The Devil’s Disclaimer

Editorial Note: The marketing of pharmaceuticals avails of something given to no other area of marketing - the product is made available on prescription-only.  In this post Johanna Ryan, from RxISK's Community Advisory Board, spells out the risks this gives rise to. This is a theme that has come up often and one we will return to.  Direct to Consumers?  If you live in the USA, I don’t have to … [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...]

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 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...]

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 to … [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 an … [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 perceived … [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 good.  We … [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...]

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 previously … [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 problems, … [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% of … [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 medica, as now … [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 syphilis … [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 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...]

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 development … [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 is having … [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 humanities. Science … [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 their … [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...]

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 Irving … [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 than suicide … [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...]