It’s doubtful there was much that was unusual going on in Sodom and Gomorrah. Natural disasters and plagues were taken as signs that communities had sinned.
But there is drama to the idea of Abraham asking God to spare the cities if he can find 50 just men, and then 40, and then 20 and then 10 – to no avail.
It feels a bit the same with the RxISK Map. The single commonest request to RxISK is – can you tell me the name of one just doctor in my neck of the woods (insert NYC, London, Addis Ababa, Helsinki or Regina), who recognises that drugs can cause problems and is willing to help me tackle the problems.
We have been asking you to find these just doctors for us but either you can’t or you don’t believe that medicine is going to be destroyed if someone doesn’t.
A doctor you like doesn’t qualify. A doctor who believes in CBT rather than antidepressants wouldn’t qualify. It has to be someone willing to stick their neck above the parapet on your behalf – someone prepared to engage with a RxISK report.
It seems that doctors like these don’t exist. Or else that we are just too scared to go out and find them.
Martin McManus’ post Being the Right Peer hinted at a world that likely most people know is absolutely the case but at the same time are in close to total denial about.
This was brought home to me by conversations with a number of clinical psychologists – colleagues I know and regard highly – who when asked about raising the adverse effects of treatments with patients make it clear that its more than their job is worth to do this.
It certainly would be a mistake to tell someone drugs are bad for you and you really should be having CBT instead. This would leave the patient caught between two bullies.
But what if you see a patient very clearly suffering from adverse effects – unable to stop treatment because they are dependent, or agitated and suicidal on some treatment, or with enduring sexual dysfunction after treatment stops and in need of support from someone who can pick out the effects of some drug and is able to help reassure someone and perhaps their family that they are not going mad.
Its not bullying to help the person make a link as we do with RxISK reports and have been doing for 5 years without the sky falling in.
But it seems that in such circumstances, psychologists also expect doctors to go into orbit and to call down fire and brimstone on them and they just don’t do it.
The other way around psychiatrists have no problem calling out psychologists for inventing false memories of abuse etc.
If psychologists who hate psychiatrists aren’t going to make a stand, it becomes less surprising that the average person will also feel intimidated.
Social workers used to also hate psychiatrists, as did a lot of nursing staff but again neither will help a person suffering from the adverse effects of a drug cocktail make a link between the treatments and the effects or help the person find a way to raise the issues with the prescriber.
In fact I am pretty certain that a doctor is more likely to get into trouble with a social worker or nurse for not prescribing than for prescribing. Go figure…
We need more reports like Martin’s pointing to the structural violence in a lot of healthcare. Given his responses to the groundswell of support for his postion, it seems clear he didn’t turn into a pillar of salt like Lot’s wife in the image above.
But above all we need you to find doctors, or pharmacists, or nurses, or even psychologists who will listen, where listening means filing a RxISK report and being willing to feature on a RxISK Map.
The image of Lot and his family above is 666 units in diameter and this post is 666 words.
Copyright © Data Based Medicine Americas Ltd.
Thanks for the follow up.
I’d like to follow on from the analogy to Lot’s wife. According to this Christian website, https://www.gotquestions.org/pillar-of-salt.html, the Hebrew for ‘look back’ means ‘to regard, to consider, to pay attention to’. This suggests that there was a yearning in Lot’s wife for the old life that she did have and she was not ready to fully follow God’s will or obey His orders. Whatever people may think of the sins of Sodom and Gomorrah, as outlined in the Bible, it seems Lot’s wife was still pining for the cities that were built on sin. To me, this is a deep truthful analogy of our holding on to or pining for the illusion of status, security and power that certain positions and lifestyles can create. To maintain these positions sometimes it requires us to do deals with the Devil, e.g. lying, keeping quiet in the face of evil/corruption/abuse of power, etc. Unless we are willing to let go of the desire for status, security and power and let go of the pining for the old sinful life, we will be forever trapped or forever yearning for the good old sinful days where we had the illusion of status, security and power.
While I do have moments where I crave for being in a position of power and being seen by others as having high social status, I probably have not turned into a ‘pillar of salt’ as I don’t yearn for the lives that many mental health professionals, pharmaceutical reps/sales people and government health employees/regulators have as they are either deliberately selling lies/deceit or they are working in toxic environments where the truth seems to be rarely understood and even more rarely uttered in public. In a metaphorical sense, and I believe deeply true sense, like Sodom and Gomorrah, medicine and our society will be burnt and destroyed in a time to come unless more professionals start speaking up and allowing the truth to shine forth. I believe that we are already on that path. The risk that these professionals, who chose to be just, true and righteous take is the loss of status, security and power. This decision is a pragmatic and ethical decision and for me, a deeply spiritual/religious one as well.
I recently conducted some research looking at the World Value Survey data. This involved approximately 84500 people across 61 countries. Of the 10 values on the Schwarz value inventory, the top two values were these two: ‘It is important to this person to help the people nearby; to care for their well-being’ and ‘Living in secure surroundings is important to this person; to avoid anything that might be dangerous.’ Two other important values that seem to transcend cultures are, ‘It is important to this person to always behave properly; to avoid doing anything people would say is wrong’ and ‘Looking after the environment is important to this person; to care for nature.’ Across religious and non-religious groups, these values still remain the top values compared to the other values. We often have conflicted values and drives and by following one value, e.g. helping someone, we risk sacrificing another value we hold dear, e.g. security or social acceptance.
These are not easy decisions to make. However across cultures we call people who have decided to risk social ostracism, their own safety and security to help others, ‘prophets’, ‘saints’, ‘heroes’ or divine figures. Like Abraham who followed God’s calling, the Buddha who abandoned a comfortable lifestyle to find Enlightenment, like Jesus who spoke Truth despite the persecution He experienced, like Galileo who wouldn’t let the truth be silenced by Catholic Church authorities, like Mather Luther King who spoke out against American racist policies, like Solzhenitsyn who spoke out against Soviet, Communist persecution and like countless people (some religious, some not, some known, rewarded and celebrated, many more unknown who have not been rewarded in this life, at least) who have followed a more noble calling and spoken the truth.
I would encourage all those who have a clear understanding of what is going on in the health field to speak up and make your voices and views known. We all know that there are risks and there is the risk of losing a lot of what you have worked hard to build up but there are people dying unnecessarily and being damaged horrifically by ‘caring professions’ due to our silence. I’ve a lot of work to do to make up for my silence in the past and being a useful cog in the Mental Health Inc. machine. I hope to do what I can. Please do what you can.
Thanks for highlighting this important issue David and making this important plea,
All the best,
D The following psychiatrists and psychologists have signed a letter of complaint to the college of psychiatry. I have tried to contact some of them mself without success but as things have moved on in some ways it may be possible to ask them as a group or idividually if they woud be willing to tackle the problem by directly putting their skills where their outrage ie work with those who are suffering – not just by highlighting the problem but to try to find a solution for individual sufferers.
There are more than ten named openly on the letter – Mary Boyle,, Pat Bracken, Steven Coles, Duncan Double, Tabitha Dow, Peter Gordon, Petr Gotzche, Petr Groot, Christopher Harrop, Carina Hakinson, Ann Kelly. Peter Kinderman, Hugh Middleton, Jim Van Oss, Magreet Peutz, Nimisha Patel, David Pilgrim, Clive Sherlock, Deerek Summerfield, Philip Thomas, Sami Timini, John Read.
