Patterns in chaos: understanding acts of “senseless” violence

At the Royal Free Hospital, London, in 1996 my gastroenterology colleagues and
I were reliably informed by our attending child psychiatrist, that acts of extreme
violence, such as the tragedy of Sandy Hook Elementary School, were perpetrated
more commonly by those with Asperger’s syndrome (AS). Like so much that child
psychiatry has had to offer – then and since – this assertion is misleading.

In support of his statement, the Royal Free’s child psychiatrist, Dr. Berelowitz, cited
the example of Martin Bryant who had recently been imprisoned for committing
35 murders and causing 37 serious injuries in Tasmania in April 1996, in what
became known as the Port Arthur Massacre. Bryant, according to Dr. Berelowitz
and later, Wikipedia, had AS. Both sources turn out to be incorrect: the report of
Paul E. Mullen, Professor of Forensic Psychiatry at Monash University, Melbourne,
Australia, who examined Bryant in prison in May 1996, tells the story. In his
criticism of an earlier diagnostic assessment by a Dr. Sale, Dr. Mullen wrote:

“Mr Bryant craves the attention of others. He desires relationships
but fails to effectively communicate with others unlike the patients
with Asperger’s who are blandly indifferent to others. Mr Bryant
also lacks, in my opinion, the central features of this condition, which
are repetitive activities, unusual skills with all absorbing obsessive
interests and problems with motor coordination. He also showed
marked delay in the acquisition of language skills and required
remedial therapy for this language deficit which is contrary to the
picture found in those with Asperger’s Syndrome.” (1)

While my experience of 18 years suggests to me that many with AS are not blandly
indifferent to others, Bryant’s speech delay precludes this diagnosis. In addition,
Bryant had an IQ of 66 – well below the average or above average IQ that experts
consider necessary for this diagnosis. (2)

More recent reviews of the relevant medical literature do not support an association
between an increased risk of violence and AS. (3) This fact is crucial, lest the wider
community stigmatize a population of individuals that are already poorly served
and badly misunderstood by many. This does not mean, however, that those with
AS are not at increased risk of violence under certain circumstances, as discussed
below.

A further Web-based review (see below) of acts of violent crime similar to those
seen in Port Arthur, Colombine, and Connecticut reveals that the majority of cases
are not associated with any evidence of an ASD diagnosis in the perpetrator at all. So
what do these tragedies have in common?

A Common Denominator

As with all tragedies of this nature, many try to make sense of the “senseless.” In the
case of Martin Bryant, Dr. Mullen failed. He concluded his expert psychiatric report
with the following:

“The enormity of Mr Bryant’s crimes call out for some
explanation equally dramatic and extraordinary. It is not to be
wondered at that the media have either attempted to portray
Mr Bryant as afflicted by a dramatic mental illness, such as
schizophrenia, or to be some kind of evil genius. In my opinion
the origins of this terrible tragedy are not to be found in a
single dramatic and sufficient cause, but in the interaction and
combination of a range of influences and events. We may never
know fully the intentions and state of mind which led to the
killings, but a number of the contributions are apparent.”

But clues to the likely origins of this particular tragedy were there – as they always
are – in the “patient’s” history; Mullen simply missed them. Bryant was taking
tranquilizers for anxiety and sleep disturbances. From Mullen’s report, he was using
these inconsistently, “on three or four occasions per week.” In a separate section of
his report Dr. Mullen also documents that:

“During the 12 months prior to the offences [Bryant’s] alcohol
consumption rapidly increased. He reports that in the six months
prior to the tragedy he typically drank every day. He would have
his first drink in the morning and then drink more heavily in the
afternoon and evening.”(4)

These factors – erratic compliance with tranquilizers and alcohol abuse – are related
and crucial. The risk of adverse reactions to tranquilizers is greatly potentiated
by alcohol due, in part, to shared metabolic pathways in the liver. The preferential
metabolism of alcohol will lead to impaired metabolism of the tranquilizer. Adverse
reactions to psychotropic drugs including tranquillizers are also more common
in those with existing mental illness, and violence is a well-recognized adverse
reaction.

Alarmingly absent from Mullen’s otherwise detailed report are the following: i. the
name of the prescription “tranquillizers” that he was taking; were they “major” or
“minor”? ii. any reference to the very real potential for interaction between such
drugs and the large amount of alcohol that Bryant was consuming in the months
prior to the attack, and iii. any mention of a violent psychotic reaction to these drugs
- particularly in combination with alcohol – playing any role at all in his crime.

The combination of alcohol and ad hoc use of tranquillizers will have produced
widely fluctuating drug levels. Fluctuations in drug levels put patients at particular
risk of adverse reactions. This phenomenon is also well recognized for the second
generation antidepressants, selective serotonin reuptake inhibitors (SSRIs) for
which the Physician’s Desk Reference [PDR] states:

“Adverse reactions are most likely to occur when starting or
discontinuing the drug, increasing or lowering the dose or when
switching from one SSRI to another.”

The PDR goes on to list an array of established central nervous system reactions
including: Mania, Hallucinations, Personality Disorder, Psychosis, Alcohol Abuse
and/or Craving, Hostility, Paranoia, Delusions, and Impulsivity.

