Crazy for cash

Hey, big pharma execs have to eat, too. It's just that they happen to prefer caviar and 14-karat utensils.

Last year in the United States, about 1.6 million children and teenagers — 280,000 of them under age 10 — were given at least two psychiatric drugs in combination, according to an analysis performed by Medco Health Solutions at the request of The New York Times. More than 500,000 were prescribed at least three psychiatric drugs. More than 160,000 got at least four medications together, the analysis found.

Many psychiatrists and parents believe that such drug combinations, often referred to as drug cocktails, help. But there is virtually no scientific evidence to justify this multiplication of pills, researchers say. A few studies have shown that a combination of two drugs can be helpful in adult patients, but the evidence in children is scant. And there is no evidence at all — "zero," "zip," "nil," experts said — that combining three or more drugs is appropriate or even effective in children or adults.

"There are not any good scientific data to support the widespread use of these medicines in children, particularly in young children where the scientific data are even more scarce," said Dr. Thomas R. Insel, director of the National Institute of Mental Health.

Of course, parents usually aren't in a position to know this, but doctors are. And those golf outings and vacations aren't going to pay for themselves, you know.

But don't judge pharmaceutical companies too harshly. After all, they're under a lot of pressure: No matter how much money a company makes, if it's less than last year, it's a failure.