HJBR May/Jun 2019

research breakdown 26 MAY / JUN 2019 I  Healthcare Journal of BATON ROUGE   grant, and the five-year study — “Affective Neuroscience of Pediatric Bipolar Disor- der” — began in January 2009. Activity in her research lab picked up and, soon after, she secured two more NIMH grants. Around the same time the lithium study began, CynthiaMallard was distraught. Her 10-year-old son, Luke, was defiant at school and had trouble controlling his emotions. “I wanted to find someone who could fix him,”Mallard said. Mallard first took her son for counseling near their home in Bourbonnais, south of Chicago. When that didn’t help, she sought referrals and decided to try to get Luke into Pavuluri’s UIC practice; she knew of Pavulu- ri’s reputation. But every timeMallard called for an appointment, she said, she was told Pavuluri wasn’t seeing new patients. She pleaded and was told Luke could get an appointment if he entered a clinical trial, she said. “They told me I could get Dr. Pavuluri to see him every week if I were to get in the study,” she said. Pavuluri prescribed lithium, and Mal- lard, a developmental therapist, immedi- ately noticed changes in her son. He paced, to her clinic. “Every time I saw her, she was very nice, very sweet,” Luke said. But he said the lithium had side effects he didn’t like. He quickly went from being a skinny kid to an overweight preteen. He said he’s upset she prescribed the drug when he was so young. “I have these issues now and I don’t know if they will go away,”he said. “I don’t know if lithiumwas a direct cause of it, but it didn’t help anything.” An Adverse Event Pavuluri’s research program began to unravel in 2013, the lithiumstudy’s final year. The issue started with a patient who came to Pavuluri when her medications for manic symptoms no longer were effective. Records do not identify the patient, but Pavuluri said in the interview that she was a girl. Pavuluri had the girl withdraw from those drugs and put her on other medication to ease her into the lithium study. But she began to experience “heightened irritability,” walked in circles around their living room and heard voices in his head. He thought he sawother people when he looked in amirror. “When he was on lithium, he turned into a different kid,”saidMallard. “I told Dr. Pavu- luri, ‘I don’t care what you have to do, get him off this stuff.’” Luke took the lithium for at most two months, according to the family’s records. Then Pavuluri switched his medication. The family’s records show that he continued to see Pavuluri for therapy for several more years and enrolled in at least one other study she led; UIC officials said that study has not been called into question. Luke, now 19, is six feet tall, with floppy dark hair that he brushes away when it falls into his square-rimmed glasses. He gradu- ated from high school, has taken commu- nity college classes and currently works at a local pizza restaurant. He said that he hopes to become a therapist to help children. On a recent evening, he sat at his kitchen table and described his years of therapy and medication. He enjoyed taking part in Pavu- luri’s studies, he said, if only because he was paid to participate and got a day off from school to travel an hour or more each way Lithium side effects “But he [Luke] said the lithium had side effects he didn’t like. He quickly went from being a skinny kid to an overweight preteen. He said he’s upset she prescribed the drug when he was so young.”