Blog archive: October, 2003

Blog subjects:

  • Pseudoscience in the mental-health industry

  • Unethical behavior among pharmaceutical companies

  • Whatever else strikes my fancy

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Note:  Blog updates occur sporadically.  I'm just too busy to maintain a schedule of daily entries.  Thanks for understanding.

Friday, October 31, 2003

And speaking of antidepressants and suicide, did anyone watch E.R. on television on Thursday night?  One of the characters revealed that she was taking the antidepressant Zoloft (generic sertraline;  called “Lustral” in Britain).  Later in the episode, this same character attempted suicide by pouring charcoal lighter-fluid on herself and lighting herself on fire.


And in a related item, British psychiatrist David Healy has written a new book about the problems with antidepressants.  The book is called, Let Them Eat Prozac.  For now, the book is only available direct from the Canadian publisher.  However, an American edition will be released this spring.  Here's an excerpt from a review of the book:

Perils of Prozac-popping

Before Prozac, few people risked getting depression.  Now, it seems, we are all at risk.  Better pay close attention, then, to David Healy's wonderfully perspicuous account of how a treatment can manufacture disease.  [...]

Of course, depression has always been with us, and Healy presents some moving stories of how this disease can blight the lives of those affected.  The great boom in depressive illness, however, dates back only to the discovery and marketing of Prozac.

Prior to the 1990s, comparatively few people were thought to suffer from depression:  perhaps one person in 10,000.  With the discovery of the Prozac family of drugs there came, not coincidentally, an explosive increase in diagnoses of depressive illness.

For an interesting interview with Dr. Healy, see this page.


More problems with antidepressants:

Group urges anti-depressant drug ban

Consumer advocates say Serzone has unacceptable risks

WASHINGTON, Oct. 29 – The anti-depressant Serzone, about to be pulled off the market in Canada and long gone in Europe, should be banned in the United States because of cases of deadly liver failure, a consumer advocacy group told the government Wednesday.

It's impossible to predict which patient will develop liver failure, an unacceptable risk considering Serzone works no better than older anti-depressants that don’t come with that side effect, Dr. Sidney Wolfe of Public Citizen told the Food and Drug Administration.

The United States is “lagging behind other countries in drug safety,” Wolfe wrote the FDA.  “Remove this drug from the market before more people are injured or killed.”


Saturday, October 25, 2003

OK, sorry about the lack of updates recently.  Here's a bunch of new stories that I've been accumulating over the past week or so:


The BBC website has an excellent article about the book, Therapy Culture, by British sociology professor Frank Furedi.  I mentioned this book in a prevoius blog update.  Here's an excerpt from the BBC story:

Desperation nation – Britain in therapy

The renowned British “stiff upper lip” has given way to a quivering lower lip as we increasingly turn to counselling, a new book argues.  But has therapy really corroded our national character?  [...]

Furedi claims that this “on the couch” culture ultimately has a damaging impact on individuals.  We are never really cured, so much as “placed in a state of recovery”, he says;  and our expectations of what we can achieve are constantly lowered by the notion that we need the guiding light of therapy to negotiate life's obstacles.  [...]

[Virginia Ironside] admits she spent 30 years having “counselling, psychotherapy, analysis and group therapy”.  But today she has serious doubts about the worth of such counselling.

“There is too much therapy around,” she says.  Ms Ironside believes that when therapy is offered for such commonplace, if horrible, life experiences as divorce and redundancy, it can actually makes things worse.

“It makes these events seem extraordinary rather than just the everyday miseries that we all have to endure,” she says.  “Therapy encourages people to look at the bad and miserable things in their lives, to focus on their misfortunes, which usually makes people feel worse and ends up inflaming their anger.”

She dismisses her own experience on the couch as “entirely harmful” “extremely expensive”.  It did little more than encourage a “poor me” attitude to life.

For what it's worth, I agree with Virginia Ironside.


Good news out of Denmark:

Denmark plans to stop prescribing anti-depressants to teenagers

COPENHAGEN (AFP) – Denmark is planning to recommend to doctors not to prescribe two anti-depressant drugs to patients under the age of 18 because of a risk they could be linked to suicides, health authorities said.

“Doctors have the right to prescribe freely what they want but we can warn them against prescribing Seroxat [called “Paxil” in the U.S.] and Efexor [spelled “Effexor” in the U.S.] to young people aged under 18 because of side effects increasing the risk of suicide attempts,” Doris Stenver of the Danish drugs agency said.


And in similar news from Japan:

Antidepressant drug Paxil poses suicide risk to young

TOKYO – The health ministry has learned that a widely prescribed antidepressant drug raises the risk of suicide by seriously depressed children at puberty, ministry and industry officials said Monday.

The Health, Labor and Welfare Ministry has ordered the importer to put warnings in its packages against administration of the drug to seriously depressed people aged under 18, the officials said.  However, it also warns that a sudden halt in use of the drug could cause perception disorders and is calling instead for a gradual reduction.

The drug, imported and sold by GlaxoSmithKline KK, the Japanese subsidiary of GlaxoSmithKline PLC of Britain, carries the product name Paxil and is prescribed by doctors in Japan often as the first choice for treating depression.

However, the drug company's clinical tests on children aged between 7 and 18 have found that the risk of patients with serious depression considering or planning suicide almost doubles when dosed with the drug, according to GlaxoSmithKline officials.


More bad news for the pharmaceutical industry:

Gloomy industry outlook soaks drug makers' stocks

NEW YORK -- Merck & Co. Inc. announced plans to cut 4,400 jobs after posting a slight drop in profits Wednesday and cutting earnings forecasts for the year, as most other major drug makers also reported third-quarter results rife with negative implications. Drug stocks tumbled.

Many analysts were worried about industrywide problems such as possible pricing pressure from a Medicare drug benefit, demands from health insurers for price cuts, a dearth of potential blockbuster medications and patent expirations.


I'm not in favor of drug abuse (obviously), but I'm also not in favor of intrusive drug testing.  I'm sympathetic to these men who were busted for using a “Whizzinator” device:

Men caught using Whizzinator at urine tests

LUBBOCK, Texas -- Some West Texas men on probation are in trouble again, this time for using the Whizzinator to help them pass court-ordered urinalysis tests.

In the past six months, five men on probation were caught using a realistic-looking prosthetic that dispenses synthetic, drug-free urine, Lubbock County sheriff's officials said. One was caught by an alert officer who heard something unusual in the restroom.

“A body part when it's up against a plastic cup isn't going to go 'clink,'” said Tom Madigan, interim assistant director of the Lubbock County adult probation office.

The device, reusable and available in five flesh colors, is sold by California-based Puck Technology for $150.  A prosthetic penis is attached to an undergarment resembling a jock strap and connects to a pouch containing dehydrated urine.  Water is added to the pouch and a heat pack can be attached to keep the urine close to body temperature.

Company owner Dennis Catalano has sold the device and one designed for women for about four years, mainly through an Internet site.


This is great:  Liza Minnelli, who's been in and out of rehab many times, has apparently relapsed yