Doctor in child drug treatment row to face GMC
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jake inva...@invalid.com
http://scotlandonsunday.scotsman.com/health.cfm?id=62892004 Sun 18 Jan 2004 Doctor in child drug treatment row to face GMC TOM CURTIS HEALTH CORRESPONDENT A DOCTOR who used controversial drug treatments on a hyperactive Scots child could be struck off after being accused of putting patients??™ health at risk.
Dr Patrick Cosgrove, a leading advocate of medication to curb hyperactive behaviour, is due to appear before the General Medical Council tomorrow accused of serious professional misconduct.
The case is thought to be the first of its kind in the UK and could have important implications both for the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD) and for the use of drugs on patients below the age for which they are licensed.
Cosgrove, a consultant child and adolescent psychiatrist who runs a private clinic in Bath, faces five allegations surrounding his practice. His name could be removed from the medical register if the GMC, which deals with complaints against doctors in the UK, finds against him.
The GMC said he was accused of "acting irresponsibly" in his monitoring of two patients receiving treatment for ADHD.
It is also claimed he failed to provide appropriate advice regarding a patient??™s treatment to his GP, failed to conduct an appropriate examination of a patient and failed, in response to a request by a mental health NHS trust, to release a patient??™s medical records.
In addition, it is alleged that on a number of occasions he made "unprofessional and unsustainable statements" about other doctors involved in the treatment of his patients which were "likely to cast doubt on their knowledge and skills".
One parent due to give evidence at the hearing in Manchester is Liz Thompson from Glasgow, who said her son Anthony was one of Cosgrove??™s patients for three years from the age of 10. Anthony had behavioural problems from the age of four but a succession of doctors in Scotland failed to find either a final diagnosis or an effective treatment.
Thompson said she later realised his symptoms appeared to match those of ADHD, which makes children constantly fidgety, easily distracted and impulsive, as well as abusive and sometimes violent.
A support group then put her in touch with Cosgrove, who was already well-known for treating ADHD patients and has previously stated that he believes falling crime rates are the result of tackling the condition with drugs.
Thompson claimed Cosgrove diagnosed ADHD within 25 minutes, without speaking to or examining her son, and immediately gave her a prescription for Ritalin, a stimulant now in common use to treat the condition. She said once her son started taking the drug he stopped eating and sleeping properly, so she contacted Cosgrove again.
She claimed he prescribed a second drug, Risperidone, which is used to treat schizophrenia. Anthony took both drugs for three years, during which he was initially less disruptive but Thompson claimed he appeared to be "doped up".
When his behaviour began to deteriorate again, she sought help from the Overload Network, an Edinburgh-based charity which campaigns on behalf of ADHD sufferers and their parents.
The organisation recommended Thompson received a second opinion and a psychiatrist in Glasgow weaned her son off both drugs.
Overload then complained to the GMC about Cosgrove in relation both to Thompson and another parent of a hyperactive child he treated.
More than three years after the first complaints, the GMC eventually decided to convene tomorrow??™s hearing. Thompson said: "When I first went to see Dr Cosgrove I thought he was a godsend - the answer to all my prayers.
"I asked if Anthony still needed help along with the drugs and he said he would not need any whatsoever, that these drugs would take away any of the problems he had been experiencing. Nothing could be further from the truth." She claimed Cosgrove never recommended that Anthony had tests to check how his body was dealing with the medication. Now 17, her son still has psychological problems, which she believes were masked but not treated by the drugs.
Janice Hill, of Overload, said she hoped the case would highlight the need to curb drug treatment for children with psychological problems.
Overload claims doctors write out prescriptions for Ritalin and other drugs far too readily, without trying alternative treatments such as altering diet or behavioural therapy.
US drug company Janssen, which markets Risperidone under the name Risperdal, says it is indicated for use only in schizophrenia and manic depression.
It is thought an adverse judgment against Cosgrove could make it more difficult for psychiatrists to prescribe such drugs "off-label" in the future.
FOR ADULTS ONLY?
MANY UK doctors routinely give patients under the age of 18 medicines that have been approved only for adults.
Seven out of 10 children prescribed a drug in the UK are given a substance that has not been officially approved for them, including psychiatric medicines, hormones, painkillers, sedatives and asthma treatments.