Taking any tranquillizers, as Bryant did on “3 or 4 occasions a week”, in combination
with large amounts of alcohol, is a recipe for disaster. Had this been recognized, as
it should have been, and had the role of prescription psychotropic drugs in such
events been flagged at that time, future disasters might have been avoided.

This brings us back to the common denominator, the one and only consistent
feature of successive killing sprees, psychotropic prescription medications. (5)

Prescription Meds and Violence

In 2011 the Institute for Safe Medication Practices published in the journal PloS
One an analysis of data from the FDA’s Adverse Event Reporting System. The
article identified 31 drugs that are disproportionately linked with reports of violent
behavior towards others. (6)

The authors wrote:

“We identified 1527 cases of violence disproportionally reported
for 31 drugs. Primary suspect drugs included varenicline (an aid to
smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3
drugs for attention deficit hyperactivity disorder….

…Acts of violence towards others are a genuine and serious adverse
drug event associated with a relatively small group of drugs.
Varenicline, which increases the availability of dopamine, and
antidepressants with serotonergic effects were the most strongly and
consistently implicated drugs.”

The top ten offenders (7) – all prescription drugs – include: the antidepressants
Desvenlafaxine (Pristiq) (x 7.9 more likely to be associated with violence than
other drugs), Venlafaxine (Effexor), a drug related to Pristiq. Both are also used to
treat anxiety disorders (x 8.3), Fluvoxamine (Luvox) (x 8.4), Paroxetine (Paxil),
an SSRI antidepressant (x 10.3), Fluoxetine (Prozac) (x 10.9), the tranquilizer
Triazolam (Halcion), also used to treat insomnia (x 8.7), the attention deficit
disorder drugs Atomoxetine (Strattera) (x 9), and Amphetamines: (Various, x 9.6).
Also included are the antimalarial Mefoquine (Lariam) (x 9.5) and Varenicline
(Chantix) the anti-smoking medication (x 18).

The Heart of the Matter: Big Pharma and Psychiatry – a Liaison Dangereuse

Aberrant behavior is at the heart of the current crisis. This behavior – not on the
part of perpetrator however – is characterized in the following reports, just a few of
many.

Johnson and Johnson

“Johnson and Johnson settles five Rispredal Suits” (8)

“The former commissioner of the U.S. Food and Drug Administration,
David Kessler, says Johnson & Johnson and its Janssen subsidiary
broke the law in marketing the antipsychotic drug Risperdal for use in
children and adolescents.”

“The promotion of non-approved uses in the most vulnerable
children of powerful drugs is most concerning. Janssen’s promotion
of Risperdal, a powerful drug, for non-approved uses in the most
vulnerable children is deeply troubling.” (9)

(CBS/AP) LITTLE ROCK, Ark. – An Arkansas judge has fined
Johnson & Johnson (JNJ) and a subsidiary more than $1.1 billion
after a jury found the companies downplayed and hid risks
associated with an antipsychotic drug. (10)

“Judge Tim Fox found nearly 240,000 violations under Arkansas’
Medicaid-fraud law over Risperdal. Each violation came with a $5,000
fine, setting the total penalty at more than $1.1 billion.”

“Lies”
“Jurors returned a quick verdict Tuesday in favor of the state,
which had argued that Janssen Pharmaceuticals Inc. lied about the
potentially life-threatening side effects of Risperdal.”

Glaxo SmithKline

“Glaxo Agrees to Pay $3 Billion in Fraud Settlement (11)

“Criminal” Acts

In the largest settlement involving a pharmaceutical company, the
British drugmaker GlaxoSmithKline agreed to plead guilty to criminal
charges and pay $3 billion in fines for promoting its best-selling
antidepressants for unapproved uses and failing to report safety data
about a top diabetes drug, federal prosecutors announced Monday.
The agreement also includes civil penalties for improper marketing of
a half-dozen other drugs.”

“The three criminal charges involved [psychotropic drugs] Paxil,
Wellbutrin and Avandia and included a criminal fine of $1 billion.”

Inducements and Fraud

“Prosecutors said the company had tried to win over doctors by
paying for trips to Jamaica and Bermuda, as well as spa treatments
and hunting excursions. In the case of Paxil, prosecutors claim
GlaxoSmithKline employed several tactics aimed at promoting the use
of the drug in children, including helping to publish a medical journal
article that misreported data from a clinical trial.”

Lack of Individual Accountability

“No individuals have been charged in any of the cases. …critics argue
that even large fines are not enough to deter drug companies from
unlawful behavior. Only when prosecutors single out individual
executives for punishment, they say, will practices begin to change.”

“What we’re learning is that money doesn’t deter corporate
malfeasance,” said Eliot Spitzer, who, as New York’s attorney general,
sued GlaxoSmithKline in 2004 over similar accusations involving
Paxil. “The only thing that will work in my view is C.E.O.’s and officials
being forced to resign and individual culpability being enforced.”

Fines – The “Cost of Doing Business”

Despite the large amount, $3 billion [fine] represents only a portion
of what Glaxo made on the drugs. Avandia, for example, racked up
$10.4 billion in sales, Paxil brought in $11.6 billion, and Wellbutrin
sales were $5.9 billion during the years covered by the settlement,
according to IMS Health, a data group that consults for drugmakers.”

