how long can we expect them to live? Now your ex-wife, I think you said she was on the drugs for about 15 years...

Rob: Yeah.

RW: ...and then she died at 56. Well I asked this question to some people who know about the -- I'm talking about psychiatrists -- who know a lot about some of the problems that they're seeing with kids on these drugs, and I said to them -- how long is the kid, you know, who is age 5 who's put on an atypical antipsychotic and stays on the drug -- and by the way once they get on the drug they're often put on a 2^nd, 3^rd -- it's just...they end up on these cocktails -- I said how long can we expect them to live? And one doctor said -- well I really don't know but that is the question we should be asking, and we should be looking at mortality rates as if they have a disease because all these symptoms are signs of an extraordinary deterioration in the capacity of the body to function; and he said I don't know but my guess is 30, 35 we'll see them dying in droves. So if you put that whole story together in which you have pharmaceutical companies identifying children as a market to expand these atypical...for atypical antipsychotics, and then you see a leading doctor at Harvard Medical School reconceiving, sort of, temper tantrums or oppositional defiant disorder or whatever you want to call that...into a brain disease that needs to be medicated for life -- I know many, many parents who've been told after their kid acted up -- Oh, he has bipolar disorder and he will need to be on medications for life, atypical antipsychotics for life because they're fixing a chemical imbalance like insulin for diabetes -- all of that's bullsh...all of that's false; and then their own studies show that once this happens, these kids tend to become rapid cyclers, they tend to become severely ill -- so if you look at what happens in terms of just their "bipolar symptoms," they become severely ill and you'll see people who do the studies saying -- Oh, these people are going to become chronically ill as adults and that's also associated with cognitive decline, physical illness, early death, and sort of a diminishment of the capacity to feel the world. Well, I'll let you do the moral calculations but in my opinion, when you put that whole story together, it's the most extraordinary attack on American children that you can imagine. It is, in essence, taking their lives away -- their God given right to grow up and live and try to make something of themselves, and instead turning them into lifelong consumers of psychiatric medications. And to let you know the extent of this now, something like 1 in every 16 American children now hits age 18 and is said to be seriously mentally ill, and in need of drugs for life. So that's the extent of this sort of pathalogizing of American childhood and getting them to become lifelong consumers of psychiatric medications. So you can do the moral equations, but I don't know of any greater betrayal that could be possible than turning kids, who have a right to live and a right to become something and a right to experience life, and a right, sort of, to grow up free, so to speak, and turning them into consumers -- I think this is one of the worst horrors ever.

Rob: Okay, now, I want to take a step back.

RW: Okay.

Rob: I agree with you. Now, in preparing for this interview I was going to ask you about the morality of this and where the malignancy is...where the evil is in this. My impression is it's the pharmaceutical companies; it's the psychiatrists....the academic psychiatrists who take a lot of money to speak for the pharmaceutical companies; it's the American Psychiatric Association that has intentionally attempted to establish this biological, medical model of drug prescription...am I on the right track here?

RW: Yeah, and here's the only thing I'd say...yeah, you're on the right track. The betrayal, in my opinion, really has to be placed with the academic psychiatrists....and why with them? Because that's the group that in our society in entrusted with our health so to speak. And our understanding of academic psychiatrists is they have devoted....academic physicians at medical schools is they have devoted their life to advancing science...right...and advancing medical treatments, and that's their motivation etcetera, and that they're going to be true to science, and they're going to be true in terms of telling us what's wrong -- you know, what they have come to learn, come to understand, and they will think critically about their medications or their treatments and they will try to improve them -- and we expect that to be done in this arena of honest, open science.

The reason I honestly don't blame the drug companies so much is I don't think...in our society we expect...we don't entrust the drug companies with the expectation that they will be honest with us. I mean, they're not doctors -- they're chemical companies that we know they try to make a profit and I think we almost expect them to try to use PR to exaggerate the safety and efficacy of their products. Now it may have gone overboard and that's why in many places they're now getting, you know, huge settlements for illegal marketing of the atypical antipsychotics, for lying and doing it off label and that sort of thing...

Rob: I'm sorry, but I do expect more from companies that the Supreme Court has now given a corporate personhood to. They do have the obligation to be honest and tell the truth, and even if the Supreme Court, or other courts, may have decided that it's okay for companies to lie, morally they corrupted by giving the money to these academics and I don't see...I mean, so we're going to disagree on that to some extent.

RW: Okay, you know, and I guess...I hear you Rob. I guess what I am trying to say is -- and maybe why I'm going too far the other way is -- it seems like we're too quick to....you know, so when I go around giving talks, people get real angry at the pharmaceutical companies as they're being the root of all evil. And all what I'm trying to, sort of, as I say this is -- again, in terms of if you want to put the biggest betrayal is -- I do put it with the academic psychiatrists, and actually with the APA as an organization because...

Rob: Okay.

