Editorial Note: Aberystwyth on the West Coast of Wales is one of the best places in the world to see starlings murmurate. Clive King from the Computer Science Department there also organises TedX talks and on November 24 convened a panel of speakers to talk about murmurating swallows, ambivalent motherhood and making medicines safer among other things.
The full set of talks is HERE – they were all fascinating. Ambivalent Motherhood was compelling. My talk on making medicines safer – or healthcare climate change – is HERE. The text is below.
The Greatest Failing in Healthcare
Two years ago, when Jeremy Hunt was Britain’s Minister of Health, he said that children’s Mental Health Services were the greatest failure of Britain’s National Health Service.
Back then and even more so now there was a range of articles and programs about university students committing suicide at unprecedented rates, distressed teenagers in schools given antidepressants because of difficulties accessing Mental Health Services, and this week a quarter of young women in Britain were reported to have a mental health problem.
This is not just happening in the UK. There are comparable articles and programs about the same issues from New Zealand to the United States.
The old media put forward the new social media as an explanation for what is going on. This looks like a new plus new makes five answer – you must remember the old media hate the new media.
What I hear from non-media people most often is we have become a quick fix culture. I think there is something to this. But I’ve struggled with the idea of what a quick fix is.
A Quick Fix
President Trump came to my aid on this recently when he said after a school shooting ‘why not put a good guy with a gun into every school?’ For many people this sounds crazy but no-one had an answer to his follow-up challenge – “Well if a good guy with a gun isn’t going to solve the problem, why do we have good guys with guns in front of the White House?”
Guns work. They’re a fix but multiplying guns and putting them into too many situations – like schools – sounds like a recipe for disaster.
Medicines are like guns. They are poisons that can fix some things but multiplied up too much and used too widely they can also do more harm than good.
Especially when the information about medicines is fake information….
Most of you have heard about ghost writers. Donald Trump’s book The Art of the Deal is very famously ghost written. We link ghostwriting to footballers and film stars, Tony Blair perhaps but Gordon Brown’s book seems less likely to have been ghosted.
We tend to think brainy people don’t need ghostwriters. Think again.
The greatest concentration of ghost writing on earth centres on the drugs your doctor gives you. Since 1989, when Prozac came on the market, almost every article in the best medical journals that has anything to do with pharmaceuticals has been ghost written. The people whose names are on these articles aren’t the authors.
The ghosts are smart women with PhDs who are better writers than most doctors – so this might not be a problem if the ghosts and the rest of us had access to the underlying trial data.
But the ghosts don’t. And we don’t. No one has access to the data. FDA who approve drugs in the USA don’t have access. MHRA who approve them here don’t have access.
So what do the nice people who write the NICE guidelines which dictate which heart medicines, or gut medicines, or antidepressants your doctor gives you base their views on?
Well – they work from ghost written articles. They have no access to the data.
This is a tricky situation for all doctors. There used to be a gulf between the NHS, a notionally public health system, and US healthcare, which is notionally private, but there is less and less difference these days – both are run by managers whose number one task is ensure doctors keep to the guidelines. This is not being done for your good – it’s being done in case you are killed or injured when if everyone keeps to the guidelines the organisation and the managers are fine. No-one cares about you.
If any issue comes up in the public domain about some drug, the response from politicians is that everything would be fine if doctors just kept to the guidelines.
All these people are looking at a rotten apple in a barrel problem. But you and I face a rotten barrel problem.
The greatest threat to you now comes from a doctor who keeps to the guidelines rather than one who doesn’t. And the “good” doctor who keeps to the guidelines is entirely in the pocket of the pharmaceutical companies – even though they haven’t paid him a cent.
The Berlin Wall and Prozac
Now let me bring you back to 1989 and the fall of the Berlin Wall.
Prozac came on the market that year – the first of a new generation of antidepressants that we call the SSRIs. These were hyped as the drugs that were going to make you better than well. Help you transition from the old you to a new and better you.
The contrast between these miracle drugs and say – the antihistamines – was extraordinary. No-one thinks antihistamines are miracle drugs. They do minor things and can cause more problems than they are worth. But Prozac and the other SSRIs are just antihistamines. The SSRIs were inferior to older antidepressants.
The hype about the miracles SSRIs produce and their freedom from harms was only possible because nobody could see the data from SSRI clinical trials. The data shows these drugs can make you suicidal, and homicidal. 80% of people get hooked to them. They can wipe out your sex life and it can remain wiped out decades after you stop if you were able to stop – these problems were all concealed.
SSRIs and Children
The drugs came on the market for adults but they began to be used for children on the back of reports from doctors claiming they worked wonders for children also.
We do clinical trials to curb the sometimes paid for enthusiasms doctors have. If the trial is negative we don’t use the drug. Well 30 trials have now been done in children – all negative. There is a doubling or tripling of suicidal events in the children on treatment compared with the children not on treatment in these trials. This is the greatest volume of negative trials for any treatment of any condition in recorded history.
What’s happened the sales of SSRIs – well aside from oral contraceptives, these drugs are now the most commonly used drugs by teenage girls and their use is exploding. Up to 50% of university students in the US are on these or related drugs. The people who take the most are trainee doctors – the people you depend on not to turn to a quick fix for your problems.
How did this happen? Well while the trials are negative, the ghostwritten articles say the drugs work wonderfully well and are safe.
But one more thing – before the ghosting and lack of access to data accidentally came to light, Prozac had already been approved for use in young people in the US and here. Now for a drug to be approved trials have to show it worked. MHRA and FDA knew there were no trials showing Prozac worked – there are more negative trials for Prozac than for any other drug. But they approved it.
NICE Guidelines recommend the use of Prozac for teenagers and young people even though NICE know there are no positive trials for Prozac.
These approvals and the ghosted articles have led to the explosion of use of these drugs in young people. Water flows down even a hint of a gradient – unless there is a bump in the way. What ghostwriters do is they smooth out the bumps so that your doctor has no hint there is anything there.
What I am saying about antidepressants applies to any drug you are on.
Poly-Fix
Through to about 1989 you were on only one drug and for a short time – an antibiotic for a few weeks.
Now 50% of people over the age of 45 are on 3 or more drugs every day of the year; 50% of people over the age of 65 are on 5 or more drugs. Guidelines mean that every year you live the number of drugs you are on will increase – many of us over 70 are on 10-15 drugs a day.
The companies who sell these drugs aren’t about making you better than well – they’re about making drug sales better than good – they want to transition their drugs from poisons into sacraments.
Sacraments are a quick fix. Poisons are not. Poison may sound like a strong word – but a medicine is a chemical plus information. The chemicals are always risky. The information is key to controlling those risks.
Donald Trump brought us Fake News. The old media imply only stupid people believe Fake News – but steer clear of the fact that doctors have been living on a diet of Fake News for 30 years.
It used to be said the magic of medicine is about bringing good out of the use of a poison. In order to bring good out of the use of poison, both you and I need to know all the risks that go with this poison, especially if you’re on 3, 4 or 5 drugs.
One of the creators of modern medicine was Philippe Pinel who was famous for saying that a Fix is great but its often more important to know when not to use that Fix.
Modern medicine began with Pinel 200 years ago, since when your life expectancy has increased year on year.
As of two years ago in the Western world it began to fall. We now expect you to die earlier than we expected two years ago.
Linked into this fall, there is a change in the climate of healthcare. Healthcare is now addicted to the idea our drugs work well and are free of harm and are a quicker and cheaper fix than have someone help tackle your problems in the least risky way.
When you hear talk about changing climates most of us think about global climate change. We can’t yet see the sea level rising but if you look online you can see you are more likely to die earlier now than we thought you would a few years ago.
Climate Change
It is very difficult for any of us to do much about global climate change – but each of us can do something about the climate in healthcare. To borrow a phrase from the pharmaceutical industry, Ask your doctor… if it would be a good idea for you and her to have access to the data on any drug she wants to put you on.
This will be a scary moment for you and for her. You will both sense the power of those interests who would prefer things stay as they are. But if you stand your ground you will not only reverse changes in the healthcare climate you may do something about global climate change too which is being driven by the same forces.
Ask an older relative or friend in a care-home or wherever how many drugs they are on – a lot are on 10 or 15 quick fixes. There is good evidence that reducing this to 5 or less adds years to their life, makes them less likely to be admitted to hospital and in many cases can bring about something close to a rebirth.
Faced with escalating healthcare costs, our politicians blame the elderly – we have no option but to throw more and more treatment at them. They make it sound like Care. But it’s not. They are throwing quick fixes at them that make the problem worse – just as we are doing with our children.
In this Simpson’s cartoon a downbeat Bart says: “This is the worst day of my life”. He looks like he needs a quick fix – an antidepressant.
Homer intervenes saying “No. This is the worst day of your life so far”.
This black humor points to something we have lost and need to regain. Regaining it needs more than listening to a talk like this, some of you need to go out and Ask your Doctor if accessing the data is good for you, for her and for us….
This is a brilliant ‘talk’, parts of which I am now hearing or reading for the third time. We all know parts of what is said here but I think it’s the ‘putting it all together’ that finally brings it all into the real world.
I cannot make any comment as to how many will be influenced by their reading of it here. Having listened to it in Cardiff, I can only assume that it went down quite well there, going by the comments that we’ve seen since the whole day appeared on social media etc.
My greatest sense of what CAN be achieved by listening to this came from David’s visit to our group in Prestatyn (North Wales), as guest speaker, in the hope of attracting more to our withdrawal group there.
In his own spectacular way, he involved his audience – nearly 50 of us – by questioning and then introducing a variety of the above facts in his explanations when correcting their flawed understanding of British ‘healthcare’. People were shocked, there was some ‘tut tutting’ and shaking of heads in disbelief BUT – they are STILL talking about that evening in early December. One person has withdrawn from her painkiller and has spread the word of its dangers to her Practice Nurse. She also refused to see her GP to report the withdrawal as she knew he’d only push a prescription for some other pain relief her way! Another has looked closely into her grandson’s medication and shared the ‘horror story’ with her daughter. Yet another has been looking into the likelihood of a link between her relative’s medication and their offspring’s autistic spectrum difficulties. We don’t seem to be any nearer to having more attending our group as yet but, to my mind, getting the general public to understand and believe what is going on is AN IMPORTANT FIRST STEP. Without those lucky enough to be untouched by adverse reactions to these drugs on our side, we are a lost cause.
