Reading the RIAT Act

Editorial Note: This is a press release for a potentially important development in medicine. You can access your copy of the RIAT Act here and an assessment of its likely significance here. Restoring Invisible and Abandoned Trials (RIAT) “to correct the scientific record” Sponsors and researchers will be given one year to act before independent scientists begin publishing the results … [Read more...]

We have a Dream: Getting engaged to a doctor

Still, you take the medication as prescribed. At first you imagine your body may adjust or the pills will come to understand you. It is no use. From Virginia Chase Sutton: Lithium and the Absence of Desire. Patient engagement Patient engagement is one of the mantras of current healthcare improvement efforts. Medical students and junior doctors likely think they are doing it better than … [Read more...]

When does Yes mean No

Slide 3 Consent

Editorial Note: This is the ninth piece or final third of the final triptych in the Lasagna trilogy of triptychs that started with Not So Bad Pharma and runs through to Marilyn's Curse. Marilyn died of an overdose of barbiturate sleeping pills (Tragedy). A bystander, Lou Lasagna, noted she had been denied access to a sleeping pill that was safe in overdose, the first pill of any sort that had … [Read more...]

Marilyn’s Curse

ut-Me-To-Sleep Pills. By Billiam James

Editorial Note: This an unexpected eighth part to the Lasagna Trilogy that started with Not So Bad Pharma and runs through to Witty A: Report to the President. Ondine Ondine was a nymph whose lover swore that his every waking breath was a testimony to his love of her. Finding him unfaithful, she cursed him – should he fall asleep he would stop breathing. Marilyn died of an overdose of … [Read more...]

Witty A: Report to the President

Editorial Note: This was to be the last in the Lasagna posts that began with Not So Bad Pharma, April Fool, Tragedy of Lou Lasagna, Empire of Humbug: Bad Pharma,  Empire of Humbug 2, and Brand Fascism. But the series will continue into Marilyn's Curse and When does Yes Mean No. Faced with questions about the $3 Billion fine imposed on GSK – is it just the cost of doing business? Andrew … [Read more...]

Brand Fascism

Hope: Pills you can believe in. By Billiam James

Editorial Note: This is the sixth in the Lasagna series of posts that began with Not So Bad Pharma, April Fool, Tragedy of Lou Lasagna, Empire of Humbug: Bad Pharma and will continue through to Witty A: Report to the President. Faced with questions about the $3 Billion fine imposed on GSK – Is it just the cost of doing business? Andrew Witty, GSK's CEO, snapped back: “Although corporate … [Read more...]

The Empire of Humbug: Not So Bad Pharma

Sheperd & Lasagna 1992v

Editorial Note: This is the fifth is the Lasagna series of posts that began with Not So Bad Pharma, April Fool, Tragedy of Lou Lasagna, Empire of Humbug: Bad Pharma and will continue through to Brand Fascism and Witty A: Report to the President. In 1954 soon after his article with Beecher put the placebo on the map, Lasagna was recruited from Harvard to Hopkins. Beecher pleaded with him to stay … [Read more...]

The Empire of Humbug: Bad Pharma

Lasagna Shepherd 1956

Editorial Note: This is the fourth in the Lasagna series of posts - Not So Bad Pharma, April Fool and Tragedy. It will be followed by The Empire of Humbug: Not so Bad Pharma, Brand Fascism & Witty A: Report to President. The first RCT In 1956, two of the creators of the modern RCT, Lou Lasagna and Michael Shepherd, met. The randomization in randomized placebo controlled trials came from … [Read more...]

The Tragedy of Lou Lasagna

Editorial Note: This is the 3rd of 6 posts. The first two are Not So Bad Pharma, & April Fool in Harlow. The rest will be The Empire of Humbug 1 & 2 and Brand Fascism. There is an independent debate on some the issues, including my writing style, at Hearing Voices on 1boringoldman.  In 1956, Lou Lasagna was on his way to being the most famous doctor in the United States. His career … [Read more...]

April Fool in Harlow: Anecdote Fishing in Harlow

Glaxo buys Open Science Federation. Patents Sharing. Promises full access. Created by Billiam James

This is the second of a series of six posts that began with Not So Bad Pharma and will continue with The Tragedy of Lou Lasagna, The Empire of Humbug 1, The Empire of Humbug 2 & Brand Fascism. To celebrate May Fool's Day last year The Scientist ran an article on Data Diving. This featured the work of Peter Doshi and Tom Jefferson and their efforts to get clinical trial data on Tamiflu from … [Read more...]

Not So Bad Pharma

The invitation from the London Review of Books to review Ben Goldacre’s Bad Pharma™ reads: “We were unsure, at first, what a review could add that isn't already in the book - scrappy summaries and bits of praise are not for us. The book is of sufficient importance that the main thing is to get someone who knows what they're talking about to present the material confidently.. frame the … [Read more...]

Six fired, one dead, no answers

This post was written by Alan Cassels and first appeared in Focus magazine online in early March. The full version is here. Alan was one of the creators of the Selling Sickness, or disease mongering idea. His recent book is "Seeking Sickness: Medical Screening and the Misguided Hunt for Disease. There is an editorial comment below. A year ago this month - March 28, 2012, to be exact. British … [Read more...]

Left Hanging: Suicide in Bridgend

table 2

The Figures In the England and Wales there are roughly 5000 suicides in roughly 60 million people per year. This would until recently have led to around 2000 hangings per year, 34 hangings per million people per year, 3.5 per 100,000 people per year. Bridgend in South Wales has a population of 40,000. The greater Bridgend area has a population of 130,000. There should be 18 hangings per … [Read more...]

Prescription-only Homicide and Violence

These are the speaking notes for two talks given in Chicago on Monday February 18th and Tuesday February 19th. The S2, S3 in the text refers to slides which are available on the RxISK.org  Video Gallery.  Video will be posted when available. The first slides features RxISK.org  where we have created a Violence Zone and want you to get anyone who may have been made violent or had … [Read more...]

Not so Black: Ablixa and Homicidal Side Effects

If you don't want to know what happens in the movie Side Effects - do not read further. The post does not reveal all but does reveal important details. So now we know Soderbergh’s movie Side Effects is not so Black/Noir after all – more Fifty Shades of Grey. Emily Hawkins (Rooney Mara) is put on Ablixa by her psychiatrist Jonathan Banks (Jude Law) and while on it kills her husband. She … [Read more...]

Prozac and SSRIs: Twenty-fifth Anniversary

One Prescription for Every Man, Woman and Child Prozac was approved in 1987 in the US, and launched in early 1988, followed by a clutch of other SSRIs. Twenty-five years later, we now have one prescription for an antidepressant for every single person in the West per year. Twenty-five years before Prozac, 1 in 10,000 of us per year was admitted for severe depressive disorder - melancholia. … [Read more...]

The Antidepressant Era: the movie

The Antidepressant Era was written in 1995, and first published in 1997. A paperback came out in 1999. It was close to universally welcomed – see reviews 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 . It was favorably received by reviewers from the pharmaceutical industry, perhaps because it made clear that this branch of medical history had not been shaped by great men or great institutions but that other … [Read more...]

The boy with the ponytail who kicked the hornets’ nest

Who Cares in Sweden

In The boy with the ponytail who played with fire, we saw Jan Akerblom struggle up the side of a mountain in his attempt to drop the Ring of Power into Mount Doom. Where others, especially doctors, are seduced by the Precious he isn't. Why do it - because he saw lives destroyed and wonders if we are at risk of destroying society itself. Are any contracts anyone enters into while on an SSRI … [Read more...]

The boy with the ponytail who played with fire

He is 6’4” at least - 192 cm. He has blonde hair tied back in a ponytail. When he first suggested making a program about SSRIs I was not very helpful – very little of the media coverage by 60 Minutes or anything else has ever seemed to make much of a difference. They may have just increased the sales of antidepressants by keeping the names of the various drugs in the limelight. And he was … [Read more...]

The girl who was not heard when she cried wolf

Crusoe was called to see Lisbeth. The girl - young woman was mute and catatonic by day but after she fell asleep she had nightmares when she wailed piteously, rent her nightdress, walked in her sleep muttering ‘the children, the children’ or other such phrases. It was a similar pattern each night, the parents said. The dreams seemed to repeat. Crusoe came in the evening when the room was … [Read more...]

101 uses for a Dead Journal

There used to be a wonderful cartoon series called 101 Uses for a Dead Cat, which led me 25 years ago to give a talk at a British Association for Psychopharmacology meeting entitled 101 Uses for a Dead Psychiatrist. That was back in the days when Psychopharmacology meetings were places of debate and the British Journal of Psychiatry was guaranteed to have something of real interest in every issue. … [Read more...]

The Shipwreck of the Singular

Crusoe’s first appearance was in The Creation of Psychopharmacology, where in recognition of the tensions inherent in medicine between the numerous who enter clinical trials and the single person being treated by a doctor, the book opened with a quote from George Oppen’s Of Being Numerous, in which he notes that: “Crusoe we say was rescued”. Since Oppen wrote these lines, the idea of … [Read more...]

RxISK STORIES: If you’re going to look after patients, Man up

Pharmalot has just posted a piece - 'Controversial FDA official, Tom Laughren, retires.' This is a must read for anyone with anything to do with mental health - both the post and the comments afterwards where some have posted that they still believe the Black Box warnings on antidepressants arose because of pressure from the Church of Scientology rather than in response to the … [Read more...]