“So a $3 billion settlement for half a dozen drugs over 10 years can be
rationalized as the cost of doing business,” Mr. Burns (12) said. Mr. Burns
and others have said that to institute real change, executives must be
prosecuted criminally or barred from participating in the Medicare
and Medicaid programs, an action known as “exclusion.”

Abbott Laboratories (13)

Abbott Labs to Pay $1.5 Billion to Resolve Criminal & Civil
Investigations of Off-label Promotion of Depakote

“Criminal Misdemeanor”

“[The] Company Maintained Specialized Sales Force to Market Drug
for Off Label Purposes…”.

“Abbott has pleaded guilty to a criminal misdemeanor for
misbranding Depakote in violation of the FDCA.”

Side Effects “Downplayed”

“Not only did Abbott engage in off-label promotion, but it targeted
elderly dementia patients and downplayed the risks apparent from
its own clinical studies,” said Acting Associate Attorney General Tony
West. “As this criminal and civil resolution demonstrates, those who
put profits ahead of patients will pay a hefty price.”

A “Catcher in the Rye”
For President Obama to become a “Catcher in the Rye” (14) – a savior in this relentless
tragedy – he must take the Pharmaceutical Industry head on. Through the
Department of Justice, he has made a start. However, fines should be a multiple of
Pharma’s revenues and not some nominal settlement that does little to discourage
their insatiable greed. Individuals within offending companies need to be held
accountable and face criminal prosecution.

Obama must meet the autism tragedy head on and deal with the proximate cause
of the epidemic – unsafe and untested vaccination practices. The treatment of
autism spectrum disorders must start with an understanding of these disorders as
primarily medical conditions with toxocological, immunological, gastrointestinal,
and nutritional (15) issues front and center. Through the Interagency Autism
Coordinating Committee and the CDC his administration has been a dismal failure.

And for those at risk – young people receiving off-license mind-bending drugs, an
urgent overview of individual indication, efficacy, compliance, and adverse effects
must be undertaken, funded by the relevant players in the pharmaceutical industry
and conducted independently of any other input from them.

Tragically, predictably, there will be more events like at Sandy Hook Elementary.
The vast number of individuals with developmental disorders presages such events.
This is not because of their diagnosis, per se, but rather I would suggest, because
they may be at increased risk for adverse reactions (due to pre-existing conditions)
and are being inappropriately medicated with drugs for which violence is a
recognized adverse reaction. These drugs are being prescribed by a “mainstream”

medical system that, through clinical neglect, has run dry on alternative treatments
for autism spectrum disorders while enjoying Parma’s inducements way too much
to look for any.

My opinion is neither mine alone, nor is it new. In attempting to make sense of the
“senseless” it offers both tangible reasons and approaches to prevention. It is not
enough that our hearts break for those affected; we are compelled to act. Perhaps
inevitably, I am left with a mental image of Pharma lobbyists, like an army of Orcs
closing on Helm’s Deep, scaling Capitol Hill. It’s a hideous sight.

Appendix 1.

Red Lake, Minnesota – March 2005: 16-year-old Jeff Weise, on Prozac, shot and killed his
grandparents, then went to his school on the Red Lake Indian Reservation where he shot dead 7
students and a teacher, and wounded 7 before killing himself.

El Cajon, California – March 22, 2001: 18-year-old Jason Hoffman, on the antidepressants Celexa and
Effexor, opened fire on his classmates, wounding three students and two teachers at Granite Hills
High School. He had been seeing a psychiatrist before the shooting.

Eric Harris, one of the killers at Columbine High School, was on the antidepressant drug Luvox.
Court records show that the prescription for Harris had been filled ten times between April 1998
and March 1999.Three and one half months before the shooting, the dosage had been increased.
The Physician’s Desk Reference records show that during controlled clinical trials of Luvox, manic
reactions developed in 4 percent of the children given the drug.

Thomas Solomon, a fifteen-year-old at Heritage High School in Conyers, Georgia, shot and wounded
six classmates. He was on Ritalin at the time.

Kip Kinkel, a fifteen-year-old at Thurston High School in Springfield, Oregon, killed his parents and
two classmates and wounded twenty-two other students while on Ritalin and Prozac.

Notus, Idaho – April 16, 1999: 15-year-old Shawn Cooper fired two shotgun rounds in his school,
narrowly missing students. He was taking a prescribed SSRI antidepressant and Ritalin.

In 1989, less than one month after taking his first dose of Prozac, Joseph Wesbecker massacred eight
coworkers with an AK-47 before turning the weapon on himself.

Michael McDermott, convicted of killing seven co-workers, tripled his dosage of Prozac before the
shootings. On the witness stand he said he believed that he killed Nazis and not his co-workers.
He said an archangel appeared to him before the massacre, telling him that he could prevent the
Holocaust if he traveled back in time to 1940 to kill Adolf Hitler and six German generals.

Brynn Hartman, wife of comedian Phil Hartman, shot and killed her husband and herself while on
Zoloft.

Andrea Yates in Houston, Texas, drowned her five children while on Effexor and Remeron.

Christopher Pittman shot and killed his grandparents when he was age twelve. He claimed that
a voice inside his head told him to kill his grandparents on November 28, 2001. Christopher had
recently started to take Zoloft to treat mild depression.