David is now asking us to tackle our GPs about the hidden data. If, like me, you rarely see your GP or any other doctor, maybe it’s our duty to print copies of this post and distribute them far and wide. Without having this knowledge we cannot expect those in our communities to stand with us against the wrongs that we have already witnessed. Maybe they have heard the story of our ‘lived experience’ of the problems and have thought of us as being the ‘unlucky ones’. Hearing or reading the facts in this post brings home the reality of the situation – not only can it happen to any one of us BUT IT HAS ALREADY HAPPENED to a huge percentage of the population.
David,
A well constructed fact-based argument.
I focus on just one of many issues you raise – SSRIs [anti-depressants] cause suicide in teenagers, 30 clinical trials prove they don’t work at all in teenagers but are now commonly prescribed to teenage girls. They also cause thoughts of self-harm and provoke it and have been linked to homicides [including in some leading legal cases in the USA].
The problem is political. Why do politicians allow this to go on? It does not matter which party is in Government, the corruption in the Department of Health and other government agencies like the MHRA continues.
The same civil servants remain in post advising Ministers and those Ministers continue to facilitate what is properly described as corruption in the full breadth of meaning that word connotes. The new civil servants who take over continue their predecessors’ legacies.
You exposed the problem of antidepressants [SSRIs] many years ago. The problem persists.
Charles Medawar in his time running Social Audit also spent decades fighting for recognition that Seroxat [an SSRI] causes withdrawal symptoms which are so bad the drug is addictive. Three Panorama documentaries later it remains on the market many years later with belatedly a few words added to many others provided with the product to refer to the problem.
If we remain in the EU the problem will become far worse with little prospect of tackling it politically. It has not been addressed with our government. Imagine how much more difficult it all is with 27 EU States dictated to by Brussels bureaucrats. It is a recipe for corporates with the funds to lobby holding sway over Europe in much the same way they do so now in the USA.
In addition the old media has been corrupted with the same journalists pushing out the same lines thereby maintaining what has become an ineffective sold out fourth estate.
In short, political checks and balances are gone. Democratic systems cannot function without an effective fourth estate to inform the electors and with politicians who are easily bought with currency as inexpensive as getting favourable media coverage [and avoiding unfavourable] plus other relatively trivial benefits in kind.
It is unsurprising corporate USA always promotes democracy internationally – it is the easiest political system to manipulate for those with the money to do so.
Thank you for your excellent comment, Mr. Miller.
If the local post office had not have installed a Computer for public use, Charles Medawar would have been lost to me around 2002.
The Secrets of Seroxat in 2003 enabled me to explain to a luckily new young psychiatrist the details and if it wasn’t for this, she would not have gone out of her way to design the year long withdrawal with liquid Paroxetine – thereby quelling the rather unsophisticated treatment of the unfortunate year before..
You make some sound points.
The reason why the government won’t do anything about Pharmaceutical companies behaving badly is because companies like GSK are major cash cows for the UK economy. Yes, they commit fraud, they bribe, they produce some dodgy drugs like Seroxat that harm people, and they get away with it. This is not even hidden anymore, it’s blatant, in your face -corruption and deception. The cash cows like GSK are the top of the capitalist food chain, and we mere mortals cannot cause a dent in these greedy Goliaths because there is an economic imperative to make sure that GSK thrive.
You hurt the cash cow then you hurt the economy. The cash cows are protected. Many of the members of the house of Lords in the UK have shares in Pharma’s such as GSK. The CEO’s of these companies are often in direct contact- not just with government- but with the prime minister. Andrew Witty met and greeted the queen, and was on David Cameron’s business council, and you can bet that if the house of lords have their fingers in the GSK Pharma pie then perhaps some of the royal family assets are held in companies that also hold shares in GSK. Many pension funds and large finance companies in the UK also hold GSK shares. In fact there are several hundred financial asset holding companies that own GSK shares. The company is wedded to the economic fabric of the UK, it’s one its economic pillars. It is permitted to operate above the law because of this. GSK also creates a lot of jobs for UK workers, in various industries, from science to research etc. Pharma is a golden goose, nobody in the UK of any political sway would dare to kick the golden goose….
Many of the members of the house of Lords in the UK have shares in Pharma’s such as GSK.
https://truthman30.wordpress.com/2017/11/25/conflicts-of-interest-revolving-doors-and-the-british-lords-and-peers-with-shares-in-gsk-and-other-pharmaceutical-companies/
https://www.thecanary.co/discovery/health/2017/11/09/distracted-government-just-gave-another-top-job-one-big-business-buddies/
“….On Wednesday 8 November Theresa May’s government quietly made a new appointment to its ranks. But far from being an independent adviser, the person has come straight from one of the largest corporations on the planet. And to make matters worse, it is the second government appointment from this company in the space of a week.
The government’s latest crony
The government has made Dr. Patrick Vallance its new Chief Scientific Adviser.
But Vallance’s CV offers another reason for his appointment. Because he is currently President of Research and Development (R&D) at pharmaceutical giant GlaxoSmithKline (GSK); having joined the multinational in 2006, he was appointed to its Board in January. And Vallance is the second government appointment from GSK in the space of a week.
Oh! You as well?