Growing concern about the issue could see pharmaceutical companies forced by the European Union to carry out clinical trials to check that all medicines given to children are suitable for them. New legislation could be introduced within two years.
The Department of Health said that in hospital intensive-therapy units up to 90% of children are given a drug which is either not licensed for them or is supposed to be used in a different dose or form or given only to older children.
In normal hospital units the figure is between 36% and 67% of children. Even in GPs??™ surgeries it is estimated at between 22% and 56%.
The situation has arisen because very few drugs have been through clinical trials involving children.
On top of the difficulty of getting permission to test on children, drug companies have little incentive to get involved because children generally offer only a small market for a medicine.
__ "When society turns a blind eye to the dangers of drugs and rushes to embrace a pharmaceutical cure for nearly every condition, there is almost no end to the harm that may result".
Thomas.J.Moore
"No Name Please" N...@Nospam.com
The doctor has no legitimate defense.
There exists no clear and unambiguous evidence ADHD exists.
There exists no evidence that stimulants improve the performance of those prescribe it for the symptomology of what some call ADHD.
Hopefully, Cosgrove will lose his license and MD's around the world will take heed....and this mindless prescribing of powerful mindbenders to children will come to a halt.
It only takes one well publicized trial to turn the tide.
mark neurops...@gwi.net
Give it a rest linda.
There is plenty of evidence.
--
=============================================================== Alas for religious people who know no world except the one they live in, and who have nothing to learn from the people they speak to.
--- A. DeMello S.J.
http://home.gwi.net/~mdmpsyd/index.htm
Velvet Elvis gamb...@on.softhomed.maps.net
L. Ron Hubbard was Schitzophrenic, you know.
--
"To announce that there must be no criticism of the president or that we are to stand by the president right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." --Theodore Roosevelt
jake inva...@invalid.com
On Thu, 22 Jan 2004 19:52:34 GMT, Velvet Elvis nobody either knows nor cares..
Child psychiatrist, Dr Patrick Cosgrove, has created controversy by prescribing powerful medication for hyperactive toddlers.
He often prescribes drugs licenced for much older children - and while many parents say their children have been transformed - BBC Radio Five Live has found that others are deeply unhappy with the results.
Dr Cosgrove's private practice, The Bristol Priority Clinic, operates on two theories.
First, that children who come to his clinic seeking treatment have a specific problem: brain dysfunction. And, as far as he's concerned, this can be effectively treated using drugs.
His second theory is juvenile crime is directly linked to the failure to adequately diagnose and medicate children with Attention Deficit Hyperactivity Disorder (ADHD).
He says if children are medicated early enough, then that would eliminate the possibility of crime being committed.
Controversial methods The cocktail of drugs he prescribes for children are Ritalin, Risperidone, Pimozide and dexamphetamine. He doesn't prescribe them all together, but in combinations he claims are effective.
Ritalin is known for its treatment of ADHD, Risperidone is an anti-psychotic drug, normally used for the treatment of schizophrenia.
All the drugs can cause nasty side effects.
Dr Cosgrove's controversial methods have made him unpopular with some other child psychiatrists, and prompted complaints to the General Medical Council, although to date no action against him has been taken.
Breaking guidelines Dawn is not one of his fans. Her son Sam was a patient of Dr Cosgrove.
He was just two when his mum took him to see the psychiatrist.
Sam was Dawn's first child and she was having trouble dealing with his behaviour.
"He was very hyperactive, had frequent tantrums, he'd bang his head against the wall, hurt anybody who came near him", she says.
Dawn was on a waiting list to see an NHS specialist, and she'd already taken Sam to her own doctor several times.
He talked to us about medication and said that was the only answer to treat it Dawn Dr Cosgrove's diagnosis of Sam surprised Dawn.
"We were there just under an hour", she says. "We did a tick box form to see what Sam was like, he weighed him and said "Yeah, he's got all the characteristics of ADHD".
"He talked to us about medication and said that was the only answer to treat it." Sam was prescribed Ritalin. But not long after Dawn gave her son his first dose of medication, Sam suffered horrendous side-effects.
"He turned into a zombie", she says. "He was even more aggressive than we'd ever seen. I remember thinking: 'What have you done?'" Dr Cosgrove suggested a switch in medication might solve the problem.