The Data Access Wars

This is the first of three Crusoe posts. For background on Crusoe, see Watch where you wave that wand, The Oedipus Effect, The Tree must go. Beta Centauri was unquestionably a long way from Massachusetts. Somewhat to her surprise Crusoe found breathing no problem, and the temperature seemed just about right. The scenery as they’d come in was not unlike that of a temperate zone on … [Read more...]

Access to clinical trial data: privacy rights, property rights and phoney rights

At the European Medicines’ Agency meeting held on November 22nd convened to look at the issue of Access to Clinical Trial Data, the pharmaceutical companies came armed with an approach signaled a few weeks earlier by GSK’s Andrew Witty (see Won't get Fooled Again). The industry panelists came from Lilly and UCB along with a representative from EurorDis Francois Houyez. Possibly for the … [Read more...]

Access to RxISK data: conflicts of interest

Won’t get fooled again outlined a stunning propaganda coup by GSK. On the back of a campaign for open access to clinical trial data that has drawn its inspiration from efforts by the Cochrane Tamiflu reviewers to get access to Roche’s clinical trial data, Andrew Witty came out and proclaimed that GSK were all in favor of access to clinical trial data. The BMJ threw its hat in the air and said … [Read more...]

Won’t get fooled again? GlaxoSmithKline and access to data

On November 22nd the European Medicines’ Agency (EMA) is holding a workshop on access to the data from clinical trials. While there have been many efforts by many people over the years to make the clinical trial process more transparent, the EMA workshop has come about primarily following the efforts of Peter Goetsche of the Danish Cochrane Group and Peter Doshi and Tom Jefferson from another … [Read more...]

The St Bartholomew’s Day Massacre: Protestant Patients, Catholic Drugs

Margot's lover in La Reine Margot was one of the Huguenots who survived the massacre set in train by her brother Charles IX on St Bartholomew's Day in Paris in 1572. There are many politicians, bureaucrats, doctors and others, the Royalists, in a position to make a difference who know that psychotropic drugs can cause suicide or other serious problems but who instead attempt to close down any … [Read more...]

La Reine Margot: data access, ghostwriting, suicide and mad reviewers

Another study giving a first hint of the findings in our 2012 Mortality in Schizophrenia paper (See The Madness of Psychiatry) was published in the British Journal of Psychiatry in 2006 - Lifetime Rates of Suicide in Schizophrenia. It took several years and some smuggling to get it into print. In the course of exploring the issues, it seemed useful to touch base with Herb Meltzer who had links … [Read more...]

Benefit risk madness: antipsychotics and suicide

Suicidal Acts in AntiP trials

Following the posting of The Madness of Psychiatry, there has been a flurry of activity in the twittersphere with Louis Appleby, the UK's suicide czar posting: What makes adolescents act on suicidal thoughts? New paper shows psychotic symptoms increase risk 20-fold. archpsyc.jamanetwork.com/article.aspx?a…       You might get the impression from this that all patients have to do is stay … [Read more...]

The Madness of Psychiatry

One hundred years ago patients with psychosis were 4 times more likely than the rest of their contemporaries to be dead at the end of their first 5 years of treatment. The main cause of death was tuberculosis. The asylum was a place where if you had the wrong genetic makeup you were at great risk of catching tuberculosis, particularly if you were a young woman. the advent of the … [Read more...]

RxISK Stories: Listening to Parents

Anonymous When you lose a child or a partner from a rare illness, everyone is supportive, no-one denies you. They listen. But if a child dies from suicide or a complication of treatment with a drug especially a psychotropic drug no-one listens. Our culture has no place for this kind of death. They say maybe it’s for the best. He’d never have been able to face the life he’d have had - … [Read more...]

The Madness of Young People

In 1861 Benedikt Morel, a physician in France, described a terrifying new illness. It involved young people in their late teens or early twenties about to enter what should have been the prime of their lives who instead sank into a profound and seemingly incurable state of what he termed precocious dementia. Morel painted a picture of a terrifying and seemingly close to incurable loss of cognitive … [Read more...]

The Madness of Carl Jung: a dangerous method

Carl Jung was one of Freud's earliest supporters and in many respects rivaled him in terms of influence. Some of their interactions provide the basis for the story behind the book and recent movie - A Dangerous Method. Just as Freud did, he famously analyzed himself and while doing so apparently became psychotic. His psychosis was however seen as a way to sanity - a forerunner of 1960s thinking … [Read more...]

RxISK Stories: Night of the Living Cymbalta – B’s story

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. I myself had been on and off a long series of antidepressants, but never had really dramatic withdrawal symptoms until I stopped the SNRI inhibitor Cymbalta. It started when I tried to step down from 120 mg per day, back to the standard 60 mg dose. From … [Read more...]

