Doctor Says Maternal Deprivation Research is Unethical Promotion of Mind-Altering Drug Use for All At-Risk Children.

Dr. Francis Collins, Director
National Institutes of Health

Michael Gottesman, M.D.
Deputy Director for Intramural Research

Dear Doctors:

It has recently come to my attention that researchers at the National Institutes of Health (NIH) Intramural Research Program are using maternal deprivation to study anxiety and depression in infant macaques. As a pediatric psychiatrist who has treated abused and neglected children, and who is concerned about the welfare of primates used in research as well as the welfare of my patients, I am particularly interested in this issue. Dr. Stephen J. Suomi, leader of the project, offered this explanation to CBS News:

"These findings assist researchers in identifying humans most likely to suffer negative effects in at-risk situations and develop behavioral and drug therapies to improve negative outcomes early in development." http://www.cbsnews.com/news/mental-health-experiments-on-baby-monkeys-at-federal-nih-labs/

Perhaps more than any other medical specialty, pediatric psychiatry is an art as much as it is a science. As children are constantly growing and developing, their symptoms require frequent reassessment, and their treatment plans must continually be revised and updated. Clinical psychiatrists already know that children respond to psychotropic medications with great variability and unpredictability, and that the side effects of these medications can be debilitating. For these reasons, I believe that it is unethical and inappropriate for any physician to recommend the use of psychotropic medications in children who are "at risk" but have not yet been medically diagnosed with a DSM-5 psychiatric disorder. In his 2002 research paper on childhood predictors of anxiety, Dr. Jerome Kagan concluded with a note of caution:

"It is also important to note that a high-reactive temperament protects the child from engaging in risky behavior -whether drugs, driving at high speeds, or temptation for delinquent, behavior. Thus, the child with a high-reactive temperament has some advantages in our society and parents of such infants might decide not to change their child's behavior when the next set of pharmacological advances permits them that choice." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181685/

Identifying children who are at risk for the development of mood and anxiety disorders is a great idea, as is the use of family support and individual counseling as preventive medicine. However, there are many researchers successfully working on these issues with human subjects, utilizing low-risk and non-invasive functional brain scans which make the use of animal models obsolete. And unlike monkey researchers, who have yet to propose a single new treatment for psychiatric patients despite decades of experiments and promises, researchers who study humans can often give us useful information immediately. For example, from a 2011 study of human beings with inhibited temperament:

"Thus, a sustained amygdala response to newly familiar people may be one cause of social anxiety in inhibited individuals. This finding may also have implications for prevention or intervention. For individuals with temperament-based risk for social anxiety, increased exposure to human faces through traditional exposure therapy or through computer-based training may enhance amygdala habituation and reduce social anxiety." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190202/

I urge NIH to put an end to all maternal deprivation psychiatric research in primates, as an unnecessary use of animal models as well as an unethical promotion of the use of psychotropic medications in asymptomatic children. I have additionally contacted my representatives in the United States Congress and asked them to investigate why our public tax dollars continue to fund these studies when they do nothing to help human patients.

Sincerely,

Sujatha Ramakrishna, M.D