Some have already tried contacting specific psychiatrists for help and been told they cannot see anybody from out of their area. This is a massive cop out – if they need to be paid as a private consultant though , perhaps the funds could be collected for consultations?
I haven’t come across anything which suggests that those who are campaigning to conceal the truth about the harms, are asking to meet people whohave been harmed , (although most must have met some in their practices) Surely the leaders should be doing that now. But do it face to face human encounter between equals rather than in a clinic, not as a combatative interview. I have been wondering if there is any progress in the Rxisk project to get enough funds for a research/trial ?
First we need doctors across medicine – not just in mental health. This affects all of medicine. In my experience many (I’m not saying all) people in the critical psychiatry network don’t know how to assess whether a treatment is causing an adverse event. The last thing anyone with a problem from a condition and possibly also a problem from a drug needs is someone who is automatically going to say the drug is causing the problem. It needs someone who can take the steps we outline in the RxISK causality algorithm and come to a reasoned judgement that they can stand behind in the public domain – if need be in court.
Its at the point of committing to completing something like a RxISK report that the patient then has a copy of that you or i as a patient find out what those involved in our care are made of. For psychologists there is the easy way out – they aren’t trained in how to make these assessments. Its something their patients could likely train them in if they were open to taking it on though. For medics, there is the unwillingness to go against what another medical colleague may have said or done.
The best people so far have tended to be pharmacists.
Thanks David — I didn’t realise they are all from Critical Psych Network but can see they could actually undermine things if they are supporting Duncan Double’s suggestion on his blog that psychological factors are the problem rather than physical harms. Frankly I am longing for the day when a legal case will win in the courts – which maybe won’t be altogether fair if an individual takes the rap – but individuals have responsibility too
I find all the above extremely interesting but also worrying. It seems that the idea of “I daren’t” is holding so many people ( both lay and professional) back from speaking out about the many worries that so many of us seem to have. Due to this, we seem to be stuck in a whirlpool. We’re not exactly drowning but we’re not making very good progress either.
The ‘map of doctors’ seems not to be progressing as hoped – is there any way that a similar idea could be put into place for showing doctors who do NOT listen? Maybe then it would at least become obvious whether there is a severe lack of ‘listening doctors’ or is it actually a lack of ‘active patients’ who are willing to stick their necks out and speak about their lack of medical support? I appreciate that, for many patients, their energy levels are such that they find it difficult to respond and, instead, hope that the rest of us with a little more energy will speak on their behalf.
I will fight for the right of ANYONE to be listened to and to have the chance of an improved life but, in the present climate, I feel that we desperately need the voice of ALL who have not been,or still are not being, listened to rather than the third party ‘voices’. Third party recording of problems, backed up by the signature of the sufferer should then be accepted as ‘the truth’ – whether it be psychological or physical harms. To be honest, I bet that the sufferers worry very little about which TYPE of harm they are suffering from – all they crave is an END to their suffering.
In my eyes Pharmacists are the unsung heroes
Having increased my dose of Seroxat to 40 mg, a typical reaction from a psychiatrist, having had ‘severe withdrawal’…it was a stroke of luck that he transferred me to a young lady who I initially thought was a medical student but she listened to me about Panorama and events and straight away contacted the Hospital Pharmacist.
The GP who got me in to this mess hand wrote the new plan with me next to her in the room where it was all happening ..
It meant liquid and tablet reduction over 12 months.
At the final hurdle, I was gasping for breath, like before and the ‘severe withdrawal’ started all over again.
My partner of 20 years who thought everything was fine now, as did I, said “please, don’t start all that again”
During the next few months I really don’t know how I didn’t grab the packet of Seroxat, every day, I thought, I have got to get myself the Seroxat
But, how could I?
The nightmares, the two hospitals, the extremely rude and extremely careless doctors and psychiatrist, had made it impossible to take the Seroxat ever again.
If I took it again, what would happen, a re run of all that happened before?
There is nothing like being up against it to get through the most horrific drug induced experience of my life – focus on the child, look after the dog, make sure the new accommodation fits in with these two, drop from being a Marketing Director to scrubbing around for cleaning and gardening jobs to pay the bills, fight off the school headmaster who almost stopped my child’s home education exams at his school because I told him about Seroxat and on it went …
Years and years of fighting against enormous odds
It will come to the courts, in due process, and we have to keep this blog and rxisk alive, it is imperative to do so and thankfully we are all in good company
So, lets open the doors to the Pharmacist ..
As I said, around six years ago, here on this blog, its like a ‘warm womb’ ..
GSK say Seroxat withdrawal is mild to moderate and not worse than any other SSRI
But: they jumped on to the SSRI bandwagon with ghostwriters and suicides in clinical trials, and so really they are up against it
How would you argue the case with GSK…
Do you accept NHS referrals? I could do with your assistance after a severe adverse reaction to Zoloft/Sertraline which has destroyed my life
Yes but your GP has to write a referral and give a history and they may have to commit to paying – some will some won’t – even if they do agree to pay I doubt if anyone ever collects the money. It would cost more to collect that its worth.
Such an interesting piece. Thank you. One of my best friends is a general practice physician. She tells story after story of offering people medications that she really doesn’t want to offer because she is afraid of being held legally liable if she doesn’t and something goes “wrong”. Should she prescribe a medicine she doesn’t think has a good risk/benefit profile, and something goes “wrong”, she will NOT be held liable. Whomever controls the standards of care, controls the situation, it seems.
Thank you for your work. Your incredibly valuable work. I will send this on to my friend of course. : )
Jen – hopefully your friend is spelling out the risk/benefits to those she is prescribing to , in order to gain informed consent. She has a legal duty to do . She could of course also be informing individuals as well as friends and colleaues about the David Healy Blog and the Rxisk blog which would be a valuable way of assisting them to make up their own minds about the risks. It is vital than more people get to know of such first hand accounts as well as practitioners.
Jen – the GPs dilemma is summed up perfectly by Dr Andrew Green at an event about Prescribed Drug Dependence at Westminster in 2016. Here’s the link (starts at about 1hr 15mins)
I expect to be shot down for saying this, but my feeling is that in the field of mental unwellness, doctors are pretty much a total irrelevance. They do not have the time to really try to empathise with the patient, and many do not have the desire to do so anyway. They offer drugs routinely. People who are mentally unwell are not behaving like their reasonable previous selves, they can be difficult, tetchy, unco-operative, irritating, hard to understand, simply because they are suffering, lost in symptoms that scare them or render them hard to reach. When you put shortness of time and lack of compassion on the part of the doctor against this, you can’t surely get good productive results. The ‘listening’ element is vital, but there needs to be a plan, hope, support, put in place, as though the person is setting out on a journey of self learning, to find their way forward, through the mental hell they are suffering, by getting the fear (cortisol levels maybe surging up) to fade away. All they want is to feel well and normal again. They need patience, kindness, good common sense applied to their situation, to guide and support them whilst they are flailing around trying to make sense of what has happened to them.