The Madness of Childbirth

The North Wales asylum made its way into my life by accident. The history department at Bangor University secured a grant to look at the social impact of the asylum. Looking at the records they collected, it was striking how people declared their madness a century ago – they tore off their clothes and escaped through windows, which they never do now. a quixotic database But when we set about … [Read more...]

RxISK Stories: Cora’s story – a benzodiazepine story

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. In RxISK Stories, we regularly take you to dark places where few would wish to go. We have perhaps become too used to the horrific consequences of medicines going wrong that we fail to appreciate how off-putting this sequence of posts can be. It is like a … [Read more...]

The Madness of North Wales

Influenced like many of my generation by the writings of Laing, Szasz, Illich, Jung and Freud, I studied medicine to do psychiatry. At the time research was becoming mandatory for anyone hoping to engage with the field. I chose to work on the serotonin system. But this was working on the mind as much as the brain; this was the serotonin system brought into view by LSD rather than the one that … [Read more...]

RxISK Stories: Gambling on the side effects of antidepressants – does Pfizer play dice?

This piece by Daniel O'Sullivan was first posted on Crikey.com. Our interest was stimulated by a query to RxISK from Daniel who had been told by the Australian regulator (the TGA) that they only had one report of this. Looking for gambling in RxISK, gives 1 case in Australia, but 4 cases of pathological gambling - more than from all the rest of the world combined, and 8 cases of impulsive … [Read more...]

Dance with Python: healthcare in peril

Figure 1

This is the last in what was once the BarMittzva Romba series aimed at Bar(ack) & Mitt.  These have now been renamed as a series of Dances - Dancing as fast as we can, Dance to the Music of  Time, Dancing in the Dark, Dance of the Sugar Plum Fairies, & Shadow Dance . Between them they reprise the plot of  Pharmageddon. In Malaysia, Dancing with Pythons is an art form. Women dance … [Read more...]

Shadow Dance: is alcohol safer and more effective than SSRIs?

This is the fifth in the Dance series tackling the crisis in healthcare We have dug a deep hole. The regulatory hoops through which a company has to jump are now so minimal that it would be easy for us to get alcohol, nicotine, benzodiazepines or opiates on the market as antidepressants. Opiates in fact have a much better track record than SSRIs for treating severe depression - melancholia. … [Read more...]

Dance of the Sugar Plum Fairies: how prescription only keeps doctors’ healthy and wealthy but not wise

This is the fourth in the Dance series that tackles the crisis in healthcare. In 1962, politicians attempting to put things right in the pharmaceutical sector accidentally created the perfect raw material for drug development, and the basis to transform this raw material into  the perfect product. But to complete the perfect market needs one extra element - a perfect consumer. By continuing … [Read more...]

Dancing in the Dark: how patents make drugs the perfect objects of desire

This is the third of six posts in what was the BarMittzva Romba series, now a dance series. A further step taken in 1962 made it possible to shape the raw material from clinical trials into the perfect product. This development hinged on the strategy chosen to reward pharmaceutical companies. In 1962, the options were to offer product, or process patents for drugs or some other form of reward … [Read more...]

Dance to the Music of Time: how clinical trials help pharma invent data

This is the second post in a 6-part what was the  BarMittzva Romba series, now a dance series. Every product is built from a raw material. The raw material puts constraints on a product developer. There may be difficulties fashioning the product from the material, or the material may be costly or scarce. There is the delicate matter of how the mark-up from raw ingredient to product is … [Read more...]

Dancing as fast as we can: the crisis in healthcare

This is the first of 6 Dance posts that cover the role of pharmaceuticals in the current healthcare crisis.  It is based on Pharmageddon.  In succeeding posts the role of clinical trials, patents, and prescription only status will be covered.  The first five posts have been renamed from BarMittzva Romba; this combination of Bar(ack) and Mitt seems to have been too clever for its own … [Read more...]

RxISK Stories: Weight gain on thyroxine

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. If there is one thing most doctors think they know its that weight gain can be caused by an underactive thyroid and having an overactive thyroid leads to weight loss. So the thyroid hormone, thyroxine, will lead to weight loss. And magazines, newspapers and … [Read more...]

RxISK Stories: Smoke & Pfizer get in your eyes

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. On March 15, Out of My Mind was published on davidhealy.org. This was one of the first RxISK stories. At the moment it is the blog post that has attracted the most comments. The comments are worth reading - there is close to universal recognition of … [Read more...]

RxISK Stories: The Myth of the Magic Bullet – Flox Tox

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. In July this year, Antimicrobrial Agents & Chemotherapy had an article - Fluoxetine is a Potent Inhibitor of Coxsackievirus Replication by Zuo J, Quinn KK and colleagues. "No antiviral drugs currently exist for the treatment of enterovirus infections, … [Read more...]

