This is a murky story that like Study 329, to which it links, doesn’t leave anyone looking good.
First the journal – Frontiers in Psychiatry – which is one of the Frontiers group of journals. As outlined in Neo-Culturalism – a must read to get what is going on here and being done to all of us – there is no-one at home in Frontiers. There is a vacuum where once the soul (or at least the rear-end) of the medical establishment could be found. This is where the Surveillance Society meets academia.
Frontier operations recruit people for the most part probably flattered by the idea of being an editor for a day, perhaps occasionally knowing what they are getting into but with some vision of doing good.
In this case, Michael Hengartner, who being Swiss might have found it difficult to resist the overtures of a Swiss business, agreed to get involved in putting together an issue on antidepressants and children. Michael would generally be regarded as an all-round good guy.
Michael recruited Irving Kirsch, also regarded as one of the good guys, to help out, and then reached out to me. Irving dropped out when he realised that despite being an editor it would still cost him a lot to get his article published in the issue he was helping to organize – see Neo-Culturalism.
I initially recruited more contributors than Michael and Irving combined but then began to run into difficulties when Frontiers effectively started to insist it owned me – I had to keep to its deadlines rather than it fit around mine – see Neo-Culturalism.
As part of my recruitment efforts, I figured there were too many good guys being asked to write articles, all saying antidepressants were not a great idea for minors. Fine if you were going south of the border to sort out some pesky Mexican bandits but this was more complex. It would be helpful to get input from some of the guys pushing antidepressants for minors like Elias Eriksson, an aggressive pusher, and Andrea Cipriani. Eriksson refused.
Andrea, who is very charming and difficult to dislike, agreed to get involved. He has pioneered a technique he calls network meta-analysis. He also runs a Precision Psychiatry centre in Oxford University, linked to Evidence Based Medicine – the rough idea is that practice should be based close to exclusively on clinical trials. Andrea and his team would put together a network meta-analysis on trials of antidepressants done in children.
By this point, however, my difficulties with Frontiers were coming to a head and I withdrew from the process. I mentioned modern slavery to them – see Neo-Culturalism – but there was complete incomprehension on their side. There was no great ill-will – for me it was an insight on the way academia and publishing is going and emphasized the need for more co-operative, Samizdat-like publishing.
So, when I was asked would I be prepared to act as a reviewer for an article in the issue, I said yes. The Cipriani team’s article was sent to me. I was one of 4 reviewers – one dropped out early on.
The Cipriani article has just been published. Like Andrea’s widely cited 2018 article on antidepressants, the message in this article is that antidepressants work for children. If you read the fine print there are nuances about some not working that well for some conditions with one or two drugs thrown in that don’t really work at all and one or two conditions for which none work – but the bottom line is they work.
This was a review challenge for someone who has published articles in English and Spanish saying that 30 of the 30 trials done on these drugs in minors are negative. In the case of clinical trials in depression you can look at each of the 30 or so trials and if each are negative and none positive you can say this is the greatest concentration of negative trials for any condition in any age group ever in human history.
Or you can add up the ‘data’ from 30 negative trials and get a marginally positive result which is what Andrea does. This seems crackers to me, and goes completely against the rational of RCTs, but many people including the editors of the Lancet, BMJ, NEJM and JAMA don’t bat an eye at this.
But this wasn’t the core problem. The core problem is that, as in his adult work, Andrea and his team have been working from ghostwritten publications with no access to the raw data. In the case of the GSK paroxetine trials, including Study 329, and the Forest citalopram trials, these publications have led to fraud charges and Department of Justice fines ranging from hundreds of millions to billions of dollars.
It’s not the case that GSK and Forest were just the bad guys who were caught. GSK were pretty ethical, as companies go, when running Study 329. What they did was standard company modus operandi – back in the 1990s. Things are a lot worse now, and it’s almost for certain some of the trials the Cipriani team depend on for their ‘positive’ result are a lot shonkier than Study 329 was.
The Prozac trials are a case in point. They were all negative on their primary outcome – despite published claims that Prozac worked. Regulators in fact approved Prozac on the back of two negative trials, and there are more negative Prozac trials than there are for any other antidepressant given to children.
Then there is the supposedly independent Prozac trial run by the NIMH – the TADS trial, which may have essentially been run by Lilly. This returned something like 34 suicidal acts on Prozac versus 3 on placebo but these all go missing from the 7 publications of this trial. When Jon Jureidini and colleagues tried to get hold of the data in order to look at some of these more closely they were told it had been destroyed.
Pointing things like this out to the Cipriani team and asking is it really possible to do what you are claiming to have done and for it to be meaningful – drew a response from them like the quote Tom Lehrer, the satirical songwriter, put in the mouth of the Nazi and later American rocket maker Werner von Braun: ‘once the missiles are up who cares where they come down, that’s not my department’ says Werner von Braun.
It’s a technical operation, like constructing train carriages for transporting animals and ensuring there are systems to allow urine and effluent outflow – who cares if the animals are cattle or humans.
It’s now the job of academics to take the published literature as it stands, not asking if its fake or honest, and network meta-analyse it and see what comes out. This is a technical exercise not a moral one. Whether we put garbage or genuine material in, the technique guarantees publishable results.
I recommended rejection. The other two reviewers recommended acceptance – primarily on the basis that there were no technical faults. The question then became which way the editor and the journal – if there was anyone at home – would jump. The article was accepted.
In this way, decent academics, nice, even good guys, who are sticking to their job description, and being ethical by doing so, become, to borrow from the Covid lexicon, infection super-spreaders.
They take a ghostwritten, in some cases fraudulent literature, which breaches the basic norm of science which requires claims to be backed with data that can be scrutinized, and they whitewash it.
The image below is from one of the Cipriani network jobs – it even looks like the images for Covid super-spreaders.
When published, these papers get presented at primetime in media outlets with a tagline something like – Biggest study ever proves Antidepressants Work. Everyone it seems can compartmentalise the fact that with a big enough study Snake Oil can be shown to work.
This is not just Andrea spreading problems. Most of the Cochrane Collaboration are complicit in something similar. Around 1995 when they began Systematically Reviewing Drug Trials Cochrane could have insisted that they would only include those trials where the raw data was present – but they didn’t. Around 2005 Iain Chalmers and Richard Horton of the Lancet told the world that ghostwriting and lack of access to trial data were not a problem. Around 2015 the Collaboration were well on their way to being a publishing business – not unlike Frontiers.
Antidepressants appear now to be the second most commonly taken drugs by teenage girls. This weekend, the BBC website contains an article on a doubling of suicides among young women, which speculated on the reasons for this without mentioning antidepressants as a cause – perhaps because Andrea never has said anything other than these drugs work. It says to steer clear of drugs and alcohol which can disinhibit you without mentioning prescription drugs like SSRIs disinhibit too – perhaps because nothing Andrea has ever written mentions this possibility. The case featured in the article, ‘Lauren’, describes effects very like the emotional numbing found on SSRI antidepressants..
This is a generation of women who may never get off psychotropic drugs, who will have miscarriages caused by these drugs, pregnancies on the drugs with babies who have gross birth defects or subtle behavioural changes – autistic spectrum disorder, who may become alcoholic, end up with enduring sexual dysfunction and kill themselves. That’s not my Department says Werner von Braun.
Copyright © Data Based Medicine Americas Ltd.
Michael Hengartner responded to the post with the following email
That‘s absolutely fine with me. Just one note: Frontiers has a rather peculiar way of editing articles. As soons as two reviewers have recommended acceptance, as editor I have no choice but accepting the article. Unless there is a serious flaw, which you might argue is there, as no-one has access to the raw data. However, on this ground I cannot recommend rejection, as this would mean to reject about 90% of clinical research and call into question everything EBM has achieved, including the Cochrane collaboration.
And was happy to have the comment posted as part of an effort to get a conversation going
why not publish together with an article that there was a disagreement about acceptance with an explanation as to the reason?
The point is there is no one at home in Frontiers to make a sensible decision like this – and there is also the point that this scenario calls the entire modus operandi of Cochrane and NICE and others into question. It also applies as much to vaccines as to drugs
The Giant Anteater…on the previous ‘Meta’ Ruckus..
Anatomy of a Confidence Trick
Auntie Psychiatry June 21, 2018 at 1:09 pm
“Kate Adlington, suggests that much of the media coverage of The Lancet’s antidepressant network meta-analysis was insufficiently nuanced…”
This makes me so angry! There can be no doubt that all media coverage was very carefully orchestrated by the Royal College of Psychiatrists via the Science Media Centre. Professor Sir Simon Wessely is conveniently on the Board of Trustees of this shady “charity”.
In fact, the journalists in the mainstream media did a pretty good job of accurately reporting what was fed to them by the lead authors of the study and other high-profile, media savvy psychiatrists. They were out in force and all dutifully on message with the line “antidepressants work, and more people would benefit from treatment for depression…”
Here it is again…
1. Lead researcher Dr Andrea Cipriani, from the University of Oxford, told the BBC: “This study is the final answer to a long-standing controversy about whether anti-depressants work for depression… I think this is very good news for patients and clinicians.”
2. Andrea Cipriani in The Metro: “Under-treated depression is a huge problem and we need to be aware of that. We tend to focus on over-treatment but we need to focus on this.”
3. Carmine Pariante was another one on our screens:
“This meta-analysis finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression.”
4. “Good news… antidepressants do work and, for most people, the side-effects are worth it.” Allan Young
5. “It puts to bed the idea that antidepressants don’t work – all 21 antidepressants were more effective than placebo at treating depression”. Prof Anthony Cleare
Then there was the “million more” claim:
6. John Geddes, professor of epidemiological psychiatry at Oxford University, who worked on the study, told The Guardian: ‘It is likely that at least one million more people per year should have access to effective treatment for depression, either drugs or psychotherapy.’
This was accurately reported via the Press Association as…
“It has been suggested a million more people per year in the UK should be given access to treatment for depression, through either drugs or talking therapies, with scientists saying the study proves drugs do work.”
7. The Raconteur:
John Geddes: Only one in six people with depression receive effective treatment with GPs “squeamish” to prescribe medication for mental health conditions.
Pariante: We have a wealth of evidence that antidepressants do a good job for some people, and there are a lot of people who could benefit from them and now will.
“Such broad-brush headlines and content do not accurately reflect the study’s scope and results, Adlington contends…”
But this was NOT media spin – it was deliberately put out there by Psychiatry’s PR machine.
Thanks for that collection! Telling.
Head To Head
Covid-19: Should doctors recommend treatments and vaccines when full data are not publicly available?
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3260 (Published 24 August 2020)
Cite this as: BMJ 2020;370:m3260
Raymond M Johnson, associate professor of medicine (infectious diseases)1, Peter Doshi, associate professor2, David Healy, professor3
This week’s poll
Covid-19: Should doctors recommend treatments and vaccines when full data are not publicly available?
No 79.67% (1,489 votes)
Yes 20.33% (380 votes)
So now dear doctors put your votes into practice – even take the trouble to put a response in your name in reply to the article in thebmj so that those who consult you will be reassured ou have their best interests in mind , especially when payments for this years’ vaccines are in the pipeline. You might also start some action yourselves to put the message of the article in the public domain ie We won’t start jabbing any one without the evidence we can give people in writing and with evidence of their informed consent
“What you resist not only persists, but will grow in size.” – Carl Jung
Cipriani is just doubling down, it’s more of a middle finger to the resistors than actual evidential science. He’s not the only one, others have done it before him, although they were highly paid by the drug companies, Keller, Nemeroff, Biederman spring to mind.
This is what we all face as we become part of the resistance ~ the propaganda machine (Science Media Centre, paid KOLs and mainstream media) continually churn out the same outcomes.
Look at history.
In the 1960’s the KGB ran a series of psychological experiments. They learned that if you bombarded human subjects with fear messages non-stop, by the end of two months most of the subjects became brainwashed and believed the false message, to the point that no amount of clear (truthful) information they were shown would change their minds.
The chemical imbalance is a classic example of this. It’s still touted today by some celebrities, general practitioners and the field of psychiatry, the latter, despite their protestations, being responsible for its dissemination.
Most mainstream headlines are duplicated in Google searches. Whereas years ago one newspaper would have an exclusive story, today is different as we see numerous media outlets copying and pasting from one another – this doubles-down the message and relates to what the KGB did back in the sixties.
All drug company driven, of course.
Do you have a source for this experiment?
I think the last part of your comment re:- ‘jabbing consent’ will show us very clearly where we stand here in the UK and possibly elsewhere too. Generally, people think that anything offered as a vaccination is truly for their benefit. However, I’m not sure that that rings so true as far as this epidemic is concerned. I’m afraid that we are slowly separating into ‘old’ and ‘young’ in all aspects of dealing with the virus. The ‘old’ have suffered the loss of so many friends in the last few months that they, I feel, will quite willingly take up the offer of being vaccinated. The young, on the other hand, are now, quite suddenly, having the finger pointed at them as being the ones who are “not keeping to the rules” and I think that it will be found that they will not be as compliant when it comes to the jab. They are quite astounded that they are now in the blame game’s frontline and will show their discontent by walking away from the vaccination.
As for ‘informed consent’, who are we to believe? Trust in the government is very low – so many u-turns have killed whatever trust there was six months ago. Can we trust the scientists? Many probably would prefer to give them their trust but will feel the ‘rush for a vaccine’ and trust will wane there too.
Will there be a choice at all or are we talking compulsory vaccination here? My fear is that the reality may well be that either it will be compulsory for all or that for the ‘young’ it will be compulsory for fear that, otherwise, they’ll infect the ‘old’. Whichever way the cookie crumbles I fear that we’re in for a “winter of discontent” the likes of which we’ve never seen before. The young will rebel whichever way things go and THAT will create scenes that will shock us all.
Hasn’t all of this happened at a convenient time though? Brexit is now on no one’s lips; even young children are now playing ” hunt the virus” on their return to school. Covid has got us all under its spell!
Michael P. Hengartner, PhD
Pfizer, the manufacturer of sertraline, even dared to misattribute suicidal events during the lead-in phase as placebo-events, thus biasing the risk against placebo
Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment. For suicidality venlafaxine was associated with risk in people with depression and sertraline with risk in those with anxiety.
Agree. I don’t really understand why one antidepressant should be more likely than another to increase suicidality. Good to see a review though.
Michael P. Hengartner, PhD
Yeah, but that‘s just half the story.
When the whole class of SSRIs have varying degrees of propensity to cause Suicidality and each SSRI has been examined at length, here there and everywhere, and the entire UK Seroxat Class Action was based on Paroxetine being ‘worst in class’ isn’t it a wonder how then each psychiatrist and general practitioner makes a decision every day as to which SSRI to prescribe to their patient…
Spread it – to all Departments…
Weelll … it’s at least possible that Prozac is *somewhat* less detrimental to troubled kids than Paxil or Effexor. But that’s a lot like saying prescription Adderall is less dangerous than the crystal meth your neighbor cooks up in his bathroom sink. Should you rush to put more patients on Adderall, then? Or should you think about the fact that they are both amphetamines, and check to see whether some of the damage suffered by meth addicts is also being visited on your Adderall patients?
You might also remember that both drugs are “efficacious” in a way: Meth might even help you lose weight and cram for your school exams, thus increasing your scores on a self-esteem scale! At least in the short term. Just like Adderall. But a year or two on meth, of course, will lay waste to your schoolwork, your looks AND your outlook on life. So if you find after a year or two on Adderall that your kid’s “improved grades” have long since disappeared, and his mood and behavior are as dysfunctional as ever if not more so? Don’t be surprised.
