Long Term Seroxat/Paxil User: ” the only reason I am on the drug is because I am dependent upon it. And that is not good enough.”…


https://www.theguardian.com/society/2017/may/06/dont-know-who-am-antidepressant-long-term-use

‘I don’t know who I am without it’: the truth about long-term antidepressant use

Prescriptions have doubled in a decade, but very little is known about the effect of taking SSRIs for years and years. Is it a lifesaver or a happiness trap?

Noma Bar illustration of bird in cage shaped like a pill
Long-term side-effects of taking antidepressants are sometimes ignored or misunderstood. Illustration: Noma Bar

Sarah never planned to take antidepressants for 14 years. Three years after she began taking them, when she was 21, she went to her GP and asked to stop: 20mg of Seroxat a day had helped her live with anxiety and panic attacks, but she began to feel uncomfortable about being on medication all the time. Her doctor advised her to taper down her medication carefully.

At once, “I was a mess,” she says. “I thought I was losing my mind. My appetite completely went. I lost the best part of two stone. I was anxious constantly. My mouth was dry. It was difficult to sit and be calm.” She became withdrawn, refusing to see friends, and remembers asking her mother to get her a couple of boxes of paracetamol, thinking, “I’m going to have to take all these tablets, because I can’t live like this.”

Sarah’s doctor encouraged her to go back up to 20mg. “Within a week, I was much better. I feel anger when I look back. That wasn’t me relapsing, that was withdrawal. But I was so unwell, I didn’t stop to think, ‘I’ve never had this before.’ I truly thought it was me. Now the only reason I am on the drug is because I am dependent upon it. And that is not good enough.”

Prescriptions of SSRIs (selective serotonin reuptake inhibitors), the most common type of antidepressant, have doubled in the past decade. There are now more than 70m prescriptions dispensed in the UK in a year, the “greatest rise” of any drug in the last year, according to NHS research. But while the side-effects of starting and then withdrawing from these drugs are reasonably well known (the patient information leaflet accompanying the SSRI Seroxat is six pages long), there is very little research into the long-term effects of using antidepressants.

Last year, an all-party parliamentary group began hearing evidence as to whether there is a link between a measurable rise in mental health disability claims – 103% between 1995 and 2014 – and that in antidepressant prescriptions. (Claims for other conditions fell by 35% in the same period.) “We need to have a serious rethink about current levels of prescribing, because it may well be that the drugs are in fact contributing to the disability burden,” Dr Joanna Moncrieff, a consultant psychiatrist and senior lecturer at University College London, told the committee.

Reports both anecdotal and clinical have included side-effects such as constant pain, an altered sense of smell, taste or hearing, visual problems, burning hands and feet; food or drug intolerances and akathisia (the medical term for a deep inner restlessness). When a patient begins tapering down their dosage, these effects are generally ascribed to the drug leaving their system; if it is long after withdrawal is supposed to be over, however, patients are often disbelieved (according to the drug companies, withdrawal should take just two weeks for most people, though they acknowledge that for some it can be months).

Professor David Healy, director of the department of psychological medicine at Cardiff University and author of 22 books on psychopharmacology, believes that antidepressants are overprescribed. “If you go into your average doctor – if you’ve been off the drug for half a year or more – and you complain [of a range of symptoms] and say, ‘I think it’s caused by this pill I was on’, he or she would say, ‘It’s been out of your body for months. You’re neurotic, you’re depressed. All we need to do is put you on another pill.’”

GPs, Healy says, are “relying on your word, and if it’s a choice between believing what you say and relying on what drug companies say to them, they [tend to] believe the drug companies”. Healy, who has been a consultant for, and expert witness against, most of the major pharmaceutical companies, has long argued that long-term side-effects are routinely ignored or misunderstood.

But many experts believe these drugs do more good than harm. “Most of the people I see who have moderate to severe depression benefit from them,” says Daniel Smith, a professor of psychiatry and researcher into bipolar disorder at the University of Glasgow. For some, medication can be no less than “transformative. It can get them through a really critical period of their life.”

However, when it comes to long-term impact, especially after a person stops taking SSRIs, Smith says it can be hard to work out which symptoms relate to the drug use and which to the underlying conditions. “There’s obviously an issue of cause and effect. How can we be certain the SSRI caused it? Depression affects libido and sexual interest. How much [of the reported effects] is depression and/or anxiety symptoms coming back?”

A Seroxat box and pills
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By 2003, worldwide sales of Seroxat, manufactured by GlaxoSmithKline, were worth £2.7bn. Photograph: Alamy

SSRIs have been around for more than 40 years, but grew in popularity in the late 1980s and 90s after pharmaceutical company Eli Lilly launched fluoxetine, otherwise known as Prozac. Time magazine put the drug on its cover twice, asking, “Is Freud finished?” and describing SSRIs as “mental health’s greatest success story”. In 2001, a landmark report on a clinical trial into paroxetine (sold as Seroxat in North America and Paxil in the UK), called Study 329, concluded that it demonstrated “remarkable efficacy and safety”. Study 329 led directly to a massive increase in prescriptions: by 2003, worldwide sales of Seroxat (manufactured by GlaxoSmithKline) were worth £2.7bn.

But concerns were raised about the study –the US food and drug administration (FDA) officer who reviewed the data disagreed with the findings, calling it a failed trial – and in 2015 the British Medical Journal published a re-evaluation. Seven authors went through as many of the thousands of individual case reports as they could, and found not only that “the efficacy of paroxetine… was not statistically or clinically different from placebo”, but that “there were clinically significant increases in harms, including suicidal ideation and behaviour”. The original study reported 265 adverse reactions; the BMJ found 481. The re-evaluation also found that psychiatric responses were grouped together with “dizziness” and “headaches”, rather than given their own category. In 2003, the UK banned the use of Seroxat by anyone under 18; and in 2004 the FDA required a “black box warning” on all antidepressants, its strictest level of patient warning.

“Patient safety is our number one priority,” a GlaxoSmithKline (GSK) spokesperson tells me. “We believe we acted responsibly in researching paroxetine, monitoring its safety once it was approved and updating its labelling as new information became available.”

Many SSRI users report blunted emotions, even long after they have ceased taking pills, and an impact on sexual function. “They should be called anti-sex drugs rather than antidepressant drugs,” says Jon Jureidini, a child psychiatrist of 30 years’ standing, a professor of psychiatry and paediatrics at the University of Adelaide and co-author of the BMJ study, “It’s more reliably predictable that they’re going to get rid of sexual function than it is that they’re going to get rid of depression.” Again, some people find this persists long after they cease taking the drug. One person I spoke to, Kevin, had taken Prozac for six months when he was 18; now 38, he hasn’t had an erection since.

Last September, Healy and colleagues published a further examination of the data gathered for Study 329. This data followed the trial participants for six months after they started taking paroxetine (the “continuation phase”) and while they were tapered off it. GSK, which in 2004 published a clinical study report, had argued that “the long-term safety profile of paroxetine in adolescents appears similar to that reported following short-term dosing”. Healy and co, however, concluded that the “continuation phase did not offer support for longer-term efficacy”. More alarmingly, they found that the taper phase, when patients were being taken off the drugs, was the riskiest of all, showing a “higher proportion of severe adverse events per week of exposure”. This, they said, opens up the risk of a “prescribing cascade”, whereby drug side-effects are thought to be symptoms, so are treated with further drugs, causing further side-effects and further prescriptions – thus increasing the risk of long-term prescription drug-dependency.

In October, the British Medical Association published its response to a two-year fact-finding exercise into long-term use of psychoactive drugs. It noted that while benzodiazepines, z-drugs, opioid and antidepressants are “a key therapeutic tool”, that their use can “often lead to a patient becoming dependent or suffering withdrawal symptoms… the evidence and insight presented to us by many charity and support groups… shows us that the ‘lived experience’ of patients using these medications is too often associated with devastating health and social harms”; it was therefore, the report concluded, a “significant public health issue”.

The BMA made three key recommendations: first, and most urgently, that the UK government establish a 24-hour helpline for prescribed drug dependence; second, that it establish well-resourced specialist support units; and third, that there should be clear guidance on prescription, tapering and withdrawal management (they found the current approach to antidepressants, in particular, to be inconsistent: too many patients were suffering “significant harm”). There are also increasingly urgent calls for studies into long-term effects that are not funded by drug companies, because, Moncrieff says: “We don’t have very much data. This research is really important, but hasn’t been done. It’s a massive blind spot. It’s extraordinary – or maybe, given the pressures and interests at work, not extraordinary at all – that it hasn’t been filled.”

In March this year, members of the BMA, along with MPs and researchers from Roehampton University, went to parliament to lobby Public Health England, armed with research estimating that there are 770,000 long-term users of antidepressants in England alone, at a cost of £44m to the NHS per year (a figure that does not account for the cost of GP appointments, or the impact of side-effects, withdrawal effects and disability payments).

“I think you have to adopt a very conservative approach,” says psychiatrist Jon Jureidini. “These are brain-altering drugs, and our overall experience with brain-altering drugs of all kinds is that they tend to have a detrimental effect on some proportion of people who take them long term. All we know about the benefits is from short-term symptom-reduction studies. The careful prescriber needs to say, ‘Well, in balancing the likely benefits and harms, I need to be very cautious about how much benefit I’m expecting, and I need to be very generous about the possibility that the harms might be more than they appear to be.’”

Quite a few long-term users, such as those I spoke to below (and who wished to be anonymous), would agree.

‘Tapering off is the hardest thing I’ve ever done’: Sarah, 32; has taken Seroxat for 14 years

I was prescribed Seroxat when I was 18, the year I started university. I grew up with a disabled sister, so things at home were very stressful, and I had a history of anxiety and panic attacks. I had counselling, but the problems persisted, so I went back to the GP. I don’t remember everything that was said, but there was no conversation about side-effects.

Within the first two weeks of starting Seroxat, I remember I was sitting in the front room watching TV when out of nowhere I had this intense feeling of heat, like an electric shock. It started in my hands, went all the way up my arms and through to my head.

The GP said it was probably just my body getting used to the drug. And after a few weeks the weird sensations did ease off. I had a fabulous time at university. I still had panic attacks, and there were certain situations I would avoid – as I still do – so it wasn’t a wonder drug, but there were no major problems.

But in 2006 I tried to come off it. There were a couple of Panorama documentaries about the side-effects and I was starting to become concerned. The GP said, “That’s fine, but do it gradually, over three weeks.”

I immediately became incredibly unwell. I thought I was losing my mind. I was going to work, but it was difficult to get through the day. My mouth was so dry, I was constantly drinking water. I had bizarre thoughts – not hallucinations – that were frightening or distressing. I had a strong sense of detachment from reality.

Eventually, the doctor said, “Look, you coming off is obviously not working: we need to get you back to 20mg.” Within a week I was much better.

A few years later, when I realised my mental health was getting worse, even though I was on the medication, I started to do some research, reading case studies about withdrawal. I find it so offensive when a GP says, “This is who you are.” I didn’t have these symptoms 10 years ago. I didn’t have this sense of detachment. I saw various psychiatrists. They just kept saying, “The drug is safe, you need to be on it.” A couple of others told me the reason I was having these problems was because I wasn’t taking enough. Another said, “If you were diabetic, you’d take insulin and you wouldn’t have an issue. Why are you so bothered about taking this drug?”

I’ve been on it since I was 18, so I don’t know who I am without it, as an adult. Who knows? I might have all kinds of problems, but I need to know I’ve tried. Tapering off is the hardest thing I’ve ever done. It’s taken me three years just to get from 20mg to 5mg. I’m no longer with my partner – we were together for six years. I believe Seroxat has played a part: it affected my moods, it made my anxiety worse and, by necessity, I’ve had to be selfish, really. I don’t want to say all my problems are to do with Seroxat, because they’re not. But I do believe that it has caused me harm.

‘I don’t have much of an interest in interacting romantically or physically with the opposite sex’: Jake, 24; took SSRIs for eight years

I had been dealing with symptoms of OCD and anxiety for a lot of my childhood. It’s in my family, affecting two siblings and one parent. I was prescribed Zoloft when I was 12; I took a variety of SSRIs, Zoloft to Prozac to Lexapro, and then two others, for eight years.

Did they help? You know, I can’t really tell you, because I got through school. I got high marks, I had a lot of friends. So, in that sense, they must have helped. That’s the thing: for people with major depression, it’s easy to say, this has a measurable effect. But I kept taking them just because that’s what I’ve always done.

I went to university right out of school. I did very poorly. I had a bit of a breakdown, isolating myself, not sleeping. I was still on medication. I came home and enrolled at a community college. That was my worst period – I was very depressed. And I started to think, “I’ve been on these medications a long time. I’m not doing well – why not get off them?” I don’t recommend this at all to anyone, but I stopped going to a psychiatrist and took myself off.

prozac
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Prozac. Photograph: Getty Images

For months I had trouble sleeping. I was jittery. I had brain zaps. My anxiety was pretty ramped up. I would feel numbness in my extremities – generally my arms. My psychiatrist told me these were just normal withdrawal symptoms, and they’d be gone in four to six weeks: “Anything you feel beyond that is your anxiety and depression returning.” Basically, if you still feel anything beyond this window that the medical community has established, it’s all in your head.

Eventually I went back to school full-time, and I remember doing OK, feeling somewhat better.

I’ve now been drug-free for four years. What’s lasted are the sexual side-effects. They were definitely worse in withdrawal than they had been on the drug, even though I didn’t really realise or understand it at the time, primarily because I started to take SSRIs at 12. While my brother took the same medicine over the same period and had a normal sexual life, I had a lack of sexual interest. I had erections, and I have regularly masturbated my entire life. But I don’t have much of an interest in interacting romantically or physically with the opposite sex.

I didn’t even start thinking about sex until a couple of years ago. It’s almost like I woke up one day and thought, “OK!” I started getting these windows – days or weeks – when normal sexual feelings would appear. But they’re new to me and I don’t know what to do about them. And because I don’t know what to do, I get anxious, and the anxiety kills any feeling – and then I’m anxious because I’ve lost all my feeling.

Online, I’ve come across a big asexual community. Some also took antidepressants; I think there are a lot of people like me out there. I’d like to think that if I keep going to counselling and sleeping and eating properly, I can rectify these things.

In the end, it’s about pros and cons. If you’re lying in bed and can’t get up, is it better to function? If it was up to me, I’d say that, barring extreme circumstances, nobody under 18 should be prescribed these things. Your brain develops around them. Drug companies should be thinking of the long-term effect on people who can’t even consent.

‘If I missed a dose, I’d get shocks down the side of my body’: Chris, 43; has been taking Seroxat for 26 years

I was originally prescribed Seroxat for mild anxiety about my GCSEs. It was 1991, about the time GlaxoSmithKline released Seroxat. I was one of the first people to be given it.

I was prescribed 20mg, the basic dose, to start with. It helped me: I got through school, I went to uni, I went to work. But I had side-effects from the off: profuse sweating, low libido. I’m quite a placid person, but I became aggressive. I never suffered, in the beginning, with the suicidal thoughts that people talk about now, but what I did notice was that if I missed a dose – especially after eight years of taking it – I’d get shocks down the side of my body. I’d be nauseous, my limbs would become weak. I’d be in a constant state of confusion and was very impatient. I couldn’t communicate well with people. I said this to the doctor, and he said, “We’ll up the dose to 40mg.” That was 1998.

The 10 years after that weren’t too bad. I managed to work, as a sales rep, for 18-20 years. But by 2012, by which time I was up to 60mg, I had tried on numerous occasions to withdraw. I tried to go back to 20mg, but my words became slurry, so the doctor put me back up to 60mg.

By the time I was 38, even that wasn’t enough. I tried to take my life. The doctor wouldn’t prescribe a higher dose. I couldn’t do my job, I couldn’t concentrate, I couldn’t drive. A psychiatrist once said to me that coming off Seroxat is harder than quitting heroin. That really hit home.

I have now been unable to work for four years. I’m still seeing a psychiatrist. I’ve also been diagnosed with fibromyalgia: constant tiredness, aches in the neck, and in the lower back and lower limbs. I’m 43 and still live with my mum and dad.

I also have no libido. Since the age of 30, I have had no feelings in that regard whatsoever. I have had relationships, but they’ve all failed. I haven’t been in a relationship for 10 years, which is a long time to go without sex, but I just don’t get the urge.

I don’t really have emotions, to tell you the truth. The drug takes your emotions away. I’m sort of existing, not living.

And when the drugs do work…

‘I wanted to be able to feel good when good things were happening, bad when bad things were happening’

By Simon Hattenstone

I suppose I was a depression snob. A purist. Why should I take antidepressants? Yes, there was something rubbish about crying all the time, not functioning, being unable to answer simple questions because of the fug in my head. But, hey, at least I was true to myself.

My depression went back to my late teens. I didn’t like to think of myself as depressive, because depressives were losers. And I didn’t think I fitted the bill: I was pretty funny and able, and I could get girlfriends. I guess most depressives don’t think they fit the bill.

It might have been genetic. My dad had paralysing depression, and so did his father. As a young boy, I’d spent three years off school with encephalitis – an inflammation of the brain that is often fatal. Survivors are often left with depression.

I remember as a teenager being on holiday in Greece with friends. The weather was gorgeous, and I thought, “Why can’t it piss down, because then at least I’d have a reason to feel this way?”

That is what I always craved – objectivity. To be able to feel good when good things were happening, to feel bad when bad things were happening. I hated the fact that my feelings rarely correlated to what was going on in my outer world.

In my 20s, I got by. I held down a good job, fell in love, had kids, made friends, had a pretty good life. But things came to a head when my best friend killed herself. I’d find myself weaving in between traffic wondering what the impact would be like. I took a period off work and gratefully accepted my Prozac prescription.

Things had changed since I first rejected them. Prozac looked cool (lovely green-and-white pills) and rock bands wrote great songs about it (even if REM’s Shiny Happy People was supposed to be dystopic). After telling people I was off work with depression, I ended up feeling like a priest at confessional. It turned out that virtually everybody I knew was a depressive and pilling their way out of it; now it was “our secret”.

Initially, Prozac made me feel sick. And then magically, after a couple of weeks, I felt lighter, as if something had been lifted. I could hear questions properly, answer logically, enjoy a sunny day.

My partner said I was transformed. Occasionally, I would try to come off the pills and felt rubbish again – not more rubbish than I had before, but the same. So I returned, and after a while, I thought, “What’s the point of even thinking about coming off the pills if they make life work for me?”

There are times now when I wonder if I weep and fret and withdraw too much, and whether I’m becoming immune to the Prozac. But on balance I think not, because life is still so much better than it was.

If Prozac was no longer working for me, would I stop taking it? Probably. Would I stop taking antidepressants full stop? I doubt it. I’d simply look for another super pill.

Are you a long-term user of antidepressants? Tell us about your experiences

  • If you are affected by the issues raised in this piece, contact the Samaritans here.
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(2012) GlaxoSmithKline Bribes..


http://www.theguardian.com/commentisfree/2012/jul/04/glaxosmithkline-big-pharma-not-working?CMP=share_btn_tw

GlaxoSmithKline’s bribes are evidence that Big Pharma isn’t working

Philip Ball The inadequacies of relying solely on market forces for our drugs are clearer than ever. This scandal should prompt a rethink

Wednesday 4 July 2012 14.45 BST Last modified on Wednesday 21 May 2014 05.11 BST

Comments 132

Perhaps the most shocking thing about the latest GlaxoSmithKline drug scandal is that malpractice among our overlords still has the ability to shock at all. Yet despite popular cynicism about doctors being in the pockets of the drug companies, there remains a sense that the people responsible for our healthcare are more principled and less corruptible than expenses-fiddling politicians, predatory bankers, amoral media magnates and venal police.

If this were a junk food company lying about its noxious products, or a tobacco company pushing ciggies on schoolkids, we’d be outraged but hardly surprised. When a major pharmaceutical company is found to have been up to comparable misdemeanours – bad enough to warrant an astonishing $3bn fine – it seems more of a betrayal of trust.

This is absurd, of course, but it shows how the healthcare industry benefits from its proximity to the Hippocratic oath. “Do more, feel better, live longer” GSK purrs. How can we doubt a company that announces as its priorities as “improving the health and wellbeing of people around the world” and “being open and honest in everything we do”?

Now GSK admits that, in effect, it risked damaging the health of people around the world, and was secretive and fraudulent in some of what it did. Among other things, it promoted antidepressant drug Paxil, approved only for adults, to people under 18. It marketed other drugs for non-approved uses; it suppressed scientific studies that didn’t suit (for example over the heart attack risks of its diabetes drug Avandia), and over-hyped others that did. It also hosted outings for doctors in exotic locations and showered them with perks, knowing that this would boost prescriptions of its drugs.

 

GSK Ebola Vaccine: Big pharma has an interest in rich people being sick


http://www.theguardian.com/commentisfree/belief/2014/oct/17/big-pharma-interest-rich-people-sick?CMP=fb_gu#start-of-comments

Big pharma has an interest in rich people being sick

What profit is there in a healthy population? If everyone were healthy, it would be the job of the pharmaceutical companies to persuade us that we were not well
A burial team with the body of an Ebola victim in Monrovia, Liberia. Photograph: Marcus DiPaola/NurP
A burial team with the body of an Ebola victim in Monrovia, Liberia. Photograph: Marcus DiPaola/NurPhoto/Rex

The giant pharmaceutical company GlaxoSmithKline said yesterday that its work on a vaccine for Ebola will “come too late” to do anything about the current situation. Even now it is trying to compress trials that would normally take a decade into a year. The impression it gives is that it is working flat out, no holds barred. But hang on a moment. Ebola was discovered back in 1976. What has GlaxoSmithKline been doing since then? Answer: not much.

A small clue to why can be found by looking at the stock price of Tekmira Pharmaceuticals, the Canadian-based drugs firm that some investors seem to think is leading the pack on Ebola research. Tekmira shares rose a massive 180% from mid-July to October, with most of the share-price action coming when the virus jumped to Europe and the US.

Ebola has been killing people in central and western Africa for at least 38 years – but it’s only when the virus becomes a threat to the developed world that there is seen to be a profit in it. I know it sounds cynical to say it flat out like that – but it sounds cynical because it is. What business case is there for developing drugs to save the lives of poor Africans when they don’t have the money to pay for them? Especially when there is so much more profit to be had in – for instance – giving rich white men erections. As a study in last year’s Lancet showed, of the 336 new drugs developed in the first decade of this century, only four of them were for what are known in jargon as neglected tropical diseases – three for malaria and one for diarrhoea.

The point being this: the business model of market-driven big (or even medium-sized) pharma does not work well to address the challenges posed by a virus that ultimately has no respect for geography or bank balance. Some of the developed world’s early interest in Ebola was in whether it could be weaponised. It was said that the Russian biological weapons unit – Biopreparat – had turned Ebola into an aerosol spray.

All of which is red meat for conspiracy theorists (like those who tell you that the patent for the Ebola virus is owned by the US government, which is true). But my suspicion is not about shady government actions but about basic capitalist economics. Isn’t it interesting that there is money about to ask scientists to turn a virus into a weapon, but not the money about to ask scientists to find a vaccine? And by the time there’s a market for a vaccine, it’s too late.

What better example of what is commonly called market failure – that state of affairs in which market forces do not make for desirable outcomes. Here’s another example: remember Nelson Mandela having to take on the big pharmaceutical companies as thousands of dying South Africans were unable to afford Aids drugs. Apparently, the market-driven economics of health care do not have an answer to a virus that begins in a part of the world where there isn’t much money. And that is often where dangerous viruses begin. Which is precisely why market forces will not be able to save us.

Indeed, on the contrary, market-driven healthcare is incentivised to keep us sick. For what profit is there in a healthy population? If everyone were healthy, it would be the job of the pharmaceutical companies to persuade us that we were not well, that certain things about us needed fixing, putting right (even if they didn’t).

Its a bit like Friedrich Nietzsche’s criticism of the Christian priest: that the priest first has to poison us into imagining we are unwell – and thus in need of saving – before he can present himself as the cure, as salvation. There is no market for salvation in a sinless world. Of course, big pharma presents itself as evidence-based and scientific. Not at all like Nietzsche’s Christianity. But it’s not the science that calls the tune. It is the stock price. And the stock price goes up when rich people feel threatened.

What’s The (Real) Story Simon Wessely?


“…The other thing of course, is it’s not as simple as simply to say this is all the fault of psychiatrists trying to make more money or evil drug companies trying to sell more drugs, both of which, of course are- ya know true– but it’s not the whole story”… (Simon Wessely BBC Radio 4 August 2014)

http://www.bbc.co.uk/programmes/p018qfjm (2hr 35mins)

So what is the whole story Dr Wessely and why do you go on BBC Radio 4, and other media, and not tell people the whole truth about your profession and the drugs you prescribe? Why do you mention ‘treatments’ but fail to illustrate that these treatments are almost always psychiatric drugs with horrendous side effects? Do you not have a conscience? It seems to me that you are a kind of pied piper type character- dispatched from the royal college of psychiatrists to perpetuate the status of psychiatry- to maintain psychiatry’s dominance of the mental health arena- and to recruit potential clients into psychiatric treatments and beliefs.

Or am I wrong? Do anti-depressant’s not have side effects? Are the PIL’s just made up in order to frighten us? (have you seen the length of the Seroxat PIL? It’s practically a novel). Are we all imagining the akathisia, de-personalization, de-realization, cravings for alcohol, zombie-like disinhibition, violent thoughts, violent dreams etc… are those weird things inherent to depression? (I’d be pretty sure that they are not). 

http://www.theguardian.com/society/2014/aug/13/two-thirds-britons-not-treated-depression?CMP=twt_gu

When you say (in the article above) that two thirds of Britons are not treated for depression, where does this percentage come from? What study was done in order to generate this fantasy? It seems to me to be quite an arbitrary number because there could be no logical, reasonable or scientific way that you could possibly arrive at that figure. It is an absurd statement because if two thirds of people suffering from depression are not treated, and have never sought treatment, and maybe don’t even identify with being depressed at all, how do you know they exist in those numbers? Why not say half? or three quarters? It seems to me that you just made that figure up in order to get a headline…

Wessely said there would be a public outcry if those who went without treatment were cancer patients rather than people with mental health problems. Imagine, he told the Guardian, the reaction if he gave a talk that began: “‘So, we have a problem in cancer service at the moment. Only 30% of people with cancer are getting treatment, so 70% of them don’t get any treatment for their cancer at all and it’s not even recognised.”

 

Why are you comparing depression to cancer, not only is this a bad analogy (depression is nothing like cancer, it’s an emotion not a disease) but it’s also scare-mongering (although of course more people go for treatment, psychiatry gets legitimized, and psychiatry makes money and that’s what’s really happening here).

People like you are very dangerous Dr Wessely because you are more concerned with promoting the ideological paradigm of psychiatry than anything else..

You’ll deny (or fail to mention) side effects and ignore patients bad experience of psych meds because it simply doesn’t fit in with how you want psychiatry to be perceived… and you’ll do this blatantly, without shame, on national radio stations, because you are really that arrogant…

It’s simply abhorrent, your statements lead to damaging the mental and physical health of patients, and the meds you espouse destroy lives.. people become trapped in the system and get drugged to death eventually, lifelong customers, or mis-diagnosis after misdiagnosis, ending up on the psychiatric merry go round, never getting better, always getting worse

But all these medicated, confused and disempowered patients gives loads of fodder for the psychiatric system though doesn’t it?.. More money in the coffers… keep the system rolling..

How much do you get paid to sprout this dangerous, hysterical, misleading nonsense anyhow?…

Whatever it is Simon- it’s way too much! 

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The Guardian (Peter Gøtzsche) : ‘Psychiatric Drugs Are Doing Us More Harm Than Good’


http://www.theguardian.com/commentisfree/2014/apr/30/psychiatric-drugs-harm-than-good-ssri-antidepressants-benzodiazepines

Psychiatric drugs are doing us more harm than good

As with benzodiazepines in the 1980s, the UK is prescribing SSRI antidepressants at a staggering rate – and to no good effect
'More than 53m prescriptions for antidepressants were issued in 2013 in England alone.'

‘More than 53m prescriptions for antidepressants were issued in 2013 in England alone.’ Photograph: travel-and-more/Alamy

We appear to be in the midst of a psychiatric drug epidemic, just as we were when benzodiazepines (tranquilisers) were at their height in the late 1980s. The decline in their use after warnings about addiction led to a big increase in the use of the newer antidepressants, the SSRIs (selective serotonin re-uptake inhibitors).

Figures released by the Council for Evidence-based Psychiatry, which was set up to challenge many of the assumptions commonly made about modern psychiatry, show that more than 53m prescriptions for antidepressants were issued in 2013 in England alone. This is almost the equivalent of one for every man, woman and child and constitutes a 92% increase since 2003.

Sales of antidepressants have skyrocketed everywhere and are now so high in my own country, Denmark, that – if the prescriptions were equally distributed – every citizen could be in treatment for six years of their life. The situation is even worse in the US, where direct advertising of prescription drugs to the public is permitted and where more psychiatrists were “educated” with industry hospitality than any other medical discipline.

I began to realise the scale of the problem when I was persuaded seven years ago to become a tutor for a PhD thesis on whether history was repeating itself, by comparing benzodiazepines (“mother’s little helper”) with SSRIs. This research has established that people get as hooked on SSRIs as they did on benzodiazepines, and 37 of 42 withdrawal symptoms were the same for SSRIs as for benzodiazepines.

It is hard to believe that so many people have become mentally disturbed and that these prescription increases reflect a genuine need, so we need to look for other explanations. There seem to be three main reasons for the huge growth.

First, the definitions of psychiatric disorders are so vague that many healthy people can be diagnosed inappropriately. Second, some of the psychiatrists who wrote the diagnostic manuals were on the industry’s payroll, and this may have also led to significant diagnostic inflation. Third, the companies’ behaviour has been worse in psychiatry than in any other area of medicine, with billion-dollar fines paid for the illegal marketing of psychiatric drugs for non-approved uses. The rise in sales reflects patient dependency on these SSRIs: they may have great difficulty stopping even when they taper off the drugs slowly. Withdrawal symptoms are often misdiagnosed as a return of the disease or the start of a new one, for which drugs are then prescribed. Over time, this leads to an increase in the number of drug-dependent, long-term users.

Another major problem with psychiatric drugs is that they can cause the symptoms they are supposed to alleviate. Unfortunately, psychiatrists tend to increase the dose or add another drug when a patient reports negative effects.

The problem is that many of these drugs simply do not work as people suppose. The main effect of antidepressants is not the reduction of depressive symptoms. They are no better than placebo for mild depression, only slightly better for moderate depression, and benefit only one out of 10 with severe depression. In around half of all patients, they cause sexual disturbances. The symptoms include decreased libido, delayed orgasm or ejaculation, no orgasm or ejaculation and erectile dysfunction. Studies in both humans and animals suggest that these effects may persist long after the drug has been discontinued.

The US Food and Drug Administration has shown that antidepressants increase suicidal behaviour up to the age of 40, and many suicides have been reported even in healthy people who took the drugs for other reasons (for example, for stress or pain). Another report also said that, among people over 65, antidepressants are believed to kill one out of every 28 people treated for one year, because they lead to falls and hip fractures. Indeed, it is not clear whether antidepressants are safe at any age.

My studies of the research literature in this whole area lead me to a very uncomfortable conclusion: the way we currently use psychiatric drugs is causing more harm than good. We should therefore use them much less, for shorter periods of time, and always with a plan for tapering off, to prevent people from being medicated for the rest of their lives.

The public relations minefield that is Big Pharma


Taken From :  The Ethical Nag Blog 

http://ethicalnag.org/2013/10/26/pr-for-big-pharma/

When I used to teach public relations classes on things like Reputation Management or Crisis Communications, I taught the old PR maxim about“depositing in the bank of goodwill”out there.  Simply put, the better you or your organization are at honourable citizenship on a day-to-day basis, the more public goodwill you’ll build up in this account, and the more others will be wiling to trust you.

And vice versa: the more slimy your ongoing behaviour, the less you can realistically expect anybody to trust you. Yes, even when you are telling the truth.

The good news is that, when your balance in the bank of goodwill is healthy, your chances of that trust remaining stable even if you do something bad are improved.  So if you should need to make a “withdrawal” one day when a crisis hits, you’ll have the social capital of public trust nicely tucked away in that bank.

It’s also why Phillip Ball – the London-based science journalist, former editor of Nature, and the author of Curiosity: How Science Became Interested in Everything – is taking aim at Big Pharma, and particularly at British drug giant GlaxoSmithKline (GSK).

In fact, although Ball readily acknowledges that the pharmaceutical industry has benefited the world – making life more tolerable and advancing scientific understanding – he now accuses GSK of being “busy squandering the social capital of public trust.”

Let’s revisit the reasons that Philip Ball is so angry at GSK.  Regular readers here may recall that last year, the U.S. Department of Justice announced that GSK agreed to pay $3 billion in criminal and civil fines. Yes, that’s billions with a ‘b’.  The judgement was against GSK for:

  • bribing physicians to help market their drugs
  • failing to report drug safety data
  • inappropriately marketing its antidepressant drug Paxil (approved only for adults) to people under 18 despite knowing from its own unreleased studies that Paxil was associated with increased risk of suicide in younger patients; Paxil was also known to be addictive, as well as the cause of birth defects in babies whose mothers used the drug during pregnancy
  • inappropriately marketing another antidepressant Wellbutrin by paying doctors, including TV celebrity “Dr. Drew” Pinsky, to promote Wellbutrin to their peers as the “happy, horny, skinny drug,” claiming that the drug (approved only to treat depression) was also good for obesity and sexual dysfunction
  • withholding information on the cardiovascular risks of Avandia, a diabetes drug that has been linked to a 43 percent increased risk of heart attack – and the FDA has linked over 83,000 heart attacks from 1999 to 2007 directly to the use of Avandia (1)
  • promoting Advair, an inhaled lung drug, to patients with mild asthma even though it was neither approved nor appropriate for them

GSK was also manipulating data from its clinical trials to try to minimize the adverse side effects that might be blamed on its pills – or “cooking the books”, as a former British naval lawyer indelicately described the company’s fraudulent attempts.

A report by the corporate reputation measurement firm, GlobeScan, called The Pharmaceutical Industry: Issues & Reputation, confirmed that among stakeholders surveyed, many believe that the reputation of the pharmaceutical industry is poor (2):

“Past scandals and heavy fines for big companies found guilty of unethical practices have coloured public perceptions. In Great Britain and Canada in particular, they find a very negative environment.

“Pharmaceutical companies’ names are virtually unknown unless through scandal or plant closures. Personnel within the industry are very aware of this negative reputation and appear to feel helpless about it.”

That $3 billion fine for fraud was the largest ever imposed by the U.S. on a pharmaceutical company, and settled both civil and criminal charges.

That much money sounds huge, which it is, even for a company whose net income last year topped $7.7 billion. But Sean Tracey, the Houston attorney whose firm handled most of the GSK birth-defect lawsuits, dismissed the $3 billion penalty like this:

“GSK simply considers this the cost of doing business.”

Philip Ball, however, calls the fine “disgusting”. Here’s his take on the GSK scandal from an interview with The Guardian:

“If this were a junk food company lying about its noxious products, or a tobacco company pushing ciggies on schoolkids, we’d be outraged but hardly surprised. When a major pharmaceutical company is found to have been up to comparable misdemeanors – bad enough to warrant an astonishing $3 billion fine – it seems more of a betrayal of trust.”

And once the public feels betrayed, as any good PR professional will tell you, your company is forced into damage control.

AdWeek reported recently the results of a national Edelman survey found that only 56 percent of consumers last year said they trusted drug companies. With the exception of a single company (Johnson & Johnson), the reputation of the industry continued to plummet, and the public standing of two major drug companies – Pfizer andMerck – went from ‘neutral‘ to ‘poor’, according to research by Prophet consultants.

This is critically important if you happen to be a public relations consultant for Big Pharma, charged with being both the apologist and PR strategist during international scandals like GSK’s record-setting $3 billion fraud scandal.

If people don’t trust you in the first place, you’re in for a bumpy ride with even the first whiff of wrongdoing. Again, you can’t make withdrawals from your bank of goodwill if that account is empty.

Consider, by contrast, how Johnson & Johnson handled the shocking Tylenol murderscase back in 1982. I’ve often used this as a classroom case study, a story described by one scholar as “without a doubt the most exemplary case ever known in the history of crisis communications”. 

Unlike the GSK scandals, the J&J incident was not at all due to corporate wrongdoing, but to a person or persons unknown who tampered with bottles of Tylenol Extra Strength pain pills sold in retail shops near Chicago.  Seven people died from taking cyanide-tainted doses of Johnson & Johnson’s trusted pain reliever. Throughout the dramatic police investigations, the company demonstrated how their existing popularity among consumers (that bank of goodwill) along with open communication, empathy for the victims and their families, swift pro-active strategies, and immediate product recalls to protect the public (costing the company millions of dollars) all served to help enhance their public reputation.

The end result of J&J’s reaction was that the public viewed Tylenol as being the unfortunate victim of a malicious drug-tampering crime.  After an initial drop in sales immediately following the product recalls, the Tylenol brand soon regained its entire market share. And even more importantly, Tylenol became the first product in the industry to feature new tamper-resistant drug packaging safety – and within just six months of the crisis.

You can well imagine how the general public today might react if this same crime involved a GSK drug now that the company has been vilified through its fraudulent activities, each one deliberately undertaken purely to increase sales revenues.

GSK’s drugs named in the $3 billion penalties were considered blockbusters for the company – well worth paying off criminal and civil fines for. Annual sales of the drug Avandia were still as high as $1.2 billion in 2009, and that was two years after alarming study results published in The New England Journal of Medicine had linked Avandia to significantly increased heart attack rates.

But it’s not just the drug company under the glare of criticism here.

Philip Ball not only attacks industry marketing practices, but he also has some withering words to describe physicians who are on the take from GSK and other drug companies, in what’s been called a trend toward “marketing-based medicine”. The drug industry spends up to 25% of overall annual operating budgets paying doctors (those they declare as thought leaders or key opinion leaders) to speak to other doctors through corporate Speakers Bureau programs to help convince them to prescribe specific brand name drugs. Ball believes, as he told The Guardian, that, despite widespread popular cynicism about doctors being in the pockets of the drug companies:

“There remains a sense that the people responsible for our healthcare are somehow more principled and less corruptible than expenses-fiddling politicians, predatory bankers, amoral media magnates and venal police.

GSK hosted outings for doctors in exotic locations and showered them with perks, knowing that this would boost prescriptions of its drugs.

“It’s partly a failure of culture: the jollies and bribes came to seem normal, ethically unproblematic, even an entitlement, to both the donors and recipients.”

But as Kate Cronin, global managing director at Ogilvy CommonHealth PR, explained to AdWeek, the way the pharmaceutical industry has tried to market its drugs (both legally and fraudulently) may soon be over:

“The era of Big Pharma and the marketing of the magic of a pill is gone. Now, pharma brands are about everything that surrounds a pill, including services, disease awareness, education and prevention.”

In fact, nearly half of U.S. healthcare marketing executives in an Ogilvy CommonHealth survey this year agreed that the heyday of Big Pharma is history. The writing, it seems, is indeed on the wall.

Things may already have begun to shift into new territory as drug companies seek ways to deposit into that bank of goodwill.

To enhance or replace past marketing methods (but without those pesky multi-billion dollar fraud penalties), the drug industry’s PR advisors are steering their clients toward marketing tricks like online health and lifestyle content, cool mobile apps, direct-to-consumer (“Ask Your Doctor!”)  advertising, and educational outreach.

In a previous post, I described how industry has even managed, brilliantly and invisibly, to infiltrate online patient discussion groups to help shill their products. Jeff Chester, executive director of the Washington, D.C.-based Center for Digital Democracy, explains:

“Pharmaceutical companies are using stealth marketing tactics by eavesdropping on patients’ discussions on social networks and tracking patients’ ‘digital footprints’ online to target them for advertising.”

In fact, the pharmaceutical marketing website Dose of Digital now lists more than 350 examples of online patient support forums and social media sites run by drug or medical device companies.

.

See also:

Would The Real Ben Goldacre Please Stand Up?


Ben Goldacre is a doctor, journalist, blogger and writer whose media profile has risen exponentially over the past few years, particularly with the release of his last book on the pharmaceutical industry, Bad Pharma.  But who is the real Ben Goldacre- and what does he really stand for?

   Whilst Bad Pharma catapulted Ben Goldacre’s career firmly into the mainstream (and his trendy hip-doctor/guardian-journo persona seemed to capture the interest of the public imagination)- the content of Bad Pharma had more or less been covered already by other writers such as David Healy , Marcia Angell and others- over the years.

   Actually, most of the topics and issues in Goldacre’s book had also already been covered on this blog alone – predating the content of his book by five years ( I set up this blog in 2007- Bad Pharma was published in 2012).

   In other words- for a seasoned pharmaceutical industry critic, patient advocate, ex-Seroxat addict and blogger like me – what he had to ‘reveal’ about the badness and misdeeds of pharmaceutical companies was hardly revelatory at all. I could  have written it myself as I was certainly familiar with most of the information.

All that aside- what interests me most about Goldacre is his association with GlaxoSmithKline.

   Back in 2003- Goldacre received the GSK/ABSW award for his Guardian article ‘never mind the facts’. The article itself was basically a rebuttal piece in defense of MMR Vaccines and thus in turn- a defense of the pharmaceutical companies who make them and somewhat of an attack on those who claim that they can cause harm.

   I am no expert on vaccines or their link to Autism, nor would I ever claim to be- but I am well versed in pharmaceutical misdeeds- in particular those of GSK (I have been researching and blogging about GSK related issues for over 7 years now). I am aware that one of GSK’s vaccines, Pluserix was banned in 1992 and like other GSK medicines-  such as Seroxat and Avandia- not only was it causing immense harm- but GSK were allegedly aware of it.

  From my own experience of Seroxat- I would like to categorically state that I believe GSK were aware that Seroxat might harm me but like many instances with many other GSK products, they failed to warn- because all that matters to GSK is the health of GSK. Profit is the bottom line. Patients- like me- are merely collateral damage. However, considering that Goldacre is a psychiatrist (a fact he seems resistant to overtly publicize) maybe he just doesn’t care much for those who claim to be harmed by psychiatric drugs like Seroxat? Nonetheless- there is surely enough quackery and pseudo-science in Seroxat marketing which could keep a self-proclaimed quack-buster like Goldacre steeped in column inches for months.

   GSK have a murky history of malpractice and deception- their corporate history is littered with headline after headline of disturbing unscrupulous behavior. They are quite simply- pathologically sociopathic when it comes to harming the public. As a physician- I am surprised that Ben Goldacre would be so quick to jump to their defense- surely fraudulent clinical trials, intimidation of critics and widespread corruption resulting in damage to patients- would go entirely against the physician’s hippocratic oath?

Not so- it seems… in Ben Goldacre’s world.

Below is a picture of Goldacre receiving his BSW/GSK ‘science writers’ award from (none other than) GSK’s infamous Seroxat apologist Alastair Benbow (pictured right) in 2003. Apparently the award includes a 2000 pound bursary. (see link) http://www.badscience.net/2006/07/test-2/

6a00d8357f3f2969e2013485f7e002970c

Benbow was interviewed by BBC Panorama for their Seroxat documentaries and in (a diabolically delivered) defense of Seroxat he basically eventually admitted that Seroxat caused some children to commit suicide (after previously denying this in the Panorama documentary before it). Chillingly, Benbow seemed to think that this fatal side effect was almost inconsequential in the grand scheme of pharmaceutical depression treatment.

   The year Mr Goldacre was receiving awards from GSK for writing articles in favor of the pharmaceutical industry, was also the year that coroners in the UK were calling for a withdrawal of GSK’s Seroxat from the market (see here).

   2003 was also the year that (due to overwhelming evidence from the public) GSK were forced to abandon their no addiction claim about Seroxat. (see here)

   The year that Ben was posing with an award from a GSK funded initiative is also the year that the UK regulator banned Seroxat for under-18’s due to it’s propensity to make them suicidal- a sinister fact that GSK failed to inform the public of- for years. (see here)

 (Thankfully, for users of Seroxat, it was Ben Goldacre’s colleague- Sarah Boseley of the Guardian -who covered most of these stories)

   According to a tweet (screen-grab below) sent in 2010 in response to Seroxat Secrets, Goldacre, knows the’ Seroxat story well‘ and apparently he thinks it’s ‘vile‘. If this is the case then perhaps he would relay his opinion on Seroxat to his chum Andrew Witty because Mr Witty doesn’t seem to give a damn about Seroxat at all. If Goldacre really thinks that the Seroxat story is so vile- then why be so chummy with GSK?

gold

   Goldacre’s stance on pharmaceutical companies seemed to take a sharp turn with the release of Bad Pharma, which on the surface paints them in a very negative light. However, since most of the content of Bad Pharma had already been covered either online,  by blogs, in news-articles or in print form already- one would have to question whether it really had any negative impact at all on the reputation of the industry? Did it enlighten us to anything we did not know already?

   An insightful (albeit also complex) review of Bad Pharma from David Healy (not so bad pharma) seems to conclude that the problem with Bad Pharma rests not upon the repetition of content already covered, or the many flawed arguments raised which seem to rally against the pharmaceutical  industry but actually often work in their favor, “but on the premium Ben puts on controlled trials not found in other books”.

  You would have to read Healy’s review a few times to understand just how flawed and  -dare I say it- impotent –Bad Pharma is- particularly from a patient’s (or patient advocate’s) perspective. Perhaps it’s justified to ask- if a book highlighting the badness of Pharma actually serves to work in their favor in the long term- what use is it for the benefit of the public? Are we any safer? Possibly not.

   In a video of a parliamentary discussion of clinical trial transparency in the UK parliament from April 2013- Goldacre sits alongside GSK exec- James Shannon, and William Burns from Roche (19:06:00). In this inquiry, Goldacre refers to GSK as being ‘rather badly behaved‘ in the past- he then goes on to congratulate them on their current progress towards atonement (a fairy-tale like ‘atonement agenda’ which Goldacre seems to be swallowing hook-line-and sinker). The irony of this is- GSK have no intention of giving any access to clinical trials which predate 2000- therefore trials on drugs like Seroxat will not be released for inspection (Seroxat Trials pre-date the 90’s).

   I find Goldacre’s choice of words also quite astounding- ‘rather badly behaved‘ really doesn’t describe the destruction of life from a defective drug like Avandia or Seroxat.  “Rather badly behaved‘ doesn’t illustrate the magnitude of a 3 Billion dollar fine for fraud and corruption does it? “Rather badly behaved‘ is the kind of phrase we might use in regards to naughty children who won’t do their homework- not the UK’s biggest drug company (with the responsibility and power to enhance or extinguish human life on any given day depending on which way their ethical compass intends to sway). Goldacre then proceeds to  heavily criticize Roche and their Tamiflu debacle -conveniently leaving GSK looking much more ethical by comparison.

In an interview from March 2013– Goldacre says that he met Andrew Witty, CEO of GSK, before the announcement that GSK will release all trial data relating to its current products, with older data being released over several years. “He’d obviously thought very carefully about the practicalities of it, and that reassures me – he’d thought about how to do it, what the costs would be, and I think it’s to his enormous credit.”  Following the announcement Among one of many celebratory tweets, Goldacre said the news was: “Amazing. Fantastic. Historic.

   Thanking GSK for its decision, he added: “This is the beginning of the end for a dark era in medical history.” This ‘end of an era‘- and ‘the beginning of a new ethical GSK’ concept– has long been the mantra of Andrew Witty and GSK- particularly in regards to crimes that were committed prior to Andrew Witty’s tenture as CEO. I’m sure that GSK is delighted to have people like Goldacre championing (and echoing) its PR agenda- tweets from Ben Goldacre (with 250,000 followers) go far and wide.   Furthermore, these are just the perfect type of glowing PR sound-bytes that- pharmaceutical reputation management consultants- can’t even buy for GSK. Goldacre’s support must therefore be -utterly invaluable to them…

   And here we come back  again to Ben Goldacre and his association with GSK. At every given opening in the clinical trial transparency debate- it seems Ben Goldacre  just can’t resist an opportunity to lavish praise upon GSK CEO Andrew Witty. In an article from October last year (2012) he says:

“I think Andrew Witty, the current head of GSK, is a good guy, and I discuss this at length in the afterword of Bad Pharma: because I don’t realistically think that we can rely on one person in one company being nice, as a strategy to address ongoing regulatory failure in a global $600bn industry where lives are at stake.” (see here

   Perhaps Goldacre is incredibly naive, easily manipulated, under a spell, or utterly gullible? or maybe he genuinely does believe that GSK have changed their spots? I really have no idea

  However, considering that Andrew Witty has worked for GSK in various high level positions for most of his adult life I think it would be safe to assume that as CEO now he would have knowledge of most things that have – and do occur -within the company- including those things which would often undoubtedly come under the banner of big bad pharma

   And Ben… “good guys don’t become CEO’s of Billion-dollar Global Pharmaceutical companies”…

“You cannot hope to bribe or twist,
Thank God, the British Journalist,
For seeing what the man will do
Unbribed, there’s no occasion to.1

What is true cannot be minted

into a falsehood, even by

the most distinguished professor. 4

1 Anon.
4 Samuel Hahnemann.”

(Quotes Kindly Taken From http://www.whale.to/b/dwarfs01.pdf)

Take The Guardian Survey on Antidepressant Efficacy and Effects


http://www.theguardian.com/society/2013/oct/29/do-antidepressants-work-prozac-paxil-zoloft

Do antidepressants work?

The prescription of antidepressants is growing faster than for almost any other drug – in the UK and around the world – but the debate over their effectiveness rages on. Have you ever taken or prescribed antidepressants? Share your experiences anonymously in our online survey

Prozac, Paxil and Zoloft antidepressant tablets.
Prozac, Paxil and Zoloft antidepressant tablets. Photograph: Jonathan Nourok/Getty Images

Proponents say they save lives and help millions of people. Critics say the science is questionable. What’s unquestionable is that the use of antidepressants is surging around the world. In some countries, prescriptions have more than doubled in a decade. Around one in 10 European adults are estimated to take the pills. In the UK, The Health and Social Care Information Centrefound that more than 50 million prescriptions for antidepressants were issued in England alone last year, the highest ever number and a 7.5% rise on the year before.

The Guardian and its partners in Europe – Le Monde, El País, La Stampa, Gazeta Wyborcza and Süddeutsche Zeitung – want to hear from patients and doctors around the world about their experiences of taking and prescribing antidepressants. Responses to the form below will feed into a special report by our six newspapers planned for later this year.

To take part fill in the form anonymously below. Please only take part in the survey if you are over 16.

For further information about depression, or talk to someone about it, please visit Mind’s website http://www.mind.org.uk, or Mindfull for 11-17 year olds.

Are you over 16?
We can not accept submissions from people under the age of 16
  •  Yes, I am over 16
  •  No
Are you a doctor or a patient or both?
  •  I am a patient. Please go to question 1
  •  I am a doctor. Please go to question 13
  •  I am both. Please answer all questions
1. Name
You do not need to give your real name
2. Where do you live (town/country)?
3. Date medication first prescribed:
4. Brand and dosage:
5. Length of time taking antidepressants:
6. Describe how you came to be prescribed antidepressants:
7. Were you offered an alternative to medication?
8. Did you stick with the prescription:
9. How did you feel three months after you took the medication:
10. Describe the process of coming off the medication: was it easy? Were there side-effects?
11. Would you say antidepressants helped you?
12. How are antidepressants viewed in your country?
Can we use your answer for publication?
  •  Yes, entirely
  •  Yes, but do not use my name
  •  No
Contact details – will be treated as strictly confidential
You do not need to supply contact details. If you supply your contact details a Guardian journalist may contact you for more information
13. Doctors: Name
Please supply your real name. We will keep you anonymous but it will help us in confirming your status as a registered doctor.
14. Which country did you train in and which country do you now practice in?
15. Can you describe the process involved in deciding whether to prescribe antidepressants?
16. Can you describe the process in deciding which antidepressant to prescribe?
17. Do you have any formal training in psychiatry?
18. Do you ever feel under pressure to prescribe antidepressants? If so, why?
19. Do you offer patients alternative therapies ?
20. Do you believe there is a ‘prescribing culture’ in general practice in your country?
21. What support is available for people suffering from depression in your country and do you think it adequate?
22. How are antidepressants viewed in your country?
23. Contact details
Please supply contact details so we can confirm your status as a registered doctor

Seroxat : MPs Alerted To ‘Unfavorable Medical Trials Being Withheld’


http://www.gulf-times.com/uk-europe/183/details/366031/unfavourable-medical-trial-results-being-withheld%3A-mps

Guardian News and Media/London

Drug companies and medical researchers are putting patients’ lives in danger by failing to publish unfavourable results from clinical trials, MPs have warned.

The lack of transparency means many trials are not registered before they are done, while results are held as private documents that cannot be scrutinised by patients or independent experts.

The practice skews the information that is available to doctors because trials that show new experimental drugs in the best light are more likely to be published, and results that could prevent harm or save patients’ lives may never see the light of day.

Often, trials that indicate a new treatment is not effective are never published.

In a report delivered to ministers, MPs express dismay at the government’s efforts to tackle the problem and set out concrete proposals to make data from clinical trials more openly available.

“Many of the trials taking place today are unregistered and unpublished, meaning the information that they generate remains invisible to both the scientific community and the public. This is unacceptable, undermining public trust, slowing the pace of medical advancement and potentially putting patients at risk,” said Andrew Miller, chair of the Commons science and technology committee.

The MPs’ report broadens the traditional battleground over clinical trials data to include academic researchers who fail to publish studies of companies’ drugs or other medical interventions. The pharmaceutical industry is under intense pressure to release more clinical trial data, and some companies, such as GSK, are already committed to greater openness.

But the MPs call for government action to speed the process, by requiring all future trials to be registered, and summaries of trial results to be made public. More detailed “clinical study reports” should also be released, with redactions to protect patient privacy, when they have already been prepared for regulators.

In another recommendation, the MPs urge the government to demand the registration of past trials too, with summary results released for all publicly funded trials since 2000. Failure to release clinical trials data has led to hefty fines for some pharmaceutical companies.

In 2004, GSK paid $2.5mn to settle a consumer fraud case during which it emerged that the company had lied about the safety and effectiveness of its antidepressant Paxil, also known as Seroxat.

But academics are also guilty of suppressing data that could have helped patients. In 2006, six volunteers suffered severe reactions to an experimental drug called TGN1412 in a trial at Northwick Park hospital in London. An inquiry into the incident found that a single patient had suffered the same catastrophic reaction after taking a similar drug, but the scientists had never reported the findings.

Scientists estimate that half of all clinical trials that have been completed have never been published in academic journals, and trials with favourable results are twice as likely to be published as others.

“There have been these examples of publication bias which have resulted in lots of people suffering and dying unnecessarily, which somehow people haven’t taken seriously,” said Iain Chalmers, co-ordinator of the James Lind Initiative at Oxford University, which lobbies for better trials.

The Guardian 2012: GlaxoSmithKline’s Bribes Are Evidence That Big Pharma Isn’t Working


Lest we forget..

http://www.guardian.co.uk/commentisfree/2012/jul/04/glaxosmithkline-big-pharma-not-working

GlaxoSmithKline’s bribes are evidence that Big Pharma isn’t working

The inadequacies of relying solely on market forces for our drugs are clearer than ever. This scandal should prompt a rethink

GSK’s anti-depressant drug for adults, Paxil, which the company was promoting to under 18s. Photograph: Joe Raedle/Getty Images

Perhaps the most shocking thing about the latest GlaxoSmithKline drug scandal is that malpractice among our overlords still has the ability to shock at all. Yet despite popular cynicism about doctors being in the pockets of the drug companies, there remains a sense that the people responsible for our healthcare are more principled and less corruptible than expenses-fiddling politicians, predatory bankers, amoral media magnates and venal police.

If this were a junk food company lying about its noxious products, or a tobacco company pushing ciggies on schoolkids, we’d be outraged but hardly surprised. When a major pharmaceutical company is found to have been up to comparable misdemeanours – bad enough to warrant an astonishing $3bn fine – it seems more of a betrayal of trust.

This is absurd, of course, but it shows how the healthcare industry benefits from its proximity to the Hippocratic oath. “Do more, feel better, live longer” GSK purrs. How can we doubt a company that announces as its priorities as “improving the health and wellbeing of people around the world” and “being open and honest in everything we do”?

Now GSK admits that, in effect, it risked damaging the health of people around the world, and was secretive and fraudulent in some of what it did. Among other things, it promoted antidepressant drug Paxil, approved only for adults, to people under 18. It marketed other drugs for non-approved uses; it suppressed scientific studies that didn’t suit (for example over the heart attack risks of its diabetes drug Avandia), and over-hyped others that did. It also hosted outings for doctors in exotic locations and showered them with perks, knowing that this would boost prescriptions of its drugs.

I’m incensed. Not because this vindicates a conviction that pharmaceutical companies are staffed by profit-hungry liars and cheats, but precisely because I know that they are not: that so many of their scientists, and doubtless executives and marketers too, are decent folk motivated by the wish to benefit the world. They have been degraded.

It is precisely because Big Pharma really has benefited the world – making life a great deal more tolerable and advancing scientific understanding – that the industry has acquired the social capital of public trust GSK has been busy squandering.

But it’s time we accepted that it is a business like any other, and does not operate on a higher, more altruistic plane than other multinationals. It will do whatever it can get away with, whether that means redacting scientific reports, bribing academics and physicians, or pushing into “grey” markets without proper consent or precaution.

After all, this has happened before. All the giants – AstraZenecaBristol-Myers SquibbMerck, Eli LillyPfizer – have been investigated for bribery. One of the most notorious episodes of misconduct involved Merck’s anti-inflammatory drug Vioxx, withdrawn in 2004 after the company persistently played down its risk of causing cardiovascular problems. History suggests that GSK’s chief executive Andrew Witty’sassurances that lessons have been learnt are meaningless.

As with the banking scandals, GSK’s downfall is partly a failure of management – those at the top (some of the malpractice predates Witty’s incumbency) weren’t watching. It’s partly a failure of culture: the jollies and bribes came to seem normal, ethically unproblematic, even an entitlement, to both the donors and recipients.

And it’s partly a failure of regulation. The US Food and Drugs Administration has seemed at times not just toothless but actually collusive. Meanwhile, some American academics, having enjoyed Big Pharma’s kickbacks for decades, are now shrieking about the Physician Payments Sunshine Act – a part of the ObamaCare package that would make it mandatory for physicians to declare any perks or payments received from drug companies greater than $10, whether as speaker fees, theatre tickets or Hawaiian holidays. The protesters claim they will drown in bureaucracy. Harvard physician Thomas Stossel claimed in the Wall Street Journal that the backhanders don’t harm patients. The GSK ruling shows otherwise. In reality they will be forced to reveal how much these things supplement their already healthy income.

But the problems are still deeper. You don’t have to be an anti-capitalist to admit the inadequacies of relying solely on market forces for our drugs – not least for those that, being urgently needed mostly by poor countries, will never turn a profit.

Incentives for Global Health, a non-profit organisation at Yale University, has argued the case for a global, public sector drug development agency, funded for example by a Tobin tax. In the unlikely event that our leaders should dare to demand such genuine recompense for the moral bankruptcy of the financial world, there would be few better uses for it – and freedom from the corrupting influence of the profit margin adds another argument to this already compelling case.

One way or another, some rethinking of how drugs are discovered, developed, sold and used is needed, before the noble art of medicine comes to look more like Mr Wormwood selling a dodgy motor for whatever he can get away with.