Dawn was horrified. She started doing some research and found out that Ritalin is not licenced in the UK for children under the age of six.
This means that little research has been done into its effects - or side effects in this age group.
Just because a drug is not licenced, doesn't mean that doctors are banned from using it, or even necessarily wrong to do so.
Many drugs have no licence for use in young children, but still get prescribed, with the doctor concerned signing to take personal responsibility for the outcome.
However, Dawn was alarmed and stopped giving her son the medication and removed him from the psychiatrist's care.
'Revolutionising medical practice' Dr. Cosgrove is unapologetic about his treatment and medication of young children. "I've used Ritalin and dexamphetamine in three year olds with good results," he says.
In fact, Dr. Cosgrove was again prescribing outside the approved licence of the drug.
Dr Cosgrove The Medicines Control Agency - the government body that issues licences for every drug in the UK - has only licenced it for use in over-15s.
Dr Cosgrove's campaign to medicate children and encourage his profession to adopt his approach continues.
Session beginning 19 January 2004 (Panel 1) Barnett House, 53 Fountain Street, Manchester, M2 2AN The Professional Conduct Committee will meet at Barnett House, 53 Fountain Street, Manchester, M2 2AN, to consider a New Case of Conduct.
Case No. 1 Area of Practice: Avon and various other locations Type of Case: Alleged serious professional misconduct The Committee will inquire into allegations that Dr Patrick Vernon Finn Cosgrove, a Consultant Child and Adolescent Psychiatrist, acted irresponsibly in his monitoring of two patients receiving treatment for Attention Deficit Hyperactivity Disorder. It is also alleged that Dr Cosgrove on a number of occasions made unprofessional and unsustainable statements regarding other medical practitioners involved in the treatment of his patients which were likely to cause the reader to doubt their knowledge and/or skills.
It is further alleged that Dr Cosgrove failed to provide appropriate advice regarding a patient??™s treatment to his General Practitioner, that he failed to conduct an appropriate examination of a patient, and that he failed, in response to a request by the Oxfordshire Mental Healthcare NHS Trust, to release the medical records of a patient.
jake inva...@invalid.com
the problem is he gave toddlers dangerous long term anti-psychotic drug cocktails in the pursuit of his crackpot theories without either examining them or monitoring them..
http://www.drpvfcosgrove.com/GoldEra.htm First of all, I ***ert that crime has NOTHING to do with the environment in which the child lives. Secondly, crime results from brain dysfunction.
And thirdly, that the brain dysfunction is the genetically determined ADHD + Conduct Disorder.
no evidence whatsoever exists to support these ***ertions/delusions of his..
http://www.drpvfcosgrove.com/RispMPD.htm In 50 children, low-dose Risperidone was added to the MPD with the following results: Significant reduction in aggression; Removal of thought disorder The use of a dopamine releasing agent (MPD) and a dopamine and serotonin antagonist (Risperidone) may allow both ADHD and Conduct Disorder to be treated simultaneously in the same child.
-----
and refused to disclose what "records" he had kept when requested to..
hardly suprising when his modus operndi appears to be telephone contacts and the only role of patients doctors is to arrange money for him!
Appointments can only be booked by telephone First appointments are in Bristol To enable necessary follow-up contact without frequent long journeys, a telephone consultation appointment scheme has been developed Follow-up appointments in Bristol can also be arranged whenever required NHS funding can be arranged for appointments with Dr Cosgrove by asking your GP to write to your Primary Care Trust/Group to arrange a contract with him http://www.gmc-uk.org/news/current/pccnews.htm The Committee will inquire into allegations that Dr Patrick Vernon Finn Cosgrove, a Consultant Child and Adolescent Psychiatrist, acted irresponsibly in his monitoring of two patients receiving treatment for Attention Deficit Hyperactivity Disorder. It is also alleged that Dr Cosgrove on a number of occasions made unprofessional and unsustainable statements regarding other medical practitioners involved in the treatment of his patients which were likely to cause the reader to doubt their knowledge and/or skills.
It is further alleged that Dr Cosgrove failed to provide appropriate advice regarding a patient??™s treatment to his General Practitioner, that he failed to conduct an appropriate examination of a patient, and that he failed, in response to a request by the Oxfordshire Mental Healthcare NHS Trust, to release the medical records of a patient.