RxISK Stories – Facts about FACS

This blog post has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. Janet's Story I was diagnosed with epilepsy at the age of 14. After trying different drugs my seizures were controlled by a combination of Phenytoin (Epanutin) and Sodium Valproate (Epilim). What they didn’t tell me was that Sodium Valproate carried … [Read more...]

RxISK Stories – Azathioprine withdrawal

This post was written by Ken Spriggs and comes from his DIYEHR (do it yourself electronic health record) site, and has first been published on the RxISK.org website. If you would like to comment on this post, please do so using this link. It brings out nicely how some people are only aware of the problems their drug causes when they stop. This is particularly true for people taking statins, but … [Read more...]

RxISK Stories: Withdrawal from antidepressants – V’s story

[For the next few weeks, this blog will take a feed from RxISK.org of RxISK stories. If you would like to comment on this post please do so on the RxISK website using this link. RxISK is open to stories from anyone on drugs who have adverse events and are in need of answers or from doctors managing adverse events on any medical drugs]. Question from V This is what V wrote on filing a RxISK … [Read more...]

RxISK Stories – Withdrawal from Clopidogrel

[For the next few weeks, this blog will take a feed from RxISK.org of RxISK stories, alternating with posts challenging Barack and Mitt to get to grips with healthcare costs. RxISK is open to stories from anyone on drugs who have adverse events and are in need of answers or from doctors managing adverse events on any medical drugs]. Query from Fiona Barton  Dr Healy, a friend suggested I … [Read more...]

The tree must go

Crusoe had a chance to view the new facility - the brainchild of one of the world’s wealthiest men, who had made his name in a race to sequence the genetic code. He had famously used his own DNA in the process. He later went on to create synthetic life and it was from synthetic biology He made his fortune. The inspiration to recreate Eden came from watching an old movie, The Truman Show, in … [Read more...]

The Oedipus Effect

Crusoe was called to see the woman. It all began she said when on the way home after a successful board meeting, taking shelter from a sudden downpour, he stepped into an empty building. There he saw something. Perhaps it was the nutmeg with the meal or the mushrooms that did it. A bunch of children, he said, sitting looking at a stockmarket ticker tape. Many of them appeared limbless, had … [Read more...]

Suffer the little children

This post was written by Dr Irene Campbell-Taylor, a former Clinical Neuroscientist and Assistant Professor of Medicine at the University of Toronto. This phrase means, of course, to allow the little children but today I want to write about children who are suffering in the other sense. The word “patient” comes from the Latin patire, to suffer or to endure. The children I write of here are … [Read more...]

Krystallized

BBC Radio Four's Today program ran a piece on August 2 in response to an NHS report showing a startling 500% rise in prescriptions for antidepressants since the advent of SSRIs and a 9% rise last year. Close to 47m prescriptions were dispensed in the NHS in 2011 for anti-depressants and sleeping pills. There has been a rise year on year for the last two decades. “antidepressants work” and … [Read more...]

The Hidden Gorilla

Three weeks ago What would Batman do Now covered the issue of suicide in the military – an issue that had Batman missing in action, and the Joker suffering the adverse effects of psychotropic drugs. Then along came James Holmes to the premiere of Dark Knight Rises in Aurora. Most drugs that can cause suicide, including the antidepressants, mood-stabilizers, antipsychotics, smoking cessation … [Read more...]

One Script to Rule them all

So Long and Thanks for all the Fish portrayed doctors in a rather flattering light – the victims of a tragedy. They were portrayed as losing out in a Faustian bargain when they failed to realize the hazards in making all new drugs available on prescription only. The bargain offered them a chance to entrench themselves inescapably in healthcare as the only legal source of all treatments that … [Read more...]

There’s something about Mary

A paper looking at antidepressants and birth defects in Denmark has just appeared. Anyone can download it and read for themselves (Jimenez-Solem et al 2012). Its worth reading. The published data demonstrate an increased rate of major birth defects on SSRIs which fits what almost all other studies have found. But this study also finds that women who have stopped their SSRI 6-9 months … [Read more...]

Herding women

Since 2005, Paroxetine, first marketed by GlaxoSmithKline as Seroxat/Paxil, has carried warnings of birth defect risks. These risks led to litigation in the US – but not elsewhere. In the first case that went to court in the US in 2009, the Kilker case, the lawyers for Lyam Kilker argued that, even before Paxil was launched, there was good laboratory evidence that the SSRIs might cause … [Read more...]

A new epidemic

This post is by Dr Adam Urato, a Professor of Obstetrics & Gynecology at Tuft's University Imagine for a moment that a virus started affecting about 5% of all pregnant women—200,000 US pregnancies per year. Imagine that it caused significant pregnancy complications--more than 10% of those infected with the virus would have miscarriage, up to 20% or more would have preterm birth, and 30% … [Read more...]

What would Batman do now?

