following is a transcript of an address given to the American Pediatric
Society at the conclusion of its annual convention in Boca Raton, Florida,
last week. The keynote speaker, noted pediatric pharmacologist Dr. Matthew
C. Taibbi, addresses recent revelations about the effects of antidepressants
on minor children.
AND gentlemen. I thank you for the honor of making me your keynote speaker
this year. I am sorry only that I had to spend so much time preparing
this speech, while the rest of you worked on your tans. It doesn't seem
fair that I should be the only ugly one.
okay, that Dr. Lowenstein and I should be the only ugly ones.
kidding, Sidney. You know I'm just bitter because Marion chose you.
God, what a fox. Stand up, Marion. There we go. Ladies and gentlemen,
Dr. Marion Lowenstein!
you. What a gorgeous couple. We all love you both. We love your work.
To business. Ladies and gentlemen, my dear colleagues of the pediatric
sciences, we stand today at a crossroads. Earlier this week, I was briefly
sober enough to hear it reported on the news that the Food and Drug
Administration has, in its infinite wisdom, elected to release the results
of studies that apparently "demonstrate" that some antidepressants
cause suicidal thoughts in children. Can I get a "Like, WHATEVER!"
crowd answers: "Like, WHATEVER!")
you. Now, as most of you are aware, the prescription of selective serotonin
reuptake inhibitor drugs for adolescent and pre-adolescent depression
has been standard practice for about
Christ, I want to say five
years, but maybe it's only three. Is it three, Sidney? He's nodding.
Nodding, and now, he's holding up three fingers-that's what I thought,
too. Three fingers, right, Sidney? Well, whatever it is, in the last
few years we've been handing that shit out like candy, we all know that.
fact, some tourist in the hotel bar this morning was telling me that
in 2002 alone we wrote something like 11 million antidepressant prescriptions
for children. And she sounded like she knew what she was talking about.
Her husband is some hot-shit architect in northern Virginia, makes millions.
But he's away on business a lot and has a little problem with the ol'
ED, if you know what I mean. And this still-young woman is all alone
in the hotel this week, ladies and gentlemen. In fact, I'm going to
go upstairs and visit her just as soon as we finish here.
any case, this decision by the FDA is going to force all of us to reexamine
everything we think we know about this particular line of pharmaceuticals.
Now, I personally have been eating them by the fistful since before
they were even approved for use. In my experience, they just give you
a slight buzz, like coffee. (Reaches into pocket, takes small handful
of pills, shoves four or five in mouth.) The best, if you can get them
(chews), are Wellbutrin, because they give you that creepy awake look
in your eyes that will make your friends wonder what you're on, make
you look like the villain in a karate movie. Plus they significantly
delay ejaculation, especially if you mix them with hard alcohol.
is hard to say just what effect these drugs would have when administered
in a normal course of treatment, but I have to think that if kids are
having suicidal thoughts after taking them, it might very well be that
they are not taking enough of them, not mixing them with hard alcohol,
and not knowing enough to chase the crashes with valium or vicodin or
even, in a pinch, a whole bottle of Ibuprofen.
are weird. We just don't know enough about the brains of children. Every
now and then I'll get a kid in my office, and I'll be like, "So
what's the deal? What's eating you?" And instead of answering,
the kid will just stare glumly down at the floor and trace a circle
on the ground with his or her toe, which he/she has to stretch out just
to reach the floor. (It's just flat-out crazy how small children are,
incidentally. That always boggles my mind.) And I'll snap my fingers
and say to the kid, "Hey! You there! Look alive! What the fuck
is the matter with you?" And he'll just cringe even more, like
that's going to make me go away somehow.
just totally unrealistic that way. And if he remains unresponsive, sometimes
I'll get up from my desk, go stand right in front of him, and just drop
my pants. "How about this?" I say. "Does this interest
you? Is this what you want?" Again: no reaction. At best, no reaction.
So from there I usually just go straight to the prescription tablet,
because that's what the book says to do.
if you take a child's head and just squeeze it really hard, he will
stop talking for like four or five minutes, and they get this amazing
look on their faces, like they've just seen something startling. You
have to sneak around right behind the child and place your palms on
the sides of his head, and just squeeze like hell. I've been doing this
for about four, maybe five years. Now, when kids come into my office,
the first thing they do is back up against a wall. They can be smart
like that. That's one of the things you notice after a while.
a parent will come in to my office and say to me something like, "Why
is my child depressed?" And I'll say, "What do you mean, depressed?
Isn't he taking the drug?" And they're like, yeah, he's taking
the drug, but he's still depressed. He cries all the time and the kids
at school kick his ass every day. And I'll say, well, give him more
of the drug, then. And they're like, we gave him more of the drug. And
he just cried more and the kids at school kicked his ass even more.
And I'll say, well, maybe the kid's just a loser. And the parents will
be like, yeah, that's what we thought. We just wanted to make sure.
I got a referral from a school board. They bring me this kid and they're
like, "We think this kid has ADHD." And I'm like, "Oh,
yeah? Why do you think that?" And they say, "Well, for one
thing, he doesn't pay attention in class." So I'm thinking to myself-class?
What do they mean? "What do you mean, class?" I say. "What
kind of class?" And they say, "Well, you know, English, history,
earth science." "No kidding," I say. "What does
he learn in history class?" "Well," they say, "he
learns about the Stamp Act, the Continental Congress and the American
Revolution." "That's amazing," I say, shaking my head.
"The American Revolution. Amazing." Then I take the kid and
I just start shoving Ritalin pills in his mouth.
you imagine, ladies and gentlemen-history class! There are so many things
we just don't know.
point I'm trying to make is that children are a completely different
world, and always will be. Will the FDA ruling affect our profession?
Can I get a, "What FDA ruling?"
answers: "What FDA ruling?")
what FDA ruling? We've forgotten already! Now let's go get a drink!