Columbine, Colorado – April 20, 1999: 18-year-old Eric Harris and his accomplice, Dylan Klebold,
killed 12 students and a teacher and wounded 26 others before killing themselves. Harris was on the
antidepressant Luvox. Klebold’s medical records remain sealed. Both shooters had been in anger-
management classes and had undergone counseling. Harris had been seeing a psychiatrist before the
shooting.

Jeff Weise, age 16, had been prescribed 60 mg/day of Prozac (three times the average starting dose
for adults!) when he shot his grandfather, his grandfather’s girlfriend and many fellow students at
Red Lake, Minnesota. He then shot himself. 10 dead, 12 wounded.

Wahluke, Washington – April 10, 2001: Sixteen-year-old Cory Baadsgaard took a rifle to his high
school and held 23 classmates and a teacher hostage. He had been taking the antidepressant Effexor.
Paxil (which caused him to have hallucinations)

Thirteen-year-old Chris Fetters killed his favorite aunt while taking Prozac.
Twelve-year-old Christopher Pittman murdered both his grandparents while taking Zoloft.

Thirteen-year-old Mathew Miller hung himself in his bedroom closet after taking Zoloft for 6 days.

Fifteen-year-old Jarred Viktor stabbed his grandmother 61 times after 5 days on Paxil.

Springfield, Oregon – May 21, 1998: 15-year-old Kip Kinkel murdered his parents and then
proceeded to school where he opened fire on students in the cafeteria, killing two and wounding 25.
Kinkel had been taking the antidepressant Prozac. Kinkel had been attending “anger control classes”
and was under the care of a psychologist.

Luke Woodham age 16 (Prozac) killed his mother and then killed two students, wounding six others.

In 1998 A Pocatello had a Zoloft-induced seizure that caused an armed stand off at his school.

Michael Carneal (Ritalin) a 14-year-old opened fire on students at a high school prayer meeting in
West Paducah, Kentucky.

Andrew Golden, age 11, (Ritalin) and Mitchell Johnson, aged 14, (Ritalin) shot 15 people, killing four
students, one teacher, and wounding 10 others.

Conyers, Georgia – May 20, 1999: 15-year-old T.J. Solomon was being treated with the stimulant
Ritalin when he opened fire on and wounded six of his classmates.

Rod Mathews, age 14, (Ritalin) beat a classmate to death with a bat.

James Wilson, age 19, (various psychiatric drugs) from Breenwood, South Carolina, took a .22 caliber
revolver into an elementary school killing two young girls, and wounding seven other children and
two teachers.

Elizabeth Bush, age 13, (Paxil) was responsible for a school shooting in Pennsylvania

Jason Hoffman
(Effexor and Celexa) – school shooting in El Cajon, California

Jarred Viktor, age 15, (Paxil), after five days on Paxil he stabbed his grandmother 61 times.

Chris Shanahan, age 15 (Paxil) in Rigby, ID, who out of the blue killed a woman.

Jeff Franklin (Prozac and Ritalin), Huntsville, AL, killed his parents as they came home from work
using a sledge hammer, hatchet, butcher knife and mechanic’s file, then attacked his younger
brothers and sister.

Neal Furrow (Prozac) in LA Jewish school shooting reported to have been court-ordered to be on
Prozac along with several other medications. Kevin Rider, age 14, was withdrawing from Prozac
when he died from a gunshot wound to his head. Initially it was ruled a suicide, but two years later,
the investigation into his death was opened as a possible homicide. The prime suspect, also age 14,
had been taking Zoloft and other SSRI antidepressants.

Alex Kim, age 13, hung himself soon after his prescription of Lexapro had been doubled.

Diane Routhier was prescribed Welbutrin for gallstone problems. Six days later, after suffering many
adverse effects of the drug, she shot herself.

Billy Willkomm, an accomplished wrestler and a University of Florida student, was prescribed Prozac
at the age of 17. His family found him dead of suicide – hanging from a tall ladder at the family’s Gulf
Shore Boulevard home in July 2002.

Kara Jaye Anne Fuller-Otter, age 12, was on Paxil when she hung herself from a hook in her closet.
Kara’s parents said “…. the damn doctor wouldn’t take her off it and I asked him to when we went in
on the second visit. I told him I thought she was having some sort of reaction to Paxil…”)

Gareth Christian, Vancouver, age 18, was on Paxil when he committed suicide in 2002. (Gareth’s
father could not accept his son’s death and killed himself)

Julie Woodward, age 17, was on Zoloft when she hung herself in her family’s detached garage.

Matthew Miller was 13 saw a psychiatrist because he was having difficulty and school. The
psychiatrist recommended Zoloft for him. Seven days after beginning the Zioloft samples, his mother
found him dead… hanging by a belt from a laundry hook in his closet.

Kurt Danysh, age 18 and on Prozac, killed his father with a shotgun. He is now behind prison bars,
and writes letters, trying to warn the world that SSRI drugs can kill.

Woody ____, age 37, committed suicide while in his 5th week of taking Zoloft. Shortly before his death
his physician suggested doubling the dose of the drug. He had seen his physician only for insomnia.
He had never been depressed, nor did he have any history of any mental illness symptoms.

A ten-year-old boy from Houston shot and killed his father after his Prozac dosage was increased.

Huntsville, Alabama – February 5, 2010: 15-year-old Hammad Memon shot and killed another
Discover Middle School student Todd Brown. Memon had a history for being treated for ADHD and
depression. He was taking the antidepressant Zoloft and “other drugs for the conditions.” He had
been seeing a psychiatrist and psychologist.

Kauhajoki, Finland – September 23, 2008: 22-year-old culinary student Matti Saari shot and killed
9 students and a teacher, and wounded another student, before killing himself. Saari was taking an
SSRI and a benzodiazapine. He was also seeing a psychologist.

Dekalb, Illinois – February 14, 2008: 27-year-old Steven Kazmierczak shot and killed five people and
wounded 21 others before killing himself in a Northern Illinois University auditorium. According to
his girlfriend, he had recently been taking Prozac, Xanax and Ambien. Toxicology results showed that
he still had trace amount of Xanax in his system. He had been seeing a psychiatrist.

Jokela, Finland – November 7, 2007: 18-year-old Finnish gunman Pekka-Eric Auvinen had been
taking antidepressants before he killed eight people and wounded a dozen more at Jokela High
School in southern Finland, then committed suicide.

Cleveland, Ohio – October 10, 2007: 14-year-old Asa Coon stormed through his school with a gun in
each hand, shooting and wounding four before taking his own life. Court records show Coon had been
placed on the antidepressant Trazodone.

Greenbush, New York – February 2004: 16-year-old Jon Romano strolled into his high school in east
Greenbush and opened fire with a shotgun. Special education teacher Michael Bennett was hit in the
leg. Romano had been taking “medication for depression”. He had previously seen a psychiatrist.

——————————

Footnotes:

(1) http://kildall.apana.org.au/autism/articles/bryant.html

(2) http://www.autismresearchcentre.com/as_defined

(3) Newman SS and Ghaziuddin M. Violent Crime in Asperger Syndrome: The Role of Psychiatric Comorbidity J Autism Dev Disord 2008;38:1848–1852, Ghaziuddin M, Tsai L, Ghaziuddin N. Brief Report: Violence in Asperger Syndrome, A Critique. Journal of Autism and Developmental Disorders, 1991;21:349-354

(4) http://kildall.apana.org.au/autism/articles/bryant.html

(5) See, Appendix 1

(6) Moore TJ, Glenmullen J, Furberg CD (2010) Prescription Drugs Associated with Reports of Violence Towards Others. PLoS ONE 5(12): e15337. doi:10.1371/journal.pone.0015337

(7) Read more: http://healthland.time.com/2011/01/07/top-ten-legal-drugs-linked-to-violence/#ixzz2FPdgNtLu

(8) October 06, 2012|By David Sell, Inquirer Staff Writer. http://articles.philly.com/2012-10-06/
business/34280657_1_risperdal-suits-j-j-antipsychotic-drug

(9) There are more than 400 individual Risperdal lawsuits pending around the country, with more than
80 filed in Philadelphia. Thursday’s settlement might lead to settlements in some of those. J&J, based
in New Brunswick, N.J., with divisions in the Philadelphia region, is in litigation on several levels.
Though appeals are pending, it has lost cases in Louisiana ($258 million), South Carolina ($327
million), and Arkansas ($1.2 billion) in which the company was alleged to have promoted Risperdal
inappropriately through taxpayer-funded Medicaid systems. J&J won its Pennsylvania case. After six
days of trial testimony, it paid $158 million to settle in Texas. The company also is negotiating with
the federal government on a case, with reports suggesting that J&J might pay more than $2 billion.
Previously, the company agreed to pay $181 million to settle similar litigation with 36 states.

(10) http://www.cbsnews.com/8301-204_162-57412418/ark-judge-fines-johnson-johnson-more-
than-$1.1b-in-risperdal-case/

(11) By Katie Thomas and Michael S. Schmidt. New York Times. July 2, 2012

(12) Spokesman for the whistleblower advocacy group Taxpayers Against Fraud

(13) http://www.justice.gov/opa/pr/2012/May/12-civ-585.html

(14) The Catcher in the Rye. J.D. Salinger

(15) See http://www.youtube.com/watch?v=5lTGrAkW8hU

To Deb.

Today’s blog is written as a tribute to Deborah Nash, devoted mother of David and beloved wife of Jeremy, who died after a short and unexpected illness last week. I was honored by her presence at the GMC hearings, a presence that helped to ease an otherwise intolerable burden. The untimely death of this wonderful woman came too soon for her to have witnessed the triumph of dogged, determined advocacy from the autism community on the one hand, and the abject failure of the CDC on the other. The venue was the November 29 hearing of the US Government Oversight Committee.

Steven Salzberg, writing for Forbes, offers a pathetic defense of the CDC claiming that, in the face of hostile questions from the Committee:

Alas, Guttmacher and Boyle [CDC scientists] weren’t prepared for this kind of rapid-fire assault by pseudoscience.

In fact, Coleen Boyle, when asked how many papers the CDC has collaborated on with the Danish embezzler and man-on-the-run, Poul Thorsen, she replied “a couple.” The actual number is apparently in excess of 30. In contrast with the assertion of apologist Salzberg, what Boyle was clearly not prepared for was to tell the truth. In fact the CDC continue to publish with Thorsen despite his criminal indictment. What Congress was able to witness at first hand, on this momentous occasion, was the CDC’s facility with statistical manipulation. Its Members were not impressed.

But back in England and in the wake of the Leveson Inquiry – triggered by the activities of Murdoch’s gutter press – it was business as usual. Fiona Fox, Chief Executive of the Science Media Centre, is quoted as having said in relation to the MMR scare:

“Time and time again the editor demanded that the fact that 99.99999 per cent of medical science believed this vaccine to be safe had to be balanced in every article by Andrew Wakefield or one of his supporters. So you have the terrible situation where a MORI poll showed, at the height of this crisis, that nearly 60 per cent of the British public thought that medical science was divided. That’s the bit on which the media let the public down.”

Where, Fox, does the figure (99.99999%) that you positively assert as fact, derive from? The figure is, in fact, imaginary. You, Fox, are speaking from a position of ignorance.

There is actually worrying little data on the safety of MMR vaccine. What there is in the public domain, I have reviewed in considerable detail and had done so prior to expressing my concerns in 1998.

A subsequent analysis of the safety profile of MMR vaccine was published from the Cochrane Collaboration, seen by many as the gold standard for such scientific reviews. The authors of this review concluded that:

The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate.

Unlike Fox’s fiction, this is not reassuring. Like me, the authors expressed concerns about the relative safety of MMR when compared with the single measles vaccine.

We found limited evidence of safety of MMR compared to its single-component vaccines from low risk of bias studies.

Ultimately, the consumer was left to rely MMR’s widespread use as a proxy for safety – laughable but true.

The safety record of MMR is possibly best attested by its almost universal use.

The Cochrane authors were not persuaded that there was epidemiological evidence of an association between MMR vaccine and autism. However, on closer inspection, the CDC’s own study showed an association between autism risk and younger age at MMR vaccine exposure. De Stefano et al. reported a statistically significant increased risk of autism of between 50% to 230% in children who received their primary MMR at less than 36 months, compared to those who received it later.[1] This age-of-exposure finding was reiterated in a re-analysis of Poul Thorsen’s infamous Danish Study[2], and in Richler et al’s study from the University of Michigan (interestingly, for the autism subset with intestinal symptoms).[3] More recently, Schulz et al. (after correction of the authors interpretative error) showed that an acute adverse reaction following MMR vaccination predicted later autism.[4] Finally, the latest analysis from Seneff et al at the Massachusetts Institute of Technology reported a strong correlation between autism and MMR vaccination.[5]

Really, Fox, is this only 0.00001% of the science?

MMR is not one thing

When examining the safety of MMR, it is a error to assume that it is a single biological entity – an error inherent in Cochrane and other analyses. In its litany of inexcusable errors and oversights, the UK’s Joint Committee on Vaccination and Immunization (JCVI) casually justified the introduction of MMR vaccine in the UK based upon safety data from countries that used exclusively Merck’s MMR II vaccine containing the Jeryl-Lynn strain of mumps.[6] Eighty-five percent of the UK market was subsequently awarded to SmithKline French for its Pluserix MMR vaccine containing the Urabe strain of mumps. The result was disaster – a meningitis epidemic that the British Government has been trying the cover up ever since. The responsibility for this must lie heavily on the shoulders of Dr. David Salisbury whose own CV includes, under “Personal Achievements”: “Strategy design and policy implementation, MMR vaccination – 1988.”

And not even the same vaccine, from the same manufacturer, sold under the same name, is actually the same!

As Dan Olmsted pointed out in his excellent February 28, 2009 article on Age of Autism, in 1990, Merck & Co., manufacturer of the MMR II, made a significant change to the formulation of its MMR: it quadrupled the amount of mumps virus in the combination shot, from 5,000 to 20,000 units. Then in 2007 it reversed course, reducing the amount to 12,500 units.[7] He wrote:

In looking at whether the increase in mumps potency in 1990 could buttress this theory of the autism epidemic, two questions arise: Is there evidence that increasing the mumps portion of the MMR could have any impact on measles infectivity or create symptoms consistent with those described by Wakefield and parents? And, could ProQuad’s [MMR plus chicken pox vaccine’s] higher rate of measles rash and fever-induced seizures be a warning sign that something is amiss with the MMR itself, especially beginning in 1990 when Merck tinkered with the proportions of the components?


The answers seem to be, yes and yes.

Quadrupling the dose of a blood pressure medication while marketing that medication to patients and doctors under the same name, would likely lead to a lot of dead patients and prison sentences for those responsible.

But for Fox it’s all “Ra Ra Ra” from the sidelines – go girl!

Since we cannot rely on Fox for the truth about MMR vaccine safety, where should we look? The Courts perhaps? I addressed this particular issue in my latest book, Waging War on the Autistic Child.