Johanna Ryan in her post Dependence Day points to serious problems linked to psychotropic drug use in the military and what seem to be recent alarming developments, but there is a 60 year history here. In the 1950s, the VA hospital system commissioned Norman Farberow to look at rising rates of suicides among veterans. He studied veterans hospitalized for either medical or psychiatric conditions … [Read more...]

Dependence Day

Author: Johanna Ryan, Labor Activist with Illinois Workers Compensation Lawyers (Chicago)  Last month I watched as forty Iraq and Afghanistan vets led an antiwar march to the gates of the NATO summit in Chicago, and handed back their medals. At the rally, they described the toll the wars had taken on the troops as well as the people of Iraq and Afghanistan, and demanded their “right to … [Read more...]

Pharmacosis: So long and thanks for all the fish

In 1860 at a meeting of the Massachusetts’ Medical Society Oliver Wendell Holmes made one of the most celebrated comments in medicine. While noting that medicines, particularly opium, could help, he nevertheless made it plain that he thought that on balance medicines risked doing more harm than good. You can’t be much plainer than this:  "I firmly believe that if the whole materia … [Read more...]

Pharmacosis: the day the music died

Syphilis appeared in Italy in 1498 just after Columbus had returned from the New World. This later led to suggestions that it had been brought back from the New World, in exchange for the many European illnesses that decimated the populations of North American Indians. Exposed to a virgin population new infections can be particularly virulent and during the subsequent century in Europe … [Read more...]

Pharmacosis: terminator algorithm

The single commonest question to Rxisk.org has been about dependence on and withdrawal from treatments, such as anticonvulsants, statins, diuretics and others. We often think that it is only drugs of abuse that can cause dependence and withdrawal but in fact an astonishing number, perhaps most medicines, can cause problems (see Medicine Induced Stress Syndromes, Dependence and Withdrawal, Halting … [Read more...]

Pharmacosis: trigger algorithm

The first descriptions of a drug causing suicide came in 1955. A few years later in 1958 and again in 1959 the problem was described with imipramine. Treatment induced suicide became a prominent media issue in 1990 with a paper by Teicher and Cole. But it was not until 2004 that regulators and companies conceded that these drugs can cause a problem. There are now 38 drugs listed as causing … [Read more...]

Pharmacosis

There is a new Contagion out there. Kate Winslet beware. Disease with no name This new epidemic has rapidly become at least the fourth leading cause of death and disability - it may even be the greatest cause of death because all we have counted so far are deaths in hospital where such deaths can be spotted. Where every other disease comes with a guideline for its management, this has none. Where … [Read more...]

The unbearable lightness of being

This is the last of 3 posts laying out the philosophical basis for Rxisk.org which will be live in the next few weeks. The others are Cri de Coeur & Once is Never. In his masterpiece on love and life The Unbearable Lightness of Being, Milan Kundera faces us with a dilemma about the important things in life “einmal ist keinmal” – “once is never”. Academics need lovers But Kundera … [Read more...]

Once is Never

This is the second of 3 posts laying out the philosophical basis for Rxisk.org which will be live in the next few weeks. The others are Cri de coeur & the Unbearable lightness of being. In Cri du Coeur I outlined a scenario in which a treatment that causes suicide when put into good trials without any manipulation of the data, any statistical artifice, or any ghostwriting might give rise to a … [Read more...]

Cri de coeur

This is the first of 3 posts laying out the philosophical basis for Rxisk.org which will be live in the next few weeks. The others are Once is Never & the Unbearable lightness of being. “[I suggest] a meeting with yourself and your reviewers. I have spoken in public on these issues and offered to speak on any platform. I’ve visited the MHRA [British equivalent of FDA]. Part of my … [Read more...]

The day the Lyrics lied

This post was written by Dr Irene Campbell-Taylor, a former Clinical Neuroscientist and Assistant Professor of Medicine at the University of Toronto. It is essential to read the marketing copy of pharmaceutical companies with care and attention for critical hidden details. It is rare to find an announcement with such obvious errors and dangerous suggestions up front as those contained in the … [Read more...]

Every drink spiked

This post is written anonymously (see Petra’s story). I outlined how my daughter Petra came to take Cymbalta on this blog a few months ago (see Petra’s story; also see Symbolta of Sorts). This post tells of events that led to her coming off. Petra is an enthusiast for motor sport events. She has been on track days, hill climbs and driver training events. She is a member of an Italian car … [Read more...]

A Symbolta of Sorts

In the early 1990s, Prozac was riding high but Lilly were planning its successor. The leading candidate was duloxetine – a dual inhibitor of both serotonin and norepinephrine reuptake as the older tricylic antidepressants (TCAs) had been. The company approached me in 1992 to recruit patients to a clinical trial of the new drug but before the trial could start duloxetine was pulled from … [Read more...]