This is one reason why clinical trials concentrate heavily on the short-term. And why so many “long-term” trials are confined to the people from the short-term trial who really liked the drug … and are nonetheless riddled with drop-outs. And why they almost always measure “success” with a rating scale rather than a concrete result (such as going back to school or work).
Michael H is described as a guest associate editor but In the massively detailed document I can’t spot the imperative to publish if two reviewers recommend Have I missed it?
Frontiers was founded by scientists to make peer-review constructive, to bring the best technology to the service of the authors and editors, and to ensure that the active researchers within the field shape the direction of science, not publishers.
In Frontiers, decisions on publication are decided by an external Editorial Board that is not financially incentivized to accept articles. This ensures an independence between the publisher’s responsibility to grow and promote the Frontiers journals and the responsibility of the external editors to shape the direction of research.
Frontiers distributes editorial responsibility to the entire Editorial Board. Review Editors are empowered by directly interacting with the authors in the Collaborative Review Forum; Associate Editors are empowered to accept articles; Chief Editors are empowered to enhance the integrity of peer review………………….for umpteen pages
A history of Frontieron Wikipedia shows some pretty unpleasant shenanigans
not meaning to blame any individuals, Michael, much less you – its a culture which all academics have to sign up to to some degree
Michael P. Hengartner, PhD
I am not oblivious of this (I was the editor), but denying acceptance of such an article would mean to deny the most part of clinical research and calling into question the whole foundation of evidence-based medicine, including NICE, Cochrane and so on. So what choice did I have?
‘Sign up’ to ‘Cochrane’?
Rewarding the Companies That Cheated the Most in Antidepressant Trials
— is that the companies have deliberately concealed many cases of suicide and suicide attempts in their trials and in their reports to the drug regulators. In many cases, this has amounted to fraud.
The Review on Antidepressant Withdrawal That Cochrane Won’t Publish
Peter Gøtzsche and Anders Sørensen on trying to get a review of methods for safe antidepressant withdrawal published in Cochrane: “They sent us on a mission that was impossible to accomplish” to “protect the psychiatric guild.”
19 September. Tom Jefferson: The Crucifixion of Brother Peter.
‘Sign up’ to a ‘Culture’?
NICE Guidelines are Junk.
‘calling into question the whole foundation of evidence-based medicine, including NICE, Cochrane and so on. So what choice did I have?
He made the bomb then couldn’t prevent what he knew was going to happen =and blew innocent Japanese to a hideous death and maimed lives . Those who know they are promoting publications with lack of scientific evidence (as Michael H and Joanna M seem to admit) are as guilty as hell of causing uncountable numbers of deaths and ruined lives. What could they do? Not work for such as Frontiers , Cochrane or NICE for a start. and Stop claiming to be critical psychiatrists .There are 184 Associate Editors of Frontiers of Public mental Health – they all have other jobs. Is the tainted kudos worth it?
Many of them are involved in carrying out research and teaching of the next generation of health workers – -who will sacrifice lives for lies
Storyville On channel4 TV
The Trials of Oppenheimer
J Robert Oppenheimer was one of the most celebrated scientists of his generation. Shy, arrogant and brilliant, he is best known as the man that led the Manhattan Project to spectacular success.
As the years progressed he also grew into a scientific statesman, leading a government agency, the Atomic Energy Commission, which was trying to develop ways to avoid a nuclear arms race. His attempts at politics, though, were a lot less successful than his scientific endeavours. As he grew more powerful, he started to make serious enemies amongst the establishment, particularly a friend of President Truman’s – Lewis Strauss.
it is a film that, ….. tells us a lot about the perils of mixing science and government.
Duration89 minsFirst shown9pm 15 Jul 2009
Thom Lehrer’s memorable: ‘Poisoning Pigeons in The Park’ – also seems relevant to the widespread promotion of those psychotropic drugs that induced AKATHISIA; and which have so terribly injured, and/or destroyed our beautiful children.