On 3 November, Sir Andrew Witty received the appointment of Chair of the NHS’ new Accelerated Access Collaborative, a programme designed to “speed up the time it takes for patients to benefit from ground-breaking products”. The programme will accelerate the time it takes new drugs to get from laboratories like GSK’s to the NHS. Witty was CEO of GSK from 2008 until March this year, and he now sits as a Director of private healthcare company UnitedHealth. UnitedHealth was NHS England boss Simon Steven’s former employer.
Both appointments come at a time when GSK is supposedly refocusing on R&D. As This Is Money reported, its new Chair Emma Walmsley:
….is spearheading efforts to cut costs and concentrate on research into new drugs. Glaxo has lagged behind competitors in developing so-called ‘blockbusters’…
A history of controversy
But GSK has a history of controversy. As Martin Williams notes in his book Parliament Ltd [p28]:
In 2012 the drugs giant admitted bribing doctors and encouraging the use of unsustainable antidepressants for children. In the largest fraud settlement in US history, GSK agreed to pay out £1.9bn.
And as he also pointed out [p28]:
However, sixteen [House of Lords] peers still have a stake in the company, worth a minimum combined total of £800,000.
I’ve already covered some of this ground with my “Creepy Corporate Capture Our Culture’ Post, but as I mentioned in that post- the revolving doors of GSK and the UK government are the tip of the iceberg. When it comes to just how much this coporate takeover of our lives is undermining democracy and the rights of the public, consumers, and patients, GSK and the pharmaceutical industry are at the forefront of this disturbing trend.
If you’ve ever wondered why GlaxoSmithKline gets away with its abuse of corporate power (particularly in the UK), and its consistent harm to patents and consumers with dodgy drugs (like Seroxat), you need look no further than the declared interests of the United Kingdom’s House Of Lords.
Most of the members of the house of Lords have shares in pharmaceuticals or health care companies; including of course- many with shares in Glaxo. The house of Lords has the power to amend or reject bills that pass through the UK parliamentary system, and the individual members themselves usually have a lot of political, business and social clout in UK society. The Lords might not have the power to govern directly with their limited powers in the House, however they still have a lot of sway. Their inherited peerage is in itself -symbolic- of the power that they hold from birth in the UK.
According to an article (quoted above) from the Canary website- the combined shares in GSK, declared by the UK peers in the house of lords amounts to 800,000 pounds (in 2012), however this is – again- the tip of the iceberg….
Read the (over 1000) blog posts I have correlated over ten years and feel your jaw drop at the shocking behavior of GSK over the past ten years…
With the backing of such wealthy and powerful government figures, and institutions, is it no wonder that GSK operate above the law?
It’s the ideology of Corporate Capitalism intersecting with the ideology of Faith in Medicine (without access to the data or even caring that it’s unavailable). Anything’s worth a try, but in my experience “ask your doctor” really only works if you ask what you’re supposed to according to the entrenched ideology. The last time I brought it up (RxISK/PSSD) the doctor was nice enough but still acted like I was talking about flying saucers. Only Stephen King could have thought up a worse nightmare.
In regards to GSK and influence, see this article by John Stone, and comments:
Pollard Tyrannos: Another Power Bid from the Vaccine Lobby – Some Real News: https://www.ageofautism.com/2017/09/pollard-tyrannos-another-power-bid-from-the-vaccine-lobby-some-real-news.html
In regards to GSK and vaccines, you can be sure that they are being less than economical with the truth about side effect profiles of their vaccines as much as they are with some of their other products. I don’t have a huge understanding of the vaccine stuff, however from what I do know, it seems that Pharma, with the backing of the medical community-at large- sees the odd death or disablement from the vaccines- as merely collateral damage. It’s the greater good theory….
Vaccines are the grail of medicine, they are highly valued as nothing short of miraculous. If you criticize the vaccines you commit medical blasphemy, and the medical community doesn’t like that…
Thank you very much for your efforts to inform all of us, Dr. Healy. These ideas are also presented by Dr. Aseem Malholtra in his video “Killing for Profit”, and many other scientists. In my work with chronically ill patients who are prescribed multiple medications, some up to 3 antidepressants, I been learning about the role of deficiencies of micro nutrients required for healthy neurologic function. With our massive agricultural practices depleting soil and food processing that destroys many nutrients, it seems that we all may be suffering from starving brains. How is this idea viewed in patient treatment, when we do not assess or test for these deficiencies? How can anyone with deficiencies recover if it is not addressed? This is not just about life style and food choices, as it is very hard to find truly healthy foods in our great industrialized nations. Food industries focus on profits at any cost, just as the drug companies. It is my understanding that medical education, especially here in the US, does not teach nutrition; it is considered an optional elective, per the AMA. Do psychiatrists even consider malnutrition as and underlying cause of distress?
Correction – our meeting was early NOVEMBER which is far more surprising that it’s still talked about than if it had been December as I stated above!
I don’t really understand how the ghosts operate…Are they directly employed by the pharma companies? Are they sent the data and told what the message needs to be? They are obviously ‘clever’ people so must know what they write is fraudalent? Is there a pool of them acting like a guild with obligations to keep shtum? Has there ever been a ghostly whistleblower? Do they publish under different names? Or their own names?
Is there any other profession which has a better record on revealing research data? (bearing in mind there will be corruption anywhere)
Am thinking of vets – who are as knowledgeable as clinicians and also rely on good info about drugs and devices..
Maybe some of them could be persuaded to help with re-researching and publishing data on prescribed drugs – by pass NICE and the ghosts.
It wouldn’t be considered acceptable by regulators and controllers but it couldn’t be ignored.
You ask some interesting questions here Susanne. As far as vets are concerned, my son found them to be absolutely open about the ‘products’ that they use when his dog had to undergo intense treatment a few months back. The dog had to be sedated for them to work on its ear infection, the dog had a seizure but recovered. The vet’s first words, when our son went to the surgery, (following a concerned phone call from the Surgery) were “The drugs that we used to sedate him caused him to have the seizure but we’ve managed to stabilize him now”. Would you get that from your GP or a consultant I wonder?
David,
Further to my prior comment there is another aspect to the corruption in healthcare. It is the suppression of adverse reaction reports [Yellow Card data].
I published details with references to source data in a series of three British Medical Journal rapid responses [1].
The MHRA processes the reports so that the underlying conditions suffered by the victims are rendered unidentifiable. This is in addition to ensuring no reports are properly investigated.
In other words the MHRA renders adverse reaction reports useless.
The examples I used to demonstrate this were the MHRA’s published analyses of adverse reaction reports to Pandemrix vaccine and to the HPV vaccine.
Pandemrix vaccine caused around 1000 known acknowledged cases of narcolepsy and cataplexy in children [and one assumes more which have not been acknowledged] across Europe.
[1] Re: A tale of two vaccines – MHRA Had 178 Pandemrix Altered Consciousness Adverse Event Reports in 67 Days
https://www.bmj.com/content/363/bmj.k4152/rr-23
[This response contains links to the prior two responses].
Restoring Study 329, a transparent experience of ghostwriting…
For those unversed in these issues, journal editors, medical writing companies and academic authors cling to a figleaf that if the medical writers name is mentioned somewhere, s/he is not a ghost. But for many, the presence on the authorship line of names that have never had access to the data and who cannot stand over the claims made other than by assertion is what’s ghostly.
Martin Keller et al
Letter and Response
https://davidhealy.org/study-329-mk-hk-sk-and-gsk/
Coffee and Data
https://study329.org/rewrite-team/healy-dh/
Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescenc
30 Responses
https://www.bmj.com/content/351/bmj.h4320/rapid-responses
paxil study 352 – what’s ghost-writing?
Posted on Tuesday 27 November 2012
But I thought I’d weigh in on the “what’s ghost-writing?” question before continuing to try to parse this clinical trial and article further.
http://1boringoldman.com/index.php/2012/11/27/paxil-study-352-whats-ghost-writing/
This is the point where my daughter might say, “This is why I named your blog, 1boringoldman. Who cares about an 11 year old article on an out-of-patent antidepressant?” At which point, I might respond, “I care. But hopefully I can get a few more people interested because this kind of thing is likely to happen again and again if somebody doesn’t wake up and realize how detrimental pharma driven ghost-writing and data secrecy in clinical trials can be.” She’s pretty smart, so at that point she’d likely say something wise like, “Pass the Turkey, please” or “Nice Sweater!” to divert my attention. That might work at the dinner table, but not here. This kind of scientific misbehavior has gone on far too long unchallenged, and the damage done is all around us. There’s another meaning to the word boring…
Antipsychotics Tied to Higher Risk of Death in Children
Study finds an increased risk of unexpected deaths in patients aged 5 to 24.
Christopher Lane Ph.D.
https://www.psychologytoday.com/gb/blog/side-effects/201812/antipsychotics-tied-higher-risk-death-in-children
“Long before the antidepressants were linked with akathisia,” Healy extrapolated on “Side Effects,” “the antipsychotics were universally recognized as causing this problem. It was also universally accepted that the akathisia they induce risked precipitating the patient into suicidality or violence.”
https://www.bmj.com/content/351/bmj.h4320/rr-26
In the mid-1990s, he underscored in Mania, almost half of all mood disorders were redefined as bipolar disorder rather than depression. The second-generation antipsychotics were aggressively promoted at the same time, to a greatly expanded market. Fears about SSRI-induced suicidality in children and teens would peak with the 2004 FDA decision to add a black-box warning to SSRIs, curbing pediatric prescribing, but also helping to present the atypicals as a safer alternative.
Faced with the suicidal events in Study 329, Drs Verdolini and Agius invite readers to consider the underlying neurobiology but their letter has no links to neurobiology whatsoever. It offers a series of claims regularly made by those with a mania for bipolar disorder. There is no link in these claims to biology and it is not clear that there is any clinical footing to the claims either.
For the record, healthy volunteers become suicidal on serotonin reuptake inhibitors. Are all of these bipolar? The rate of suicidal events on SSRIs in non-depressive indications is roughly the same as it is in depression – are these eating disorder and other patients all bipolar?
The rate of suicidal events on anticonvulsant supposed mood stabilizers in clinical trials of bipolar disorder is roughly double the placebo rate in the same trials – the results map onto the rates for suicidal events in antidepressant trials. It goes without saying these suicidal patients actually bipolar but offering this as an explanation would be ridiculous.
The rate of suicidal events in trials of anticonvulsants used for migraine and epilepsy is again similar to that in bipolar disorder trials – what are we to make of this.
What are we to make of the fact that the rate of suicidal events in antipsychotic trials is also roughly similar – regardless of indication?