The first probable vaccine-associated case of autism reported in the medical literature was that of Rutter et al in 1994.[i] By 2010, the public domain boasted just a handful of cases of vaccine injury, conceded by the Department of Justice or won in vaccine court where the damage—encephalitis (brain inflammation) or encephalopathy (non-specific brain damage)—resulted in an ASD.[ii] Enthusiastically, but with, nonetheless, a tangible anxiety, officials dismissed these cases as rare and irrelevant to the autism-vaccine debate. But in 2011, in a landmark paper by Mary Holland and colleagues, who had gone behind the scenes of the US Vaccine Injury Compensation Program (VICP), it was revealed that the government had settled at least 83 cases of vaccine-damage where the child was rendered autistic.[iii] Vaccine damage had been masked by government officials, wittingly or unwittingly, as the precipitating acute vaccine reaction (e.g., encephalitis) and not the actual outcome—autism. The reason that many of these cases had been settled is because they represent injuries on the Vaccine Injury Table, that is, encephalitis, encephalopathy, or residual seizure disorder with onset in a short and specific timeframe following vaccination.[iv]The very restrictive criteria applied to such injuries are defined by the weight of the scientific evidence. It would be disingenuous, therefore, to argue that these cases are due to anything but true adverse vaccine reactions. Moreover, given the parsimonious conditions applied to the definition of table injuries and the absence of adequate safety data on combination vaccines in particular, the number of compensated children with autism and autism-like symptoms will be a substantial underestimate of the true state of affairs.

Since then, another landmark MMR-autism case has been settled in the Rimini District Court in Italy. Based upon the opinion of a medical expert and conceded on medical and scientific grounds by the Italian Ministry of Health, Valentino Bocca’s autism was, “The fault of the [MMR] vaccine.” The ministry was ordered to pay compensation.[8]

Notably, soon after the MMR vaccine Valentino began to show troubling symptoms (diarrhea and nervousness) and then:

…between 2004 and 2005 occurred signs of severe psychological distress to physical recognition, 7 August 2007, the total and permanent disability to 100%.

The UK Parliament was told that the decision in favor of Valentino was just the opinion of one judge. Parliament was misled. The Italian Ministry accepted the opinion of the Court’s medical expert. They appealed the case only on the basis that MMR vaccination is not mandatory in Italy. That argument found no traction with the judge.

So, Fox, at the very least, please don’t pretend to represent some credible censorial interface between science and the public.


[1] Destefano F et al. Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Pediatrics 2004;113:259-266.

[2] Stott CA, Blaxill M, Wakefield AJ. MMR and Autism in Perspective: the Denmark Story. J of Am Physicians and Surgeons. 2004, 9:89-91.

[3] Richler J, Luyster R, Risi S, et al. Is there a ‘regressive phenotype’ of autism spectrum disorder associated with the measles-mumps-rubella vaccine? A CPEA study. J Autism Dev Dis. 2006;36:299-316.

[4] Schultz ST et al. Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: The results of a parent survey. Autism 2008; 12; 293-307

[5] Seneff S, Davidson RM, Liu J. Empirical data confirm autism exposure symptoms related to aluminum and acetaminophen exposure. Entropy. 2012;14:2227-2253.

[6] JCVI minutes. November 7, 1986. “*** enquired about the risk of adverse reactions. **** stated that favourable results on safety had been reported both from Finland and the USA.”

JCVI minutes of the working party to discuss the introduction of MMR, January 23, 1987. “The chairman said…***** felt that respectable data from other countries would be acceptable to the Committee on Safety of Medicines. It might be possible in this way to move directly toward Product Licence application at this stage.”

[7]

[8]

 

 


[i] Rutter M, Bailey A, Bolton P, et al. Autism and known medical conditions: myth and substance. J Child Psychol Psychiatry. 1994;35:311-22.

[ii] http://www.uscfc.gov/sites/default/files/Abell.BANKS.02-0738V.pdf

Attkisson S. Vaccine watch. CBS News Investigates. June 19, 2008. Retrieved from: http://www.cbsnews.com/8301-501263_162-4194102-501263.html

[iii] Holland M, Conte L, Krakow R, et al. Unanswered questions from the Vaccine Injury Compensation Program: a review of compensated cases of vaccine-induced brain injury. Pace Envtl L Rev. 2011;28:480. Available at: http://digitalcommons.pace.edu/pelr/vol28/iss2/6

[iv] The Vaccine Injury Table lists and explains injuries/conditions that are presumed to be caused by vaccines. It also lists time periods in which the first symptom of these injuries/conditions must occur after receiving the vaccine. If the first symptom of these injuries/conditions occurs within the listed time periods, it is presumed that the vaccine was the cause of the injury or condition unless another cause is found. For example, if you received the tetanus vaccine and had a severe allergic reaction (anaphylaxis) within 4 hours after receiving the vaccine, then it is presumed that the tetanus vaccine caused the injury if no other cause is found.

Government Oversight Committee Nov 29

By Dr. Andrew Wakefield

The manipulation of Lord Leveson’s inquiry into the subterfuge of Murdoch and Son’s News Corporation hangs ominously over the November 29th US Government’s Oversight Committee hearing on Autism. Why? Because the upcoming hearing was not meant to be about Autism but rather, CDC malfeasance in covering up the vaccine-autism link. Bear with me.

Faced with the Leveson Inquiry, the British Government could not afford to lose an “MMR-is-safe” inch gained for them by News Corporation aparatchick Brian Deer. Deer’s “exposé” – itself a contrivance – was demolished in the High Court ruling of Justice Mitting when overthrowing the General Medical Council’s adverse findings against Professor John Walker Smith, my Lancet co author. In a “public interest” argument, the Inquiry spun the MMR exposé as the sole mitigation for the abuses of press freedom by News Corporation employees. At the same time, parents who petitioned the Inquiry to permit them to give evidence on the MMR-autism issue were deliberately excluded. The consequence in the UK was a Government win.