His racket should certainly be closed down and hopefully will.
jake inva...@invalid.com
you have just conveniently clipped his own exposition of them for reasons best known to yourself..
http://www.drpvfcosgrove.com/GoldEra.htm First of all, I ***ert that crime has NOTHING to do with the environment in which the child lives. Secondly, crime results from brain dysfunction.
And thirdly, that the brain dysfunction is the genetically determined ADHD + Conduct Disorder.
no evidence whatsoever exists to support these ***ertions/delusions of his..
http://www.drpvfcosgrove.com/RispMPD.htm he gives these dangerous unauthorized drugs drugs to infants to reduce agression..control their thoughts and "prevent crime.
NO they are not and that is precisely why he is in front of the General Medical Council Indeed there are in the UK..
His more reponsible collegues have been reporting him for quite some time..
for giving antipsychotics to two year olds he should be in jail or sectioned and placed in a mental hospital himself..
Chris drift...@wolke7.net
Just as a sample of many: http://www.pediatrics.org/cgi/content/full/107/6/e105 If you want more, just look at their list of 78 references. Most of them are, however, not as freely available.
Chris
jake inva...@invalid.com
It was an interview with the guy made before complaints from parents..
doctors ..and other psychiatrists led to this disciplinary hearing..
the only thing senstionalist about this affair are his crackpot theories and florid claims..
"He says if children are medicated early enough, then that would eliminate the possibility of crime being committed.
The cocktail of drugs he prescribes for children are Ritalin, Risperidone, Pimozide and dexamphetamine. He doesn't prescribe them all together, but in combinations he claims are effective." one thing I do not forget is the effects of these drugs on children I have been in charge of of..and being asked to spoonfeed a baby barbiturates..
I suspect you are clueless as to what happens to children in the back wards of large mental hospitals..particulary if they either have no parents or the parents have written them off..
"elastica" helencharn...@hotmail.com
I was a patient of Dr cosgroves and he saved my life. I feel really sorry for the bloke. It doesn't seem to me that the charges are very serious.
The saddest thing is i received far better care from him than i ever recieved from other doctors etc. I had to change from 4 different doctors before any one would listen. One even laughed at me. to be honest i was pretty down and suicidal but i have been on medication for 6 months now and my life is starting to get back together. I don't believe Dr cosgrove is a crackpot at all. He just understands that adhd is a treatable condition and once it is treated it ends much pain and suffering. I wish him well and feel it is a shame that we might lose a decent and commited docter. By the way I was not even prescribed with this ritalin but with Clonidine which is an anti hypertensive used to lower blood pressure and stop migraines. Not sure what is controversail about that.
fred ...@bolox.net
I felt exactly the same way as you regarding Dr. Cosgrove, I even filled his questionairre in for the GMC hearing and used the same phrase as you `he saved my life` which he did.
One of the main charges against Dr Cosgrove was his patient aftercare.
Now I can see why, this is what happened to me.
As Dr C is 200+ miles away from me all aftercare was by telephone @ ??35 a call, no problem with that, except when it came to the GMC hearing I asked him three times what would happen to me if it went bad for him, his reply was `don`t worry about that` then all of a sudden the `clinic` closes, website shut, message on phone saying closed down.
I had no new doctor lined up, nothing on paper to prove I had been ***essed and diagnosed with ADD. So now I am back to square one with no way of getting my Dexadrine that has changed my life completely.
All NHS docs will refer you tou a physcatrist which will be fob off after fob off and take up to 3 years of tests just to allow me my prescription.
So Cossy had me money done a good job of diagnosing and prescribing but when the chips were down didn`t give a shit about the future of his patients (well me anyways, I don`t know about the rest of his patients) and for that reason the GMC has a point, when you consider that coming off Amphetamines can be a deadly dangerous business esp for a depressive personality (I.e suicidal) if I hadn`t read up on the Net how to come of the drug I may well have landed in the dumpster, and he must of known that and thought well they can up and die for all I care. GIT.
Lofty On Tue, 15 Jun 2004 14:40:17 -0400, "elastica"
fred ...@bolox.net
Yeah soon as I met him I thought he was ADD.
On 16 Jun 2004 19:12:26 GMT, Chris Malcolm <c...@holyrood.ed.ac.uk> wrote:
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