Shocking the Homeland

The thriller Homeland reached its denouement in the UK at the weekend – in an Electroconvulsive Therapy (ECT) scene. Claire Danes, a Homeland security agent supposedly taking Clozapine to contain her paranoia has to distinguish reality from psychosis to save the United States (see Homeland Security). Quite obviously to anyone who knows anything about Clozapine, she was not taking it. She … [Read more...]

The factories of post-modernism

In the 1960s revolution was afoot. Antipsychiatry was born. The new revolutionnaries targetted medicalization and claimed mental illnesses didn't exist. Out of this cauldron, postmodernism was discovered. Postmodernism provided the basis for an ongoing guerilla war against capitalism and industrial society waged by social scientists, anthropologists and others trained in the … [Read more...]

May Fools’ Day

Following the long-standing tradition, dating back at least to Chaucer, of playing practical jokes on May 1, The Scientist clearly thought it would be a good idea to show the outside world that science doesn’t always have to be stuffy and picked the appropriate day to demonstrate the point (http://the-scientist.com/2012/05/01/data-diving/). May Fools' Day Joke Sadly, the joke has gone unnoticed, … [Read more...]

We’re all North Korean now

There has been a fascination recently with watching the orchestrated demonstrations of flag-waving enthusiasm for the regime that emanate from North Korea – the waves of people moving in synchrony like a shoal of fish. It’s difficult to know whether it is scarier to have the population behave this way and not believe in their leaders or have them behave this way because they do believe in … [Read more...]

American woman 2

There are a number of features of the American Woman story that are emblematic. My original post said she contacted GSK and GSK replied but a closer reading of the emails makes all this less clear. I will continue the convention of referring to contact with GSK, as ultimately it would seem the company must be responsible for the handling of the event. There is probably nothing specific to GSK … [Read more...]

American woman

On Thursday, May 31, 2001, a woman whose name is known only to GlaxoSmithKline emailed the company: I was absolutely distraught "My name is... I was diagnosed with panic disorder about four-and-a-half years ago. Since that time I've been taking Paxil, which is truly a miracle drug. I've been panic-free with this drug and have been able to go on with a normal life. "I was married in October of … [Read more...]

Scaremongerers of the world unite

At a meeting of the Royal College of Psychiatrists in Brighton in June 2011, Dave Nutt, a professor of psychiatry at Imperial College London issued a call to arms to his audience at a plenary lecture to defend psychiatry which in Dave's view meant defending psychopharmacology. On a slide entitled ‘No Psychiatry Without Psychopharmacology’ he outlined the threats from treatment deniers like … [Read more...]

Pills and the Man

Following Louis Appleby’s, Dan Troy’s and FDA’s logic (see Platonic Lies and Pla(u)to) the greatest public health benefit would come from getting the greatest number of people on the greatest amount of medications to ward off all conceivable risks. This clearly isn’t going to work out well. This isn’t going to work out well. Let’s say we appointed someone to look after people rather … [Read more...]

Pla(u)to: The car that Pharma built

There is a line from Lilly and FDA in 1991 through to Louis Appleby in 2012 (see Platonic Lies) that runs through Pfizer in 2001. a few nights poor sleep before meeting Bill Clinton In November 1998, Victor Motus, a prominent member of the Filipino community in Southern California, had a few nights of poor sleep. He owned an architectural firm, was president of the local school district board and … [Read more...]

Platonic Lies

When she sent Margaret's Story to us, M had already written to Britain's Suicide Czar, Louis Appleby. She got the following response: Dear Mrs Thank you for taking the trouble to contact me. I am so sorry to hear about the death of your son. Those of us who work in suicide prevention are always aware of the individual tragedies that lie behind our figures. The problem of agitation in the early … [Read more...]

Margaret’s story

(The story outlined below is authored by 'Margaret'.  Since this was first written there have been a number of developments and an update to 'Margaret's Story' will follow - DH). Our son went to his GP with poor sleep because of worries at work. His doctor said he was depressed and put him on a combination of Cipramil (SSRI antidepressant) and Temazepam (a sleeping pill). A week later he took … [Read more...]

If Pharma made cars

If Pharma made cars, the seat-belt warning signs would be removed, and the beeping noise if you moved without a seat-belt on would be silenced, as the start of a gradual process that would result in seat-belts being removed or made non-functional. The safety-bags would be removed or made ornamental. The car would be turbo-charged. The accelerator would be re-engineered so that the only options … [Read more...]

Odysseus come home

Odysseus was in his 70s. Coming up to the 50th anniversary of a very happy marriage. He had formerly been a respected professional, a longtime member of the bowling and social clubs – a pillar of the community. He had had minor episodes of anxiety primarily since retirement but no diagnosis of nervous problems. He went to his primary care doctor and was given a sleeping pill for poor sleep but … [Read more...]