A much more parsimonious hypothesis is that certain drugs do not suit certain individuals. We have no idea what the biology is in these cases. We do not even know why some patients on SSRIs become intensely nauseated and others do not – a much more common side effect that suicidality. To suggest that we do know what is going on by bringing bipolar disorder into the frame, a disorder whose biology remains quite opaque, is not helpful
Competing interests: As outlined in Restoring Study 329
09 December 2015
David Healy
Professor of Psychiatry
Hergest Unit, Wales LL57 2PW
In answer to Susanne’s question about ghosts….
Well, the ghost I know has a good degree in pharmacology, she works for an Agency, so not for one particular company. She writes well and is sent all over the world to prestigious conferences where she delivers papers, with very believable honest charm, to delighted audiences of doctors. She is calm, quiet, unassuming and nice. Anyone would believe her. Her family, who I know, tell me she earns a massive amount of money, a mind blowing amount. When I have tried to talk to her about various medicines and side effects, she is evasive, hidden away by her family, and anyway, her excuse always is that she goes where she is sent, by the Agency, so she is not responsible for anything.
As to this all being driven by politics, as suggested by Mr Miller, yes, of course it is. The top CEOs in management HAVE to deliver to their political masters what will win votes and keep them in power. And again, these people in management are getting eye watering amounts of money for being lackeys to government. And they are not necessarily very bright brained. They are yes men. I know, we have one in the family, and it’s been ghastly to watch his brown nosing of politicians and his slight of hand in what is really corruption. A class of overlords, self appointed, unelected, with total power, so long as we are prepared to swallow down pills given to us by ‘nice’ doctors. We have to stop allowing ourselves to swallow anything that we have not investigated and are certain is vital to sustain life; we have to wake up, take all this on board, and save ourselves. I don’t know how we can get past the brainwashing of all the others. But they are trusting doctors less and less, thanks to the Internet. Money is at the root of all this.
Prop-a-gander …
Backtracking …
Simon Wessely
@WesselyS
The authors focus on social media and gender differences in mental disorders between younger women and men, and the rise seen only in younger women. Social media cant be blamed for the majority of mental Ill health in younger people which predates this. It has pluses and minuses
Royal College of Psychiatrists
@rcpsych
Our ex-President @WesselyS says link between social media use and poor mental health hasn’t been made yet but evidence is “starting to point in that direction”. Depression in girls linked to higher use of social media | Society | The Guardian (link:
https://www.theguardian.com/society/2019/jan/04/depression-in-girls-linked-to-higher-use-of-social-media) theguardian.com/society/2019/j…
https://www.theguardian.com/society/2019/jan/04/depression-in-girls-linked-to-higher-use-of-social-media
Fortracking …
College publishes new strategic plan
https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2019/01/02/college-publishes-new-strategic-plan
Excellence in psychiatry,
High-quality, person-centred care
Strategic Plan 2019 – 20
https://www.rcpsych.ac.uk/docs/default-source/about-us/corporate-publications/strategic-plan-web-2019.pdf?sfvrsn=73f32e7e_2
aye peter …
There is absolutely no excuse for not responding to any enquiry sent to a Public/Professional Body.
The fact that this psychiatrist is known to them, makes it all the harder to rationalise the disrespect shown.
For a Royal College to behave in this manner is reprehensible.
It almost seems like a punishment and The Royal College of Psychiatrists, head honchos, who are often criticised, should be on their best behaviour at a time when they are shouting ETHICS
Update 12 January 2019: I have had no reply to this letter (sent on the 22nd December 2018):
Dear Dr Crichton, Dr James and Professor Burn,
Forgive me writing on a Saturday morning. I am aware that the “HR Department” has instructed me not to. However I am now no longer a member of the College.
I was disappointed to learn from Professor Burn that the College will not be responding to my concerns raised in my letter of resignation to Dr James on the 24th November 2018 (I have attached the original letter). Yet, at the same time concerns have been expressed by President Wendy Burn and Vice-President John Crichton about my mental health. The Vice-President has, I understand, spoken to my Medical Director about his concerns and I have now been invited to meet with him.
I noted one of the issues of concern raised by Dr Crichton in his College Blog of this month: “If ways could be found now to encourage those approaching retirement to continue to contribute to the NHS part time – not to fill gaps but in posts which make the most of their experience – that could be the start of a model of how careers might look in the future when retirement ages are later.” My experience of raising concerns with the College has led me to the stage where I am considering my future within the profession. If the College is serious about retaining experienced staff I would encourage it to reflect upon its approach to respectful behaviour in relation to College values.
I would be most grateful if the College would reconsider its decision not to respond to the concerns I raised in my original letter.
Yours kindly
Peter
https://holeousia.com/2018/11/25/my-formal-instruction-of-resignation-as-a-member-of-the-royal-college-of-psychiatrists/
“We discussed frankly about the current situation, the potential options open to him and the steps he could take in the future. Dr Gordon plans to reflect on the content of our discussion.”
20 Replies to “My formal instruction of resignation as a member of the Royal College of Psychiatrists”
An illuminating, but sadly not surprising, talk. Thank you. The abject failure to look at the data or indeed to record clinical trial findings accurately is perhaps the reason that the HPV vaccine is causing devastation amongst our children, yet nothing is being done to even look at the issue let alone stop it or help those affected. Shame on our government. How can we do a TEDx talk about that ?!
