Sunday, 22 June 2014

reblog Critical psychiatry: The sense in saying antidepressants don't work

Critical psychiatry: The sense in saying antidepressants don't work

"According to a Times article, Sir Simon Wessely, President-elect of the Royal College of Psychiatrists, thinks it is "nonsense to say that antidepressants do not work". I presume he's saying that antidepressants are more than placebos. He may know more than I do, but he doesn't seem to think that the small effect size in clinical trials could be due to placebo amplification due to unblinding (eg. see previous post).

I guess he has to believe this as head of the Royal College of Psychiatrists. My scepticism means I'm never going to fulfill this role!  It's alright for Simon to say that he doesn't really buy parents promoting the idea that their children who get into Oxford are mildly autistic. And, that modern services couldn't be less well designed to join up physical and mental health care. But it's beyond the pale to suggest that psychotropic medication is not effective"

Saturday, 21 June 2014

Prof Peter C Gøtzsche BMJ response re antidepressants and young people

Peter Gøtzsche
BMJ response by Prof Peter C Gøtzsche, Nordic Cochrane Centre, Rigshospitalet, Copenhagen:  

'Re: Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study'

"The study is not reliable  

Lu et al. reported that suicide attempts in young people increased after the FDA warned in 2003 and 2004 that SSRIs can increase just that: the risk of suicidal behaviour in young people (1). They found substantial reductions in antidepressant use after the warnings and believe that this caused the increase in suicide attempts.  

This is contrary to what would be expected. The FDA’s large meta-analysis of 100,000 patients who had participated in placebo-controlled randomised trials found that antidepressants increase suicidal behaviour up till about the age of 40 (2), and in young people, the risk was doubled, as Lu et al. also report (1). This result was found despite the fact that many suicides and suicide attempts on active drugs were missing in the FDA analysis (3).   

It is therefore a highly convincing finding that antidepressants increase the risk of suicide in young people, and randomised trials are far more reliable than the before-after analysis that Lu et al. presented, which seemed to find the opposite result. There must therefore be major problems with their research ..."

Read complete response

Friday, 6 June 2014

Critical Psychiatry: Finnish psychologist sacked after expressing critical views about antidepressants on TV

Aku Kopakkala, who worked for Mehiläinen, a private health care organisation in Finland, has been sacked after appearing on a TV programme about antidepressants with Peter Gøtzsche (who I have mentioned in a previous post). Can someone create a better transcript of the programme for me than Google translate?  Critical views about psychiatry are discriminated against (see previous post) and this may well be an unfair dismissal.

I see that the Vice President, Working Life Services at Mehiläinen was managing director at Pfizer Oy. And, Erkki Isometsä, Professor of psychiatry at the University of Helsinki, does not seem to have liked being asked on the programme how much he was paid for public speaking by the drug companies. However, this is relevant as he is chair of the Task Force for the National Current Care Guideline for the Treatment of Depression. Confrontation about these conflicts of interest can have destructive consequences.

(With thanks to Jeremy Wallace)

Duncan Double

Critical psychiatry blog post link

Monday, 2 June 2014

Sponsorship (pharma) at Royal College of Psychiatrists International Congress - June 2014

"The Royal College of Psychiatrists International Congress is the biggest
meeting of psychiatrists in the UK, attracting 1,500 delegates.  The 2014 Congress will be held at the Barbican Centre, London, and is expected to be our biggest and best Congress yet."

"The event includes a large exhibition area (split between two foyers) where delegates will go for morning, lunch and afternoon breaks, providing an excellent opportunity for exhibitors to meet and talk to the delegates."

The exhibitors include Janssen-Cilag and Lilly.  New this year are "Exclusive and multi-sponsor options".

Why would the Royal College of Psychiatrists have to encourage sponsorship and the presence of drug companies at their conference?  This has to be a conflict of interest for doctors to be influenced by big pharma in this way.  Drug companies are all about profit, making money.  Psychiatrists should be all about their patients, person-centred in their practice.