RW: ...they nevertheless are the ones that we expect to be honest with us and that we entrust our health with...to. And so, for example, I'll just give you a very concrete example. I mean, the betrayal really runs through this whole story of telling these false stories about chemical imbalances, of hiding the long term data that shows problems -- I mean, you could see study after study that shows, you know, people not doing well and does that get published? Does that get promoted? No, they hide that, they keep it from the public. So you see this sort of betrayal at all lines of the information story -- when the drugs were tested you see that the story is told falsely...I'm talking about even at the short term trials; and then when they do their long term studies and they find, say, that unmedicated patients are doing better, they don't make those study results known. We have this early death in your...

Rob: Alright, now...

RW: Go ahead, go ahead.

Rob: Because we're not going to have that much more time but you have agreed to come back and do another show with me. I'd like to do it soon because I really haven't touched on a lot of the questions that we discussed so I'm hoping that maybe we can continue this conversation soon and keep this going.

RW: Yeah, my pleasure.

Rob: I did ask you, have you had...has there been any blowback for you on this, and I really never got an answer from you. Have the pharmaceutical companies or any of the people...or the organizations or groups that you criticize come back at you in any way?

RW: Well, this is sort of my second go around with this. Mad in America, you know, was sort of critical along somewhat the same lines, although this book I'd say is actually much more profoundly upsetting. You know after the first book came out there were some extraordinarily...there were some attacks, of course. I think like one psychiatrist wrote in a review -- if FOX television wants to do a television show on good journalists gone bad they can start with Bob Whitaker...there was that sort of attack. I got one review that said -- this is the most worst piece of journalism ever...that's Mad in America. Now when, to give an example, the day after Anatomy of an Epidemic was published, a doctor with close ties to the psychiatric...child psychiatric community in Boston published an unsolicited review, as far as I can tell, in the Boston Globe, which compared me to an AIDS denier and a South African dictator who had caused the death of hundreds of thousands of people. Now because that doctor was from a...you know, he's part of the Harvard Medical School community -- I had radio interviews cancelled, and it was basically a sign to newspapers around the country -- you do not want to review this book. So that was the blowback that began right away -- it sort of shot out of the cannon...that was number one...

Rob: Who was the doctor?

RW: A guy named Dennis Rosen. And it was a dishonest review. It said things...I responded to it -- it was just dishonest from start to finish in terms of what it said the book was about. And then, for example, someone managed to hack or somehow get into the database of a company called v-Fluence, and what v-Fluence does...it does market intelligence work for pharmaceutical companies and basically it's set up, if a critic emerges that can...is starting to do damage to that brand, you know, they'll run, sort of, disinformation campaigns to discredit that critic. Well...

Rob: How do you spell v-Fluence?

RW: v-Fluence...V, slash, I think it's F-L-U-E-N-C-E. Anyway it came out that they had a, you know, they were keeping tabs on me and they had been keeping tabs on me for some time, and they were going to continue to monitor my activities. Now I don't really know if...it doesn't seem they've actually done anything, but there was a sense of being tracked. There's...someone set up a question board on Yahoo! -- Is Bob Whitaker a Scientologist? -- which is a way to really be libeled -- and anybody who knows me, I'm like the last person on the face of the earth who would ever be a Scientologist. I'm a guy who has just been a mainstream medical reporter who believes in scientific literature and illuminating powers of science, so you see that sort of personal attack. It's a little tough...and the most...the latest thing was I got invited to be -- how crazy this whole thing is -- I got invited to be the keynote speaker at a big conference, alternatives conference...that's a conference organized for people who are users of the medications, quote "consumers and peers"...but it's funded by SAMHSA, which is a federal agency -- so I got invited and then the government said you have to disinvite Bob, and then finally after a protest by some of the peers/consumers I was reinvited; but as part of the thing of being reinvited, I gave a keynote -- this was on Friday -- and then they brought on a psychiatrist...SAMHSA insisted that a psychiatrist be allowed then to go on stage and basically rebut me and sort of, in essence, disparage me, and I was not even given any chance to respond -- so that's an example of how sometimes difficult it is to write a book like this which is extraordinarily...it's just their evidence base....

Rob: Well it's also evidence that you're touching a nerve and you're doing something important because otherwise it....what is SAMHSA? How do you...what is that? What's is the...

RW: Well it's basically the group that is a part of Health and Human Services that provides services to those with disabilities, and sort of becomes their federal...

Rob: S-A-M-S-A? What is it...S-A-M-S-A?

RW: It's S-A-M-S-H-A, and I'm not even sure what the acronym stands for. But it's S-A-M-S-H-A I believe. So it...

Rob: So...

RW: It's part of Health and Human Services -- the federal government.

Rob: Okay.