‘This is going to be a “Racey-Pacey” talk…
Ryerson University, Toronto, Canada
Can Medical Science Be Trusted if it’s Authors are Ghosts?
David Healy
March 21, 2016
https://ryecast.ryerson.ca/110/Watch/10125.aspx
Much of the apparently scientific literature on drug safety and effectiveness is ghost-written by the pharmaceutical industry, but published under the names of eminent academic researchers. Typically the research data are unavailable to experts, regulators, the legal system or the public.
David Healy will discuss what this means for the public, for patients, for doctors and for science through the story of the famous clinical trial that claimed the anti-depressant, Paxil, was safe to use for children.
David is making it clear that people themselves as well as clinicians must be asking for evidence/data about the drugs being prescribed as we cannot rely on the morality of those who regulate and provide health services.
The college of psychs has published documents which clearly show that the majority of members have no comittment to protecting the human rights of people in vulnerable positions. This includes the claim that people with capacity should continue to lose the right refuse medications including in the so called ‘community’.
Very few clinicians will know enough about the medications they prescribe yet they can over ride a person’s wish to refuse them. This would apply even if people knew from reading Rxisk and persona;l experiences of their own and those who have been harmed that there is potential for being harmed themselves.
The farcical consent process needs to be updated so that refusals are properly documented . If after refusing someone suffers adverse effects from compulsory treatments there should be consequences – the clinician should need to explain the basis on which s/he prescribed a drug, what knowledge s/he has of the data and if lack of data was expalined.. As the law is not going to change and people are being hospitalised and detained their vulnerability is not going to be protected by the use of ‘advocates; or advance directives unless they are in contact with clinicians with better personal morality than the college as a whole who will simply defend bad practice by members.
Nobody could take from the responses from the college of psychs that their human rights and their health will necessarily be protected by contact with the services.
The National User/Survivor Network has made a very critical response (on line) . They admit that the ‘user’ input was inadequate though .Other groups such as the Care Quality have made a mealy mouthed response but who respects what they think..Several of those who were asked to provide expertise resigned from the mental health review headed by Simon Wessely. Notably Suman Fernando retired psychiatrist who has campaigned about discrimination against ‘black and ethnic groups’ for decades.
Published by the college of psychiatrists 6th December:-
THE MENTAL HEALTH ACT
RcPsych RESPONDS TO THE MENTAL HEALTH ACT
links to:-
REPORT ON THE KEY THEMES FROM THE MENTAL HEALTH SURVEY (carried out by the college) re INDEPENDANT MENTAL HEALTH ACT REVIEW
This has links to:-
READ REVIEWS FINAL REPORT
READ OUR RESPONSES
READ OUR SUBMISSION TO MHA REVIEW
READ RESULTS OF MEMBERS SURVEY
The last is broken down iby links to boxes into categories eg child and adolescence/adult /addiction etc with some shocking results which are broken down into even more detail.
Complaints change doctors’ behaviour.
Views And Reviews Wounded Healer
Clare Gerada: We need a complaints code of conduct
https://www.bmj.com/content/364/bmj.l59
They become more cautious and less confident in their practice.3 Poorly handled complaints often result in dysfunctional behaviour, such as failure to disclose all events, blaming of self and others, and arguments. This hinders rather than fosters learning after a serious untoward incident or “never event” and can harm future patients, sometimes termed the secondary victims.
A serious complaint can take years to pass through the regulatory system, leaving the doctor stuck in a confusing matrix of fear, uncertainty, and anxiety.
doctors tend to “over-admit” …
and are treated with the same humanity as the patients they treat …
Wow Annie, this seems significant in terms of why we are continually brushed off.
Last complaint I made was well-worded and balanced, written and sent to a private healthcare group. It took just 4 days for the CEO to call me and say thank you for letting us know. “When something happens we want to hear about it,” he said.
Two doctors were involved and I expressed concerns about one and satisfaction with the other. CEO said both had been notified.
What accounts for the swiftness of this may be that it’s a private specialty group and that the harm was measurable. None of my other efforts have turned out like this, probably because they have been mental health medication related and “anecdotal.”
I don’t know how the feedback was handled internally. I hope they have a good system in place. But that’s not the patient’s responsibility.
That’s for sure, Laurie
There is something profoundly wrong here.
What started off reasonably chummy, with the village surgery complaints procedure, ended up with a legal gp destroying my case with the ultimate response being she had never heard of any damaging information about Seroxat.
The whole saga of a Formal complaint left me dangling in a nowhere-land, and it was hard to believe that these doctors who arrived in our village could be so hard, damaging, cold and calculating.
I think Clare Gerada needs to appreciate that the doctors, she describes, who in her opinion are going under, are generally not reflective of responses the ssri crowd are experiencing …
Her attempts might seem noble to doctors, who under extreme stress, suicide, but, to blame a patient making a perfectly reasonable complaint in order to get to the bottom of her enquiries, shows up a total disregard and unwarranted attack on the patient, and to bring in secondary patients, to boot, a somewhat naïve and oppositional approach …
Playing off the patient against the doctor, in the way she is, really, at the end of the day, shows up a rather arrogant view of the patient who is not complaining lightly.