In A&E, the doctors are very different when it’s not a mental health problem. I had to be rushed there recently for a heart problem, and although 6 hours wait on a trolley etc was inconvenient, the care I got, the kindness and compassion was great. I had an easily identifiable problem, on ECG, X-rays, blood tests etc and my mental attitude didn’t feature. So I was straightforward and easy to treat. But I remember the one time my son was taken there by paramedics (who, by the way, were kind and caring) after a single suicide attempt during which he had sustained injury. The doctors and staff were cold, unhelpful, judgemental and frankly, vile, both to him and to us, his concerned parents. We waited all night sitting beside his cubicle, for him to have stitches in a big open wound, and next morning, although he had terrible akathisia which no one seemed to recognise, he was discharged summarily, he having said to the staff he was fine now! (He was of course still suicidal but realised that no one there could help him). They let him go during the half hour we were absent at 8.00 am, we having asked to meet the psychiatric ‘team’ to put a treatment plan in place. He was dead a few weeks later. His story is not unique, as we all know.
So, what’s the difference in these various doctors? Answer: they are not, in the main, trained to be effective for mental illness, except by dishing out drugs and a passing pat on the head. So, why do we need them? I suggest we don’t, we need understanding community support and care, ‘buddies’ for people struggling, day places for them to get together and care for each other. We are working in one right now, and the results are obvious to all. We need these places all over UK. There is not a doctor in sight….but genuine love, patience, warmth, creativity, and happiness in everyone’s small triumphs.
Being uncomfortable with mental illness is one thing, but not being able to assess adverse effects is another and has nothing to do with mental illness. Doctors generally – even caring and compassionate ones – are very bad at picking up adverse events. Some of the most caring and compassionate are the worst at picking up adverse events. The one thing doctors should be able to do if they dish out poisons (hoping they will help) is to recognize the effects of a poison. Loving patience and warmth is not what we want from them – we can get that from lots of others
I so agree Heather! As long as people continue to experience extreme emotions,and little is actually known about why people go into psychosis which is still considered to be a lifelong illness, then doctors will find themselves in the position of searching for the “cure”. There is no cure for life’s experiences. Unless we delve into and invest into and enrich a person’s life who has been emotionally wounded and simply not spend 5 minutes in a surgery making poor assessments and prescribing primitive harmful neurotoxins to simply somehow make a psrson “better” from life which there are no cures then doctors will continue to harm. As a result also bury their mistakes. I was diagnozed schizophrenic. After years of therapy a huge reduction in medication and analysis of my life i would say i am totally recovered. As for having a life now worth living although recovered which i really wish had happened years ago when i was young so i could partake in society that option is no longer open to me. I am old and psychiatry in their attempts to cure me stole what life i could have had. Yes peer groups around the uk would in fact help people.
Amazing isn’t it?
Walk into a Dr’s surgery with a tummy bug and inform him you ate a distasteful meal at a restaurant – diagnosis – food poisoning.
Walk into a Dr’s surgery with an inner restlessness and inform him it happened when you halved your dose of your medication – diagnosis – anxiety.
Twitter is awash with bad Dr’s. Some of the advice I’ve seen on there is, at best, ignorant, particularly advice on antidepressant drug withdrawal.
The best advice on antidepressant drug withdrawal comes from those who have suffered severe withdrawal. – The patients.
If Gordon Ramsey cooked a steak and the customer returned it because it tasted ‘off’, Mr Ramsey would first taste it to see if the customer was right.
Dr’s need to take a leaf out of Ramsey’s book…minus the profanities.
Gordon Ramsey is our Great British Export .. EvidenceFAB
Even the Japanese have something to say ..
Allen Frances Retweeted
向精神薬の知識 @EvidenceFAB 16h
The Japanese are learning from these two books, the most important now, @AllenFrancesMD Saving Normal and @DrDavidHealy Pharmagedon. very thanks agein. It gives people strong power.
This force, the Chairman of the Royal Psychiatrist Association RCP, United Kingdom while the “withdrawal of antidepressants” was said to be within two weeks, “in the data about 800 users by us, the majority has experienced withdrawal and generally lasts for six weeks and 25% Lasted 12 weeks, but what does that mean? I’m doing it aggressively.
Bit like, Seroxat, really ..
Just to chime in here with some thoughts..
The majority of psychiatrists I have known, come in contact with, conversed with, or known (off-line and on-line) do not want to talk about side effects of meds. When you have a whole profession (the Royal College of Psychiatry UK as an example) and the heads of that profession (Wendy Burn/Simon Wessely for example) dismissing patient’s experience and belittling them, condescending to them, insulting them and patronizing them (and even blocking them on Twitter and refusing to engage with them) what you end up with is an authoritarian regime which is not in patient’s interests whatsoever. The royal college of psychiatry has NO credibility anymore, neither does the APA or any other professional body in any country that pushes the biological mental illness agenda. This agenda has clearly failed, and worse than that it has causes massive harm to people. The profession of psychiatry itself has also become utterly corrupted by the pharmaceutical industry too. What we have is a very dangerous situation for patients, particularly those harmed by psychiatry and psychiatric drugs, instead of sympathy and empathy, those harmed are further marginalized by the very profession that harmed them in the first place. This situation cannot be tolerated anymore…
Unusually ‘Inside Health’ ran another piece on Anti depressants because of what was described as the ‘recent spatts’. Margaret McCartney GP declared that her opinion was personal although she sits of the Council for GPs with Clare Gerada and others. She admitted that ‘about a third’ have problems with withdrawal stating ‘we should listen…’ to people describing problems with medications and that people should ‘not be stymied into taking medications’ M McCarthy flagged up the need to report to the yellow card scheme which contributed evidence in the 1960s about the difficulties of coming off anti depressants. MAybe but the reporting hasn’t had any significant effect obviously.. The thrust of her presentation was that the issue is ‘confusing and messy’ (ref her blog) and what is needed are good long term studies . But it’s amost 60 years since the issue of serious harms have been known about formally.. Some important points were made but the emphasis on ‘long term research’ is depressing . How long? there was no talk of setting up any research anyway and who knows who in positions of influence would be in control of it. David as you say pharmacists are more expert would other groups like the coll of psychs and GPs let go of control or start more infighting if funding was provided ..If the work already done by Rxisk was supported by NHS funding if that was a possibility, but still able to retain independance, would that would be trustworthy? . So refs –The first prog was presented on 28th Feb 2018 on ‘Inside Health R4 15.30pm the second today 15.30 pm14th March.
MHRA are about as useful as an ashtray on a motorbike.
They collect ADRs, file them, publish them online and… That’s it.
They can then sit back and claim correlation does not equal causation.
They are, of course, correct.
Without following up yellow card reports the ‘correlation’ line will always be their ‘get out of jail’ card.
They are as crafty as a box of monkies. The council Margaret sits on with Clare and others will have briefed her to mention the yellow card scheme knowing how pointless it is -but the public don’t know they would be wasting their time just as I didn’t till a while ago. Margaret’s voice is just more acceptable to many as she seems more honest ,When I contacted them I was told they were carrying out a public consultation to highlight the scheme – another waste of money… and few ‘professionals’ report anything. Too many still, even though peope have won the right to access their medical notes (with useful self protective rights to deny access not always as claimed to protect individuals from harm)They just leave misleading and offten offensive notes on a person’s file which subsequent GPs and others take a lead from and so it all gets worse.. just as prison inspectors report but ‘have no powers to insist on anything’. I still think though that progs such as the Inside Health two will jog some people into looking into things further before accepting anti depressants blindly – the last one was better than nothing.
I would love to hear what your thoughts are on a TED talk given by Dr.Goldacre in which he says a good majority of drugs have negative result trails that are never published. Would that not make most drugs based on fraudulent science?
Doctor Goldacre shows no interest in getting access to data on treatment harms. Until he does, any efforts even ones that apparently reduce the efficacy of drugs will just lead to more sales of drugs
Seizing the moment ..
ben goldacre, MBE LOL Retweeted
ben goldacre, MBE LOL @bengoldacre 4h
Our tracker at http://fdaaa.TrialsTracker.net shows every individual unreported trial. We want #AllTrials to make a fuss about every one, and get them reported. Ridiculously, fixing this problem will only happen if you crowdfund it. What do you pay tax for, eh.
Ridiculously, fixing this problem will only happen if you crowdfund it.
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First, the doctor refuses that there are any issues with side-effects, then he turns a blind eye to his own patient. And it is considered perfectly normal to do that. The doctor thinks he is Gods gift to humanity, when he really brings nothing to the table but poisons.
Well, isn’t that the disease of our time, denial.
And Sweden, where your opinion is now going up for trial, is not likely to contribute with any outspoken doctor or professor. You’d end up in prison if your speech isn’t deemed PC enough.
Believe me I’ve tried, as recently as last week. My take is that what we’re asking them to do is too far outside the box. A few have accepted new language, like using the term enduring withdrawal, but when it comes to what they’ll do on our behalf, not much.
My integrative specialist says she encourages people to get off meds but it’s not within the scope of her job to learn how to actively support a taper. She supports the person using the internet. I asked her, isn’t that dangerous? To advise discontinuing without providing any instruction? She says she has full faith in grassroots efforts. The more I thought about that the angrier I felt, because she used to prescribe just like everyone else, and maybe still does in some cases.
So I think even the best of them are out of touch with reality in a very dangerous, maddening way. And I think we are also out of touch with reality if we cannot accept that they take marching orders from above, period. At least this is what I consistently find where I live.
Speaking of which, the hero docs who are screaming fire about the opioid crisis, (which is actually leading to new marching orders), are now screaming fire about benzodiazepines, as if the issue is primarily one of addiction and abuse, as if they alone recognize all the horrors of shady benzodiazepine marketing. This is probably good news, but I have to look away or I’m gonna explode.
Hi Laurie…Simon Wesley has predicted that the ‘brew’ he has concocts at home using bendo derivatives ‘alcopsychs’will be a substitute for alcohol by 2050. Maybe he has already got the patent – His drink of choice is this derivitive of benzodiazepine with a dash of whisky…it beggars belief . Please Don’t explode!
Apologies for the mistake in response to your comment Laurie. I meant David Nutt, Director of Neuropsychopharmacology at Imperial college London – not Simon Wesley. S W seems to prefer a glass of beer.
Susanne, perhaps a more sane response (than exploding):
“Detachment allows us to let go of our obsession with another’s behavior and begin to lead happier and more manageable lives…”
Following on, and having just watched BBC 2 ‘Victoria Derbyshire’ interviewing a young girl called Sherry (who attempted suicide 9 times in 10 days and whose Dad put up a desperate call for support on social media which has received enormous acclaim), I would say to DH’s earlier comment ‘loving patience and care is not what we want from them’ referring to doctors, who we need to recognise adverse events more than that.
I’d say, David, why can’t we expect both? Why SHOULDN’T they be expected universally, as part of their supposed healing brief, to be kind, loving, caring? It only takes a minute to offer a kind smile, instead of an irritated huff. Like Truthman says, the almost universal belittling, condescension etc is what so many are getting from their doctors. The point I was making was that sometimes people who are in the throes of battling mental illness are not nice and reasonable, and they irritate the doctor. If the doctor is a mental health specialist, they need to see beyond this to find the frightened but normal person deep inside and restore them to good health, or at least, help them to find ways for better management of their problems. And if drugs are prescribed where really necessary, they must watch and mark the effects and learn from the patients reported experience on them. You won’t get that by treating them with irritation, derision etc. It costs nothing to be compassionate. Doctors often have this god-like stance, they don’t listen, they don’t recognise ADRs.
And yes Suzanne, on Radio 4 yesterday (14.3.18) in an Inside Health further comment on withdrawal from antidepressants, Margaret McCarthy spoke in a very woolly way about Mmm maybe we should listen more to patients, but her words were very measured, one would almost think she was worried about crossing any lines in a police state.
Back to today’s Victoria Derbyshire programme. The parents of the suicidal young person who hears voices telling her to self harm etc, have formed a parent group to support other parents like them who watch their youngster in turmoil and can get no inpatient help. The family gets feedback saying it has helped a lot. They are not clinically trained, but they have compassion, they are practical and they have ‘lived experience’. In a small way, we do the same with Olly’s Friendship Foundation but mostly with reference to illness caused by RoAccutane isotretinoin. My point here yesterday (14.3.18) was that we personally feel we do better without doctors – if they won’t listen reasonably and dare I say it, compassionately and respectfully, about patient reported ADRs, we don’t need ’em, we are better off without them in mental health situations. We need EACH OTHER. We need to deal with bullying and victimisation in schools, which is so often where it all begins. We need less public fear of mental illness.
We need love and kindness and caring attitudes, from doctors and all other human beings. There should not be a dermarcation line between us and doctors. We were all kids once, surely? Why does the power of ‘doctorship’ change a human being into an arrogant so-and-so. Let’s have a reversion to the humility of Dr Roger Bannister, who I saw once for migraine when aged 16, a marvellous caring, kind, compassionate and clever man.
In general loving kindness is the most important thing of all. I am not being dismissive when i say that you can however get it from your grandmother or lifestyle coach or pastor or good friend. It would be nice to get it from a doctor but not necessary. The one thing that is necessary is that if the medic poisons you that they know this is what they are doing and recognizes it when you show signs of being poisoned.
If they don’t recognise this – all the loving kindness they otherwise show is worth nothing. If its a choice between recognising harms and having the guts to publicly accept you have been harmed or loving kindness, then I would want a doctor who can recognise an adverse event and has the guts to tell you and others that part of the problem is now the treatment we are giving you. People practising medicine who can’t do that should be avoided.
I would guess that a doctor willing to acknowledge the link between your prescribed medications and the ills that you suffer as a result of those drugs is, in fact, very likely to be compassionate etc. – and discusses the reaction with you in kindness rather than arrogance.
I fear there may be another category of doctors who simply don’t understand the link between the drug and the adverse effects. Being seen by a doctor from this group leads, not to frustration, but to sheer hopelessness – for both patient and carer/family. Turning to a doctor, when you are in crisis, to be confronted by a person who is in an absolute panic about your condition is terrifying. I would like to think that this group would be willing to learn from the experience of ‘not knowing what to try next’ and would turn, to those who DO know, for support – or at least be inquisitive about the ways in which the doctor ‘in the know’ works successfully with his patients.
I really don’t know if they are willing to be that open about their own shortcomings – but I’m hoping to find out on Monday. Shane has a review with his previous psychiatrist and I would like to know from him whether or not, should he come across another case of similar complications, he would now feel more ‘in the know’ about what is going on and how to progress with that patient. I shall let you know the answer – if I’m brave enough to ask it!
Further to my last paragraph above – it is now Monday, the said review has taken place – and I was brave enough to ask the question! I’m very glad to report that his reply was very positive – that, yes, he’d certainly bear in mind the things that have made such a difference to Shane if he should ever come across a ‘mysterious case’ such as his again. He also admitted that he was at a loss of how to deal with Shane’s case – that nothing that the book said SHOULD work, worked for Shane. To anyone new to reading here – those ‘things’ are :- suggesting the usefulness of the Hearing Voices Network; full support for a VERY gradual withdrawal of medications and fully listening and believing the patient.
Congratualtions Mary H – it’s so good to hear something positive has come of your impressive persistence. So disgraceful that you felt you need to be ‘brave’ enough ..maybe he’s been reading your comments on the blog!
If you really think your doctor cares about ‘you’ amongst all the hundreds of patients they may see in one week, particularly, if you’re a city dweller, this can be a great disadvantage
If your doctor is a family friend, this can be even worse, citing David Carmichael here .. tragedy strikes .. Paxil induced ‘Impulse’ ..
I thought my doctor cared about me. The new doctor in our rural practice who swept in with ‘intellectual properties’ blazing – this was her last position as being a gp and the staff and owner were in thrall. Initially, I really liked her as it was not often a gp, of such ‘intellectual prowess’ showed up in places such as ours. She was bored at home in the I of B and was desperate for some ‘intellectual companionship’.
I didn’t realise the extent of the ‘Stockholm Syndrome’ until I got hold of my medical records and realised how she had double crossed me whilst turning me in to her friend. To a lesser extent the practise nurse did this as well.
What these two women did was almost criminally insane and certainly pretty irresponsible by leading me by the hand to self destruction from Seroxat and then turning it all around, right in the middle of all this, by clasping me to their bosoms.
Total madness, which is why my Formal Complaint to the owner of the practise was met with substantial and threatening overtones.
I learnt the hard way to keep emotionally distant from any medical person, just put the problem wait for the answer, say thank you very much, and, leave
You could make a movie about my run in with these two women worthy of Bette Davis or Joan Crawford .. “”Fasten your seatbelts, it’s going to be a bumpy night.”
“Bette crawls across the screen like a testy old hornet on a windowpane, snarling, staggering, twitching—a symphony of misfired synapses”
Isn’t that lovely .. her last tribute as an aging actress ..
Point taken. But how are we going to coral these doctors into receiving some kind of re-education to get them to admit/understand when their poisons, given, as you say, often for the best of reasons, (or as I’d say,additionally for some because it’s the easy option) cause dire effects? If they are compassionate, might they not care a bit more about the possible harms they are inflicting? Stand in the patients’ shoes, so to speak. Be interested in learning new skills. Keen to do a good job. Or better still, be worried about being sued or being put out of work for negligence.
I particularly favour Bob Fiddaman’s ‘Gordon Ramsey and the Steak’ idea. Give doctors a month off normal routine work to try antidepressants for themselves. Then get them to stop, taper, whatever for 2 weeks. Then get them to write a Report based on a daily diary kept in that period, on effects, both good and bad. Most youngsters, children of doctors do not take RoAccutane isotretinoin. They are much too sensible of the risks.
Yellow card system, described by Suzanne, is a cool idea but which sadly has not worked. The MHRA only want to hear about NEW, previously unmentioned side effects. If yours has already been reported, it isn’t interesting to them, they will argue it’s already there in the PIL so you’ve been warned. Someone we got to know recently in the NHS has a daughter who developed a tumour on her finger after taking RoAccutane isotretinoin. It was admitted by the dermatologist that the drug caused it. I am not sure whether subsequently the PIL was amended to say that in rare cases it could cause cancer. I rather doubt it. She didn’t do the Yellow card system but assumed her GP did. Maybe he assumed she did. She is now belatedly trying to find out whether anybody did, and will do so if not. It’s tricky though because now she’s discovered more about the drug from us, she doesn’t want to alarm her daughter.
James, One ….
Today, Mad in America published a blog in which I share some personal reflections on the events of the last few weeks. The issue of antidepressant withdrawal has been brought into the public eye in the UK like never before.
James, Two ..
Antidepressant Anarchy in the UK
March 16, 2018
James, Three ..
Whose Interests Does the Royal College of Psychiatrists Really Serve?
James Davies, PhD
March 16, 2018
James, Four ..
Please read and share this on your social media, thank you.
What happens next will be very interesting.
A group of eminent doctors and psychiatrists write to the President of the Royal Australian and New Zealand College of Psychiatrists in response to a press release issued by the Royal College.
‘a similar issue has arisen in the UK in recent days. A group of eminent psychiatrists and researchers has challenged a statement from the Royal College of Psychiatrists (RCP) that for the majority of patients who discontinue antidepressants, any ‘unpleasant symptoms’ resolve within two weeks. The protestors provide evidence that this is not the case and suggest that the view of the RCP is ‘misleading the public on a matter of public safety’.
RANZCP deeply concerned over stigmatising reporting of mental health treatments
Claims antidepressants don’t work ‘dangerous’, doctors say
An Imperial College of London professor visiting New Zealand says antidepressants are one of the safest medicines in the history of the world.
Claims that antidepressants don’t work are dangerous and akin to climate change denial, mental health professionals and experts say.
Stuff reported on a Christchurch conference on Tuesday, in which Cochrane Collaboration co-founder Peter Gotzsche said antidepressants don’t work and other speakers questioned the efficacy of the current mental health treatment model.
The Cochrane research organisation has said it did not share the views of Gotzsche on the benefits and harms of psychiatric drugs, according the British Medical Journal.
Views on the issue are dividing the medical community globally.
Imperial College London neuropsychopharmacology professor David Nutt, who is visiting New Zealand on a William Evans Fellowship with Otago University said views reported from the conference were “inaccurate”.
“Antidepressants do work and they’re very effective for people who are depressed and anxious. They save lives and reduce suicide risk.
“To say they don’t work completely misrepresents the data and denies people access to a potentially life saving treatment.”
Psychiatric drugs had side effects “like any other medication” but modern antidepressants were “one of the safest medicines in the history of the world.”
There were long-term trials showing antidepressants were effective, especially to prevent relapse.
There was “overwhelming evidence” supporting the view that mental health problems were caused by chemical imbalances in the brain.
Devious spouting from David Mutt – most even anti- psychiatrists are not demading a total ban on medications.
At the end of the 80’s, Bob dylan wrote the song “Disease of conseit”, presumably about american tv-preachers behaving badly. But there is alot in this song that tells a story about doctors fumbling in the darkness with a disease that seems to hit so many.
Perhaps it is the other way around: the doctor himself has the bug, and in his altered state of mind projects the disease onto his patients.
Perhaps our doctors, ill from the “disease of conceit”, sticks to the narrative that all medicines have side-effects, but as soon as they turn nasty, they are not side-effects anymore?
And as a catch 22, it turns out some research suggests this novel drug called ‘paroxetine’ might be helpful to them…..
BTW, the song is worth a listening.
Ove, your comment is succinct and masterful. I shall listen to Bob Dylan’s song. I love it where you say ‘doctors say all medicines have side effects but when they turn nasty, they are not side effects any more’. Perfect.
Oh to get doctors to suffer some nasty side effects themselves. Then we’d see some honesty and hopefully some action.
Oh! Thank you Heather, it makes me feel as if I contribute, even though it’s just words.
Yes, I saw Fiddaman also had some ideas about letting doctors try it for themselves. Perhaps we have all had that thought, I know I have. To have a doctor walk a mile or two in our shoes. My fantasies may also have included a “forced and mandatory” ingestion/stoppage of the drug for the doctors in disbelief. Ofcourse a part of me would want such a ‘revenge’.
But it wouldn’t lead to anything more than just another sufferer.
An Ego centric model, with a Medical Practice attached
Drug safety agency accused of cover-up
Sarah Boseley, health editor
Sat 13 Mar 2004
But Lord Warner, the health minister, to whom Mr Brook had expressed his concerns, intervened, and on Thursday the CSM put out a “reminder” to all doctors that they should prescribe Seroxat only at the recommended dose, which is 20mg.
Last year 17,000 people were put on a higher dose by their doctors, running the risk of increased side-effects, which some have alleged include agitation and thoughts of violence and suicide.
the announcement had stopped short of acknowledging that the crucial dosage data had been in the possession of the MHRA since 1990.
“Despite four major regulatory reviews during this period and considerable consumer reporting and disquiet, the Committee on Safety of Medicines failed either to identify or communicate these key facts. As far as I am aware, the MHRA has not seen fit to acknowledge or address what in my view appears to be extreme negligence.”
it amounts to extreme negligence and a clear dereliction of the MHRA’s duty to safeguard the wellbeing of the British public.”
No Joy – ended with a whimper
I remember it as clear as day.
Ove in Sweden, the ‘Novel’ Seroxat, of which there is so much, may now need several volumes ..
Let’s not hold our breath for some action to be taken against any regulatory body..that will probably need to be a legal individual or group action against those who have breached prescribing rules – or is there a cop out that they are only ‘guidelines’.
Bob on …
And here’s Natalie’s mother, Kristina, writing to the producer of the Dr. Oz show.
Is This The World We Created?
13 March at 05:54 ·
Tomorrow afternoon, the Dr. Oz show is airing its first episode on psychiatric drugs and school shootings/violent behaviour. My daughter Gillian and I participated in the taping of this show in New York City on March 7 but even though we’re listed as guests, I don’t think our segments are going to air until sometime in April because of the length of our interviews.
Dr. Oz ..
An In-Depth Look at Psychiatric Drugs and Violence
Originally aired on 3/14/2018
In the wake of mass shootings, one of the biggest questions everyone is asking is “Why does it happen?” Dr. Oz welcomes a panel of experts to examine the association between psychiatric medications and violent behavior.
Guests: Dr. Judith Joseph , Dr. Drew Pinsky , Dr. Casey Jordan , Bobby Chacon , David Carmichael , Gillian Carmichael , Daniel Dowd
Is there a link between Psychiatric Drugs and Violent Behaviour?
Ah yes, another honest broke – beware the honest broker. It is so important to stop people talking, stop social media. Only surrogate industry people may talk.
Let’s hear it from Margaret McCartney and Inside Health R4. Despite claiming to be talkig in a personal capacity she strongy advocated referring side effects to the Yellow Card Scheme. She sits on the GP cttee – is it likely they didn’t know anyting about the shamefull cover up by them up as reported in the Guardian?? What has the college of psychiatrists known about it? Answers on a yellow card.
David Carmichael has put up this film about what can happen, about a young Norwegian girl who was diagnosed and hospitalised over 10 years and how the drugs spiralled out of control.
I hope you will all watch it.
1 hr ·
Last night, I watched this 38 minute Norwegian film (with English subtitles) about Silje Marie Strandberg, who was prescribed an antidepressant for moderate depression at 16 years of age and then treated in the psychiatric system for the next 10 years because of other diagnosed mental disorders that even a couple of Norwegian psychiatrists acknowledge in the film were probably caused by the side effects of the cocktail of drugs she was prescribed. Silje is now off all medication, back to normal and sharing her story publicly.
It’s almost like a miracle. This story is unique. A story of hope. But it’s also the story of a young girl with little self-confidence that lost 10 years of her life. Where did it go wrong? Did she have to go through 10 years of torture in mental wards? These are the answers Silje Marie is looking for in this documentary.
John Marsden I could not believe the phone call to her first psychiatrist who admitted he knew little about the initial antidepressant medication he prescribed. If this is not an admission of incompetence and negligence, I don’t know what is. Thanks for the post, a very interesting story.
Annie, thank you for the link to Silje Marie’s powerful, moving and courageous film.
It was so painful to watch events which appeared to run parallel to the loss (via drug-dependent psychiatry) of our own dear lost-soul.
Like Silje Marie, she found eventually found a professional with integrity, intellect, empathy and courage enough to save her life, but her fight to recover from such devastating, multi-systems psychotropic drug-induced injuries has now entered her seventh lost year.
We saw a mirror of our own parental faces in the close-up images of her father and mother’s anguish and disbelief.
What immense courage for her to meet and question those whose dogma and delusions of “safety and efficacy” appear to have lead to such torment and injury.
I have shared the film with the very few friends and one relative we have left, as psychiatry’s catastrophes so isolate their victims.
It has allowed them to understand so much more clearly what has happened.
Through these few remaining contacts, it is now being distributed to wider circles who will no doubt watch with similar disbelief, anger and determination to disseminate awareness.
The images will live on in our minds for ever.
tim. I am so sorry for your loss. As someone who was drugged as a youngster, then given layer upon layer of drugs to “treat” what was actually withdrawal and adverse reactions, I am surprised I am alive. My heart goes out to grieving parents, but I also admire them for recognising and speaking frankly about the harms these drugs caused their children. My own parents prefer to pretend nothing happened, so I’m reassured by those who speak frankly.
Great film. 29 drugs for someone who was not even psychotic!!
Thank you for posting and helping others in their search for the truth
It is the prescribing psychiatrists who are actually deluded
Nicely phrased, Tim ..
David Carmichael has introduced us to another film, Cause of Death Unknown
2 hrs ·
Tomorrow afternoon, Canadians for Vanessa’s Law (KnowYourDrugs.org) is hosting the Canada premiere of the documentary “Cause of Death: Unknown” in Toronto. I was at the North American premiere last July at Michael Moore’s Traverse City Film Festival in Michigan where it won the Best Foreign Documentary Film award. I’m confident Torontonians will respond well to the film.
A personal investigation exposing the deadly secrets of Big Pharma and the multi-billion dollar industry of psychiatric diagnosis & medications.
the crimes of the pharmaceutical industry, the unheralded growth of psychiatric diagnoses and medication, and the corruption of the government regulatory agencies that have failed, repeatedly, to protect us.
the chilling documentary-thriller CAUSE OF DEATH: UNKNOWN exposes the inner workings and motivations of a powerful industry that continually puts profits before people, and has been far too influential in defining who is normal and who is “ill”.
A Scottish Psychiatrist is having a hard time ..
Fiona French Retweeted
Truthman30 @Truthman30 31m
The President of the Royal college of Psychiatry UK refuses to listen to Peter J Gordon (an ethical Scottish Psychiatrist pushing for humane/transparent psychiatric practices. I think that says it all… Wendy Burn doesn’t want to know…
Today I received this e-mail, marked “High importance” from the “HR Department” of the Royal College of Psychiatrists which has left me upset:
Professor Baldwin kindly replied that day, stating ..
It seems prudent to point out that the entire attitude of RCP, is leaving many people ‘upset’ …
Wendy Burn Retweeted
Dr Jay Watts @Shrink_at_Large 16h
Fantastic. Some important things coming out of Royal College of Psychiatrists under @wendyburn’s helm.
Now this is surreal, but also pathetic beyond words. In what way is it appropriate for the President of the RCP to send a letter to a concerned fellow professional through her ‘Human Resources’ department saying that she does not wish to be further contacted by him? The implication is that this will be regarded as harassment – yet this is not a personal matter. And in what way does it involve ‘Human Resources’ anyway?