In another winter of discontent for the rapidly growing autism community, the US Government (or someone) appears to have turned the tables on the upcoming Oversight Committee hearing. Gone is Dr. Brian Hooker’s expose of the CDC’s manipulation of the autism-thimerosal connection, told in their own words through FOIA and court-ordered disclosures. This leaves Mark Blaxill of SafeMinds a mere five minutes to discuss the original basis of the hearing – vaccine safety and autism. And in place of the exposé, various autism groups will create a worthy but irrelevant smoke screen behind which the CDC will make its escape.

The late Elizabeth Birt, who worked so effectively with Dan Burton in his earlier Oversight Committee hearings, must be turning in her grave. Come to that, where is a representative of the Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) discussing the US Vaccine Injury Compensation System’s (VICP) longstanding compensation of children rendered autistic by vaccine-induced brain damage?

Did Dr. Wakefield falsify data?

Dr. Wakefield addresses two questions– did he falsify data in the Lancet 12 paper? And is it not true that the Lancet 12 children were initially diagnosed as having normal bowel biopsies?

Due to a temporary problem with youtube embedding, please click here for the questions and answers.

Watch the entire Academic Integrity Fund interview series here.

Do you have a question you want Dr. Wakefield to answer in an interview? Leave a comment below.

Did Dr. Wakefield prove that the MMR vaccine causes autism?

Dr. Wakefield addresses the question of whether he proved that the MMR vaccine causes autism. Watch the entire Academic Integrity Fund Interview Series here.

Due to a temporary problem with youtube embedding, please click here for the MMR question and answer.

Do you have a question you want Dr. Wakefield to answer? Leave a comment below.

Monday morning thoughts

By Dr. Andrew Wakefield

We had a wonderful fundraiser for the Academic Integrity Fund at Z Tejas in downtown Austin last week. My sincere thanks to the organizers of the event on such short notice and to Elizabeth Avellán for her kind words of introduction. We intend for this to become a template for similar events around the country starting in 2013. It you are willing to organize an event in your town, please notify us below and we can send further information. I’ll be there.

Diagnostic and Statistical Manual of Mental Disorders

In the farmyard, the young rooster moves with purpose among his new harem of Rhode Island Reds. Meanwhile, the old rooster attempts to mate with a rusty pail in a pathetic parody of dominance lost. The old rooster’s displacement activity – feigning purpose and performance – provides a metaphor for Psychiatry’s check-out-my-satisfied-rusty-pale rewriting of the DSM. The question in the farmyard – the real question – is, “what in the environment is causing the autism epidemic.” At one time the rooster was too busy preening himself to hear the question; now, in his twilight, ignorant and irrelevant, he wonders why the farmer’s wife approaches with curved steel wrapped in a meaty fist. Not a moment too soon.

Thoughts on phenotype

A man gets hit by a car. The car is the proximate cause of his injuries. Without the impact of the car he would not be injured. The nature of his injuries, their site, extent, consequences – their phenotype – will depend on myriad factors related to both the car and the man himself. Absent the car, these other factors would be irrelevant.

Car-related factors that determine the man’s injuries include those that are fixed such as size, shape, and mass, and those that are variable such as speed, angle of impact, and number of passengers.

Man-related factors influencing site, extent, and consequences will include his size, shape, age, and co-morbid conditions – does he take the fender in the knee or thigh, for example. Young bones heal better than old ones. The old man on coumarin to “thin” his blood because he has an abnormal heart rhythm will bleed. The man with diabetes will suffer wound infection…the list goes on.

And so the phenotypes of twenty men ending up in a single emergency department having been struck by cars will vary considerably. The proximate cause – a car – is the common denominator. Without the car they would be going about their lives.

To be continued…

Army of Parents

By Dr. Andrew Wakefield

What are my enduring memories of the General Medical Council hearings in London – the deliberations of a deeply, deeply compromised regulatory body – one that was criticized so savagely by Justice Mitting in his High Court dismissal of the case against my colleague Professor John Walker-Smith? Was it Martin Walker’s exposure of the Panel Chairman’s undisclosed stock holding in vaccine manufacturer Glaxo SmithKline? Or, Prosecuting Counsel Sally Smith’s unfortunate fall, headlong into her case files? The damning exposure of the false testimony of Lancet Editor, Richard Horton, must rank among the leading contenders, as must that also, of the frank lies of the Medical School Dean, Arie Zuckerman.

Certainly, my fondest memory by a long, long way was the army of supporters who gathered to cheer, support, and sit through hours of the Prosecution’s interminable bilge, and then come back for more.

So thank you for this memory, and thank you to all those, worldwide, whose support has remained firm throughout a relentless PR campaign against me and many of those in the autism community– a campaign intended to bend the public mind to corporate and political wills. That campaign has failed. Since it relied upon criminals like Denmark’s Dr. Paul Thorsen, who faces extradition to the US on charges of fraud and embezzlement, its failure was inevitable.

To my supporters, a million thanks. We will prevail.