The Dram of Eale

They told me the 80 year old man who'd had a stroke must be depressed – he wasn’t rehabilitating properly. Could I see him and look at whether the citalopram he’d been started on a week before needed tweaking? Jeff was solidly middle class, professional. He had never been ill before his stroke and never ever been mentally ill. He had a large loving close-knit family who came to see him … [Read more...]

Homeland security

In the latest hit series Homeland Claire Danes plays Carrie Mathison a CIA agent with bipolar disorder taking Clozapine. She takes the drug to prevent herself tipping over into frank paranoia in a world where being paranoid is necessary for survival. Anyone who knows anything about Clozapine knows Claire Danes is definitely not on it – she would not be as slim and svelte as she is if she were … [Read more...]

We need to talk about doctors

Randomized controlled trials (RCTs) came into favor in the wake of thalidomide as a method to evaluate drugs and their risks. They were supposed to keep ineffective drugs off the market, but companies have learned that you can do any number of trials and if even some show a marginal benefit they can get their drug on the market and the others can be suppressed so no one has a true picture of the … [Read more...]

Out of my mind. Driven to drink

Author: Anne-Marie (This story epitomizes what RxISK.org is all about. It shows one woman extraordinarily getting to grips with a problem she has on treatment. The hope when RxISK.org is up and running is that we will be able to make it easier for people like Anne-Marie to engage with their doctors to solve problems like this. Unfortunately even though clearly a drug-induced problem Anne-Marie … [Read more...]

Watch where you wave that wand

It was a white wand — the kind a little girl might have. White ribbon wound round a long straw, at the top of which a double pair of white wings was set. Another more delicate white ribbon looped around the wings, to the front of which was fixed a downy feather, and behind which the ribbon was tied in a bow. Crusoe was facing her most difficult patient. A man with manic-depressive illness … [Read more...]

Notes on a scandal

In 1996 Zoe Heller, the author of Notes on a Scandal, took part in a widely reported debate with Roy Porter about Prozac. She defended the drug. It had restored her to life. He said today’s miracle invariably ended up in tomorrow’s tragedy and asked, Why is it that we never learn? The story of a schoolteacher who seduced one of her male pupils. In 2003, Notes on a Scandal came out. It was … [Read more...]

Model doctors?

Another inquest may bring out the risks to doctors from their professional associations behaving as the American Psychiatric Association (APA) or the Irish College of Psychiatry has done (see Professional suicide – the Clancy case). She posed no suicide risk. She was put on citalopram. Yvonne Woodley, a 42-year-old woman with two young daughters, ran into difficulties with her husband. They … [Read more...]

Professional suicide – the Clancy case

Shane Clancy, a 22-year-old going to University in Dublin, broke up with his girlfriend, Jennifer Hannigan, in April 2009. Despite his having broken the relationship off, he found it difficult without her. She, meanwhile, had found someone new: Sebastian Creane. Shane took a trip to Thailand and Australia, but aborted his travel and came home unhappy. His mother took him to his doctor on July 18. … [Read more...]

Professional suicide

On October 15, 2004, after FDA had put a Black Box Warning on antidepressants to draw attention to the risk that they can cause suicide, the American Psychiatric Association (APA) came out with a news release whose key statement was:    ‘The American Psychiatric Association believes that Antidepressants save lives.” This was perhaps the first professional suicide note in history, but there … [Read more...]

The story of SSRI stories

  Rosie Meysenburg's story For anyone interested in the effects of drugs, the website SSRI stories has been an inspiration. Rosie Meysenburg, its creator, was recently diagnosed with cancer and is terminally ill. The story of how she came to create SSRI stories shows what people can do to hold the powers that be to account. —David Healy   DH:          How did you get … [Read more...]

Mystery in Leeds

In my blog post The best bias that money can buy I outlined how doing trials of their drugs in conditions like depression is the ultimate way companies hide bodies. That what is needed instead are studies of drugs in healthy volunteers. Here’s a good example of what a healthy volunteer (phase 1) study can show, and how the story of antidepressants and suicide might have unfolded in an entirely … [Read more...]

The best bias that money can buy

Randomized controlled trials (RCTs) were adopted by FDA in 1962 following the thalidomide disaster. This was a way to manage the risks posed by potential poisons. If the toxicity from a drug could be shown to overcome to some extent the toxicity stemming from the illness, a risk-benefit ratio would be set up that would warrant taking the risk of giving the poison. But what happens when both the … [Read more...]

The Spin that no Data can overcome

Roger Shepard's above illustration shows two tables of exactly the same size and shape. It’s an extraordinary example of how even when you know that the table tops are the same, the data changes nothing. The dynamics of perspective mean we continue to see things in the wrong way. Early on in the Prozac and Suicide controversy, Eli Lilly adopted a strategy that has “put things in … [Read more...]