Of course, ‘Human Resources’ is in itself a de-humanising term and it sad to see the RCP using it. Bring back ‘Personnel’!
Said it in a nutshell John – makes Wendy B look pretty foolish. Doubt if Simon Wesley would have hidden behind H.R, In his final, witty as ever ‘Past President Blog’ (on college of psychs website) S.W. said ‘and now for my favourite last words….(quoted from the supposed words of a dying general to his priest) ‘I did not have to forgive my enemies, I have had them all shot’.
Is there a way to taper paxil/seroxat at all , i tried several times and i crashed a year ago at 8 mg doing the liquid 10% taper each month. I crashed because of the lack off sleep and severe stress. I dont understand why it is still being prescribed this horror medicine!!
Should i switch to citalopram or prozac because of its long halftime? and are there any risk but tapering off paxil i so hard for me i am not recoverd yet from the last crash and i went up to 20 mg again, and my shrink want me to go up to 40 mg…no way!!
Does somebody have some good tips?
Mark, there are some excellent resources on the internet which will enable you to learn more about tapering and withdrawal so you can make the best decisions. Here are a few:
Surviving Antidepressants is full of stories and help, plus tapering advice
Mad In America has information about drug withdrawal
Your surname tells me you might be based in the Netherlands, so this site might be of interest to you
Good luck with your tapering journey.
‘There is little doubt in my mind
Dodgy ‘funnel plot’ ..
experts were quoted in the press as saying this was ‘the final answer’ to the controversy.
Or was it? Here, leading experts reveal what you really need to know about so-called ‘happy pills’ – and how they could have some very unexpected benefits…
Wendy Burn Retweeted
RC of Psychiatrists @rcpsych Mar 26
.@ParianteSPILab readdresses comments made on the effectiveness of #antidepressants. https://dailym.ai/2GaI97p
Dr Neil MacFarlane @NMacFa 18h
Dodgy ‘funnel plot’ claims @EdzardErnst Member’s complaint about @rcpsych oligarchy’s false, misleading and irresponsible statement on ‘ #antidepressants ‘ spun in #MailonSunday rather than answered: http://drnmblog.wordpress.com/2018/03/27 …Now, deliberately misleading?
the Culling .. GSK – what a Horlicks ..
Syngene enters pact with GSK to provide drug discovery services
Glaxo CEO Dispenses Bitter Pill to Fix R&D
In her first year, Emma Walmsley has replaced top managers, pruned the ranks of scientists and shut down clinical trials to narrow the drug-development focus
LONDON—Emma Walmsley, the rookie chief executive of GlaxoSmithKline PLC, is giving the 300-year-old British drug giant’s ailing research-and-development operations a dose of bitter medicine.
In the roughly one year that the 48-year-old former cosmetics executive has been in place, Ms. Walmsley has replaced nearly half of Glaxo’s top 125 executives, according to the company. She has reassigned or let go some 400 scientists in its drug-development unit, and another 100 science jobs are still on the line, according to people…
The Pfizer Consumer Products deal is shelved and they are buying Consumer Products from Novartis for $13B
The Horlicks brand could be sold to raise some cash, in India ..
Talking of India ..
India: GSK Whistleblower Names and Shames – Part I
‘a strategic review of GSK’s Horlicks ..
‘Women’s Horlicks, became a leading brand, while Mother’s Horlicks ..
Sensodyne’s producer GlaxoSmithKline supplied studies to support their claims. But the ASA said: ‘No evidence was provided to show this toothpaste was more effective at whitening than other Sensodyne toothpastes that were not marketed as whitening toothpastes.’
The watchdog said it was therefore misleading and the claims should not be made again.
A good start for the ‘Consumer’ Brand ..
Industry ‘Expert’ on GlaxoSmithKline, Ben Goldacre, talks about Transparency and Payments to The Times.
In full; paywall.
The Toy maker 7 hours ago
Why do we seem to be upset with Big Pharma who presumably agreed to and did ask GPs etc to disclose payments and the GPS etc then refused.
The article should be about GPs and Consultants etc refusing to disclose these earnings usually made in addition to practice salaries etc.
Redbridge Hypnotherapy 34 minutes ago
This doesn’t surprise me at all as it’s still going on in our surgeries today unfortunately for patients and fuelling the over prescribing brigade more interested in their wealth than some patients health
£20m ‘secret payments’ to plug drugs by Astrazeneca and Shire
Two of the UK stock market’s biggest pharmaceutical companies have made millions of pounds in “secret” payments to healthcare professionals and organisations, an investigation by The Times has found.
At least €22.3 million (£19.6 million) was made in anonymous payments across Europe, including €17.9 million by Astrazeneca, the Cambridge-based company, and €4.4 million by Shire, the rare diseases and neuroscience specialist, the research showed. The figures cover payments such as consultancy fees and “related expenses” and travel and accommodation for events organised or sponsored by the companies.
The anonymous payments have been made despite a European self-regulatory code of conduct encouraging drugs companies to renegotiate contracts with professionals, such as doctors, and health organisations in order to include consent to disclose details.
The findings have triggered criticism from academics who said transparency was needed to retain public trust in medicine and called for an end to the “soft industry-led” initiatives.
The duo are among the biggest drugs companies in the world, having a combined £94 billion market value on the FTSE 100 and generating $37 billion of annual revenue between them.
Payments from drugs companies to professionals who have influence over prescribing and purchasing drugs has come under increasing scrutiny amid concerns about conflicts of interest.
The European Federation of Pharmaceutical Industries and Associations (EFPIA) introduced a code for members requiring payments to be published annually from 2016.
However, not all individual payments are disclosed as companies can report payments in aggregate because of national data protection laws.
Healthcare professionals can withhold or withdraw consent for
companies to disclose details of payments they have received. Disclosing in aggregate therefore makes the recipients of the payments anonymous.
Under the code of conduct, companies are “encouraged to include provisions relating to the recipients’ consent to disclose” payments in their contracts and to “renegotiate existing contracts at their earliest convenience to include such consent to disclosure”.
The research also found that inconsistencies in the way data is recorded by companies make it difficult to reveal the extent of anonymous payments. The Times study focused on payments by three of the biggest drugs companies on the London stock exchange across 27 countries where there was comparable data, from Russia to Sweden. It covered payments disclosed between last June and last December and made in 2016.
It found €3.6 million of anonymous payments by Astrazeneca in Russia, almost half of its total payments in the country, and €1.6 million in Switzerland, 41 per cent of its total there. Of the €4.4 million of anonymous payments made by Shire, €2.4 million was in Spain, €215,600 in Italy and €138,700 in Russia. They compare with about €300,000 of anonymous payments by Glaxosmithkline.
Ben Goldacre, director of the evidence-based medicine data lab at Oxford University, said the public “need to know if someone who praises a drug is getting money from the company”.
“The state has chosen not to invest in disseminating unbiased evidence to doctors. So industry has stepped into that gap. Doctors commonly turn to free ‘educational’ activities, delivered by ‘key opinion leaders’ paid by industry. I doubt there are many doctors who completely change their opinions about treatments in exchange for a
cheque, but it’s a temptation that some cave in to.”
A spokesman for Astrazeneca said “scientific and clinical insight exchange with the medical community is both important and relevant. All of our interactions are conducted in an ethical manner and with full transparency, and in line with the EFPIA Code.”
