UPDATED: Doc Who Urged Antipsychotics for 3-Year-Olds Funded by J&J, AZ and Shire

Last Updated Aug 30, 2010 5:31 PM EDT

A doctor who wrote in an academic journal that preschoolers may suffer from depression and could be good candidates for atypical antipsychotics received funding from three drug companies that make mental health medicines.

Dr. Joan Luby, a professor of child psychiatry at the Washington University School of Medicine in St. Louis, wrote that children as young as three years old may suffer from bipolar disorder, and that there are "promising findings for the use of atypical antipsychotic agents and mood stabilizers, both singly and in combination" in the very young. Atypical antipsychotics are not FDA-approved for such use.

Her article, in a 2009 journal titled Child and Adolescent Psychiatric Clinics of North America, does not disclose that in the past Luby's work has been funded by Janssen (the unit of Johnson & Johnson that markets Risperdal), or that she has given talks sponsored by AstraZeneca (maker of Seroquel), and has been a consultant for Shire (maker of Adderall XR and Vyvanse).

Luby (pictured) disclosed her relationships with drug companies in a 2006 article in the Journal of the American Academy of Child & Adolescent Psychiatry, which was also about depression in preschoolers. Her disclosure said:
Disclosure: Dr. Luby has received grant/research support from Janssen, has given occasional talks sponsored by AstraZeneca, and has served as a consultant for Shire Pharmaceuticals.
Luby did not return an email or two phone calls requesting comment. It is not clear whether academic journal rules at the time required her disclosures. AZ said:
AstraZeneca records show that Dr. Luby participated in our speakers program from 2003-2004. It is AstraZeneca policy to compensate speakers according to the fair market value of their services.
After checking its records, Shire said it paid $2,000 to Luby in 2004, plus a $19 in travel expenses.* J&J did not respond to a message requesting comment.

Luby is not the only academic researcher whose disclosure of Big Pharma funding has been spotty. Sen. Chuck Grassley, R-Iowa, is pushing for transparency legislation that would force all university researchers to disclose their ties to drug companies.

A selection of Luby's published papers on childhood depression shows that while in 2006 she did disclose her payments from drug companies, in 2007 she did not. In an article titled "Psychotropic Prescriptions in a Sample Including Both Healthy and Mood and Disruptive Disordered Preschoolers," in the Journal of Child and Adolesent Psychopharmacology, Luby's disclosure statement said:
The authors do not have any corporate, commercial, or financial relationships that pose conflicts of interest.
Also in 2007, Luby signed as an author to a "Special Communication" in the same journal written by a group of child psychiatrists called The Preschool Psychopharmacology Working Group. The purpose of their group, Luby and her colleagues wrote, was:
... to promote responsible treatment of young children, recognizing that this will sometimes involve the use of medications.
The other authors of that paper disclosed a wealth of company ties, including Eli Lilly, Organon, Forest Labs, GlaxoSmithKline, Wyeth-Ayerst, McNeil, Novartis, Pfizer, Bristol-Myers Squibb, Abbott, AstraZeneca, Sepracor, Cephalon, Sanofi-Aventis, Boehringer-Ingelheim, and Janssen. Regarding Luby, the paper said:
The other authors have no financial relationships to disclose.
In Luby's 2009 editorial, she wrote:
The need for large-scale and focused studies of this issue is underscored by the high and increasing rates of prescriptions of atypical antipsychotics and other mood stabilizing agents for preschool children with presumptive clinical diagnosis of bipolar disorder.
She cited a paper by Harvard's Dr. Joseph Biederman, who was subpoenaed by federal prosecutors investigating J&J's promotion of Risperdal, much of which was allegedly off-label to children. Separately, hundreds of lawsuits have been filed alleging that Seroquel has dangerous side effects such as weight gain and diabetes.

*Correction: Shire originally said it had no contact with Luby in the prior two years.
  • UPDATE: Philip Dawdy of Furious Seasons has more on Luby's disclosure issues here and here.
Hat tip to Martha Rosenberg.

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