Doctors seem to want it all ways and that is not a fair and democratic process when they have the rejection tools and the patient has only her voice …
I think we all need to look at this more closely …
“The complainant has a tried and tested framework that everyone involved—managers, clinicians, organisations—must follow. Those complained about have no similar framework.”
Thanks Annie -Maybe I missed something but Clare doesn’t suggest who would police this suggested ‘code of conduct’. She says responses are welcome and gives her twitter address – although any of the angry anti depressant and anti benzo lobbyists who respond to her twittering, don’t bother -Clare is so up upset by the ‘cruel ‘messages she receives – she is blocking them. (re wounded healer video 3/10/18) Doctors are invited to follow her on twitter (re video) to support her proposal for doctors to have exclusive access to confidential assistance separate from any regulators. (a GMC take over?) 30,000 followers already – the Wesely family is a very media savvy and so handy to have a media lead in coll of psychs
Clare who says she has had her share of complaints is member of the Institute of Group Analysis and has developed some of her work with Gwen Adshead who has described herself as a ‘distressed doctor’ – both seem to be doing very nicely though.
Gwen proposed a separate code of ethics for psychiatrists some years ago – it was rejected as too biased in favour of psychiatrists and to the disadvantage of those who consult them. The same mistake is being repeated by Clare with regard to GPs.I
They have been at this topic for at least a decade :- a few examples
re ‘Disruptive and disruptive doctors’ Personality dysfunction in doctors. The relevance of personality disorder.’
by Clare G. Martin Black.Practioner health prog. G Adshead of Broadmoor forensic psych hosp.
‘When doctors need treatment – an anthropological approach to why doctors make bad patients ‘ 2013 by Clare G and Alex Wessley Alex described only as an independant researcher.(Clare used the name of Gerada , her married name is Wessely,
GMC to introduce emotional resilience training – by Clare G adapted from work by G Adshead
and so on up to the latest wounded healer conference celebrating 10year anniversary with a song – Simon W is fond of telling people to deal with depression which is really loneliness and stress by joining a choir –
It might be an idea if the Clare Gs and Gwen A’s .could reflect a bit on whether their personal experiences are usefully influencing their advice to other practitioners – neither are doing much work with actual people in a medical sense these days. It does seem at times as though they are being disruptive rather than constructive about improving the relationship between the public and practitioners.
Tumbling Further Down the Rabbit Hole of Antidepressant Withdrawal Research
https://www.madinamerica.com/2019/01/rabbit-hole-antidepressant-withdrawal-research/
For those still interested in the recent antidepressant withdrawal debate, here is a new and important installment.
MMR safety and the rise of autism – the latest round with Dame Sally Davies, Chief Medical Officer to Her Majesty’s Government.
https://www.ageofautism.com/2019/01/confirmation-bias-and-the-united-kingdom-department-of-health.html
Scott Gottlieb, M.D.
@SGottliebFDA
Available vaccines are safe and very effective in preventing measles, which is highly contagious and can otherwise occasionally be associated with the development of pneumonia, brain damage or death. (link:
https://go.usa.gov/xE2sc) go.usa.gov/xE2sc
“Very safe” in the text, a favourite formula also once of Sir Liam Donaldson, is surely “not quite safe if we are frank” rather than simply “safe”.
Anne
As a patient, no GP, Psyche or A and E Dr has ever admitted they were wrong or mistaken.
In fact I think they may deliberately ignore what is under their noses.
Increasingly those of us suffering withdrawal, protracted withdrawal or worse
are labelled Mentally ill, having TRD or having M.U.S……..
Annie Being ignored, disbelieved, labelled and further drugged is neither humane, fair or remotely caring. ‘ First do no harm ‘ Really
BMJ Volume 326 15 March 2003
Consumers may be unaware of suicide risks associated with popular prescription drugs
https://wjla.com/features/7-on-your-side/suicide-risks-prescription-drugs?fbclid=IwAR2aChygF6WR3uYQE61xn7bc2WvbEwDBHc50JTmnnEDZn7fOBXccoNoi0ao
Suicide is a very real potential side-effect to some medications — medications that are prescribed to teens and young adults.
The dangers made headlines in the early 2000’s when FDA and Congressional hearings were flooded with families who’d lost loved ones who had taken a class of antidepressants called SSRI’s. But now, time has passed and with it the public awareness of what drugs like Zoloft, Paxil and Prozac can cause a person to do. They’re still on the market and a whole new generation of parents is unaware of the deadly risks. A reality that pains Mathy Downing.
“A black box warning means there’s serious adverse events. There could be a potential for death,” said Kim Witczak.
Dear David,
It is some weeks now since I resigned from the Royal College of Psychiatrists having been a member for almost a quarter of a century. My intention is to switch focus to my other areas of interest.
The following link is to a summary of the two main areas that I raised in my letter of resignation [it is my understanding that the Royal College of Psychiatrists does not intend to reply to this letter].
https://holeousia.com/2019/01/13/even-in-todays-enlightened-age/
aye
Dr Peter J. Gordon
Bridge of Allan
~All best wishes for what you decide to do in future Peter. If only more of those who support you and are horrified by the actions of the coll of psychs and their networks would speak out even anonymously. There are some good quotes on your blog (which I can never get into somehow) so may I add – ‘She has a voice like a perfumed fart’.