A spokesman for Shire said it was “committed to making public the details of all payments and other transfers of value made to healthcare professionals and healthcare organisations, and has been fully complying since this requirement was put in place”.
A spokesman for Glaxosmithkline said it had “played a leading role in driving transparency of our partnerships with healthcare professionals and organisations, who play a critical role providing us with medical and scientific expertise and insights into patient care”. He added: “We fully support the EFPIA’s code with one of the highest disclosure rates of over 90 per cent across Europe.”
Alex Ralph, Louis Goddard
Almost five years after Glaxosmithkline became embroiled in a bribery scandal in China, the fallout still hangs over…
April 3 2018
Glaxo and drug company rivals struggle to shake off China bribery scandal
Payments saga reveals the dilemma for industry in engaging with health professionals
Almost five years after Glaxosmithkline became embroiled in a bribery scandal in China, the fallout still hangs over Britain’s biggest pharmaceuticals company. Glaxo was fined about £300 million by China in 2014 after being found guilty of paying bribes to boost sales of medical products, yet despite overhauling its practices it remains the subject of a number of investigations.
The UK’s Serious Fraud Office, which launched a criminal inquiry in 2014 into Glaxo’s commercial operations in a number of countries, including China, has more recently requested additional information regarding third-party advisers “engaged by the company in the course of the China investigations”. It has prompted regulators in America, where
Glaxo agreed a $20 million civil penalty with the government in 2016, to investigate.
The saga is a reminder to drugs companies of the risks of engaging with healthcare professionals and organisations. Glaxo has led attempts to improve transparency, including changing how sales representatives are paid by removing individual sales targets and stopping the practice of paying healthcare professionals to speak to other prescribers about its products.
It is one of the biggest and most powerful companies, selling prescription medicines such as its Advair asthma inhaler and consumer brands such as Sensodyne toothpaste, generating £30.2 billion in revenue last year.
Glaxo has implemented a European-wide industry code “in the true spirit in which it is intended” by striving to name the individual doctors and other healthcare professionals it funds through a “no disclosure consent, no contract approach”.
The policy seems to be making progress, limiting the scale of anonymous payments made to healthcare professionals and bodies, and contrasts with its rivals Astrazeneca and Shire, which are making millions of pounds of payments to unidentified recipients.
Research by The Times Data Team has found that at least €22.6 million of anonymous payments were made to healthcare professionals and organisations across Europe by three of the London market’s biggest drugs companies. About €300,000 was made by Glaxo, including in Hungary, Germany, Spain and Italy, compared with €17.9 million by Astrazeneca, the Cambridge-based company, and €4.4 million by Shire, which has its headquarters in Dublin, the research found. The
payments were disclosed between last June and last December and made in 2016 under the self-regulatory European system. There is no suggestion of any wrongdoing by any of the companies.
Shire is a rare diseases and neuroscience specialist which generated revenues of $15 billion last year. Astrazeneca is one of the UK’s biggest companies, specialising in oncology, respiratory and cardiovascular and metabolic diseases and posted $22.5 billion of revenue in 2017.
Glaxo said the reason some recipients were not identified was “usually because healthcare professionals withdraw their consent to be named following our work together, as they are legally entitled to do. In these instances we would not continue to work with that individual.” The approach is in line with the code of conduct of the European Federation of Pharmaceutical Industries and Associations, the lobby group that helps regulate payments made to health professionals and organisations.
Under the EFPIA’s code of conduct, members are urged to include provisions in contracts for recipients to consent to being identified and to renegotiate existing contracts. For those professionals who refuse or withdraw consent, such as under national data protection regulations, payments are disclosed in aggregate and are anonymous. The EFPIA appears to acknowledge the code’s limitations, saying that it hopes individuals “recognise the benefits of greater transparency and grant consent to disclose the data”.
The extent of this weakness is laid bare by The Times’s research, which shows that in some countries more than half of payments made by companies are secret. Of the €231,200 of payments made by Astrazeneca in Ukraine in 2016, 56 per cent are disclosed in aggregate, while in Russia it is 48 per cent of the €7.5 million
payments and in Switzerland 41 per cent of the €3.9 million payments.
Ben Goldacre, director of the evidence-based medicine data lab at Oxford University, said that The Times’s findings “show, once again, that soft industry-led ‘culture change’ initiatives, and voluntary codes, are ineffective”. He said: “In the US, there is none of this messing around with voluntary disclosure, and elaborate excuses for secrecy. The Sunshine Act requires that every payment to any doctor is published openly in a government database. Compliance is universal, and the sky has not fallen in.”
However, transparency could be weakened further by data protection regulation that takes effect this spring, which could empower the choice of the individuals.
Meanwhile, Glaxo has quietly watered down its policy, introduced in 2013, to stop paying healthcare professionals to speak to other prescribers about its drugs. In its recent annual report, it said it had received feedback from scientific experts that “important scientific dialogue between GSK and them has reduced” and that having consulted with professionals, it would “now allow fair market-value payments” to be made by GSK to expert researchers and healthcare professionals to “speak about the science behind our products, disease and clinical practice in a limited number of GSK-sponsored, medical-led meetings”.
A spokesman for Astrazeneca said the “ultimate decision to disclose . . . rests with healthcare professionals” and across Europe its consent rates were “in line with industry standards”.
“We have full traceability of our efforts to encourage disclosure,” he said, adding that the payments also reflected the “distinctive strength of our pipeline . . . with a lot of new research, data and patient insights to discuss with the medical community”.
A spokesman for Shire said: “Collaboration with experts is especially important for building understanding of rare diseases, improving diagnosis and addressing patients’ needs.”
Shire added that it was “committed to making public the details of all payments” but “not all individuals have provided their consent for us to disclose this information”. It added: “In such cases . . . we disclose the number of individuals that did not provide consent and the total amount paid to them.”
Something different .. just doctors
James Moore Retweeted
Dr Neil MacFarlane MRCPsych @NMacFa 13h
Hello @MITUKteam and @Mad_In_America …I have escalated Lancet/Pariante #antidepressants complaint to GMC…
Dr Neil MacFarlane MRCPsych @NMacFa
GMC complaints about @ParianteSPILab and @rcpsych oligarchy…receipt confirmed…new Blog piece http://drnmblog.wordpress.com/2018/04/03/ …@GMC ‘Duties of a Doctor’…’You must respond promptly, fully and honestly to complaints’…this and 15 other sections contravened.
10:04 AM – 3 Apr 2018
Des Spence @heraldscotland “Doctors aren’t very good at listening to patients sometimes – especially when there’s problems.” “Nobody particularly enjoys putting their head above the parapet and getting shot at”. Thank you.
“Things have to change in general practice,” said Dr Spence. “There are problems and I suppose I’m a do-er really, so we just decided to try and do something different.”
My friends son has been purchasing xanex online and it’s part of a trend with young people. It really makes him go loopy and off the rails, what can I say to them or show them as evidence it’s not the best way to deal with problems?
I remember once transcribing an interview of yours, that opiates help, but have high risks, and that learning to cope without them has better long-term effects.
Thank You, best Wishes
Sorry, I don’t know how I forgot to mention, but it has given him seizures on several occasions, but still takes it. I think it must be addictive, what was concerning me more was the reckless behaviour whilst on it, that just isn’t typical of his normal way of being.
It’s obviously a very mind-altering drug that also causes physical threat.
What four or five main points could I illustrate to a young person who is unaware of the risks?
Thank You so much