“We’ll murder them all between laughter and merriment, except for the few we take home to experiment. My pulse will be quickening with each drop of strychnine – it just takes a smidgeon – to poison a pigeon in the park”.
Great tune, brilliant piano accompaniment, better science?
The Spanish one is the best, including the title. “Harms are not reported in the published literature and it appears that they are not properly reported in clinical study reports that go to the regulators and form the basis of decisions about licensing.”
“The strategy aims to dispel the myths around suicide, including the suggestion that most happen suddenly and without warning.”
Suicides: Plan revealed to reduce number of deaths
Spotlight on the Suicides: The Politicians
This Continues the Spotlight on the Suicides series.
Astonished by the conclusion of Stephen O’Neill’s inquest, I wrote to Northern Ireland’s Deputy First Minister, copied to the Ministers of Health in Ireland, Simon Harris, in Wales Vaughan Gething, and in England Matt Hancock, along with the Danish MEP, Margrete Auken, the European Ombudsman, Emily O’Reilly and Martina Anderson, a Northern Irish MEP.
I hear its a great read!
There was a long documentary today – also a vimeo if anyone can bring it up?
Documentary OPIOIDS, INC. tells the story of Insys Therapeutics – a drug company that bribed doctors and committed insurance fraud as its Wall Street investors looked the other way.
Insys Therapeutics profited from Subsys, a fentanyl-based painkiller up to 100 times stronger than morphine, by targeting high-prescribing doctors and nurse practitioners known within the company as “whales,” misleading insurers, and holding contests for the sales team.
However, the scheme fell apart as federal prosecutors used the same anti-racketeering laws designed to fight organised crime, with Insys Therapeutics becoming the first pharmaceutical company to have its top executives sentenced to prison. A year in the making, discover the inside story of how big drug companies have fuelled America’s opioid addiction endemic.
Fabulous review of some stellar scholarship on the perniciousness of Ghost Managed medicine
Ghost-managed medicine: Big Pharma’s invisible hands,
Review by Jonathan Jureidini
It is hard to understand the failure of intelligent well-educated doctors to recognise that if something is too good to be true, it probably isn’t. KOLs manage to turn a blind eye to the way in which they are being exploited. As the late Mickey Nardo (See: http://1boringoldman.com/index.php/2012/12/21/hide-and-go-seek/) wrote: “It’s always funny when small children try to play hide-and-go-seek by covering their eyes, but when grown-ups do it, it loses its charm.”
Ghost-managed medicine is an antidote to such childish behaviour.
Sooner or later, this whole tawdy saga is going to find its way out of the blogs and courtrooms and into the full light of day. And the question that’s going to be asked is why didn’t Medicine itself deal with the problem? Why didn’t the Journal itself retract the misinformation once they knew about it? Why didn’t the industry sponsor itself call for the retraction as part of their settlement with the DOJ? What possible reasonable reason could there be for leaving a paper that is a lie in their journal without even an expression of concern, much less a retraction? And there aren’t going to be any believable answers.
S – this film is unavailable, just a wee trailer …
The Surgisphere Scandal: What Went Wrong?
The Surgisphere Scandal: What Went Wrong?
The high-profile retractions of two COVID-19 studies stunned the scientific community earlier this year and prompted calls for reviews of how science is conducted, published, and acted upon. The warning signs had been there all along.
Oct 1, 2020
ABOVE: © ISTOCK.COM, UNIT-POLOSKUN
It sounds absurd that an obscure US company with a hastily constructed website could have driven international health policy and brought major clinical trials to a halt within the span of a few weeks. Yet that’s what happened earlier this year, when Illinois-based Surgisphere Corporation began a publishing spree that would trigger one of the largest scientific scandals of the COVID-19 pandemic to date.
At the heart of the deception was a paper published in The Lancet on May 22 that suggested hydroxychloroquine, an antimalarial drug prom
329 Lullaby, Stevie Lewis… Bloody brilliant, some astute, clever lyrics, also a plug for Children of the Cure, Bravo Stevie,… Bravo all brave dissenters,….. X