RW: So the point of this is this...is what we really need is an honest dissemination of this information and you see it in these sort of efforts to attack the messenger. But one last thing here...and the same way there's been these, sort of, problems for me personally, it's also been extraordinarily rewarding. I'm now traveling around talking, and actually because the book is so fact-based/evidence-based, there are major providers in this country now that are starting to say -- we need to change our use of these medications...and they're getting together, etcetera; and the reason for that is simple -- they do indeed know that this paradigm of care has failed and they read Anatomy of an Epidemic, and we're talking major providers, and they say this is solid evidence-based and they can't find, in essence, others to say where I'm wrong. So it...that's the point of Anatomy of an Epidemic -- it is...I'm really just a messenger. Here is what their evidence shows about long term...about these long term chronicity that chant the early death, the physical problems, and the worsening psychiatric symptoms in very many patients. So it is having a positive effect as well, and in that sense it's the most rewarding thing I've ever done.

Rob: That's awesome. Now, and we're going to have to wrap this up soon, but I want to have you back on in the next week so that we can continue this for the next show next week. Can we do that?

RW: Terrific...yeah, absolutely.

Rob: Alright, now...and what I want to talk to you about that I really haven't yet is the FDA, the connection of health insurance; we haven't touched on ADD/ADHD and the stimulant medications at all and I know my listeners are very interested in that; I want to talk about CHADD; I want to talk about psychologists who have gone along with this whole thing as well; there's a lot more that we really need to get into in more nitty gritty, and you have a chapter on ideology that I think is really important that we have touched on a bit, but I want to cover a bit further.

Now, before we wrap what I really want to get into is there are parents out there who have kids on medication, but if you read this book it's a horror story. It's like I'm putting my kid on a medication that's going to shrink his brain, that's going to make her have chronic illness, shorten her life by 15 to 25 years, yet they're being told by their doctor your child needs this like insulin for a diabetic -- and they may even be seeing some short term positive results. How do you address those people?

RW: Well first of all you did sum up...that's one of the, sort of, ways people can become deluded because they may get some short term positive results, that's true, some short term changes in behavior that are good in school and that sort of thing, and there's no way to anticipate this long term harm that's coming....or even really to see it until it's upon you. I think, you know, I have given this....I talked about the medicating of children to a big provider of childhood services recently in western...you know, in New York, and I've also talked to parent groups and all; and at some point people just can't process this information -- it's just too threatening I think because if you really looked at the long term data with the children, you do see a story of extraordinary harm done and I think sometimes parents...I've had parents come up afterwards just crying, I mean, just saying -- I don't know how to go on because I thought my child needed this drug like insulin for diabetes...and then when they were on 4 or 5 drugs, I was understanding this was all the disease -- that you really will have this sense of this extraordinary betrayal; and I've had people who were providers come up and say like -- I don't even know how to go to work tomorrow.

And really quickly on the ADD and ADHD thing, in terms of this whole betrayal, when the NIMH did a long term trial of stimulants, what...they did find some benefit with being on the medication in terms of behavior at the end of 14 months, and that was heralded, that positive result; but by end of 3 years they found that being on medication was a marker for deterioration rather than benefit, and that's even on the ADHD symptoms -- they also saw some growth suppression, etcetera; 6 years was the same thing -- you saw sort of greater juvenile delinquency, and those on the medications, some growth suppression; you saw no benefit anywhere in school; and so as one of the lead investigators said is -- we found no benefit...none to being on the medication. And if you want to enumerate the risk, something like...somewhere between 10 and 25 percent of kids placed on stimulant medications eventually end up in the bipolar camp -- in other words, they convert to bipolar, and that means now they're really...they're on this, sort of lifelong course to chronic illness, and so you really have this pathway to creating a bipolar kid that starts with the stimulants. So I don't really know how parents and people who don't know this literature...I think the sense of betrayal is so great...it's just extraordinary, and sometimes I feel like I'm the deliverer of horrific news.

Rob: Now when you say between 10 and 20 percent of children put on ADD stimulants...

RW: 10 and 25 percent.

Rob: 25 percent...are put on ADD stimulant medications, you're talking about Ritalin and Adderall and those kinds of medications, right?

RW: Exactly, so they will be put on that medication for, you know, in essence fidgeting in class, not behaving quite right in class; and as you follow those kids forward, at some point...roughly one quarter...somewhere between 10 and 25 percent will get diagnosed as bipolar. And once they're diagnosed as bipolar, then they'll often be put on an atypical antipsychotic or even multiple drugs, and now they are very much on a lifelong path to being a career mental patient. That's now the life path set out for them. And we go back to that starting moment -- they were a healthy kid who was somehow behaving no right in class at age 5 or 6, and now they've been converted into a lifelong user of psychiatric medications and really this lifelong chronic path...and that is a tale of extraordinary harm done. And by the way, you're seeing these kids who are getting in the bipolar camp as kids -- at age 18 they're going right on...so many of them are going right onto disability payments as adults.

Rob: This is the Rob Kall Future Health OpEdNews Bottom Up Radio Show, sponsored by opednews.com and futurehealth.org. If you want to hear the next part of this, come back next week to opednews.com or futurehealth.org/podcasts and we're going to have a continuation of this conversation. This is WNJC 1360 AM Washington Township. Thank you for listening, and Robert hang on a second. We're going to discontinue the recording of this now but we're going to keep talking for a minute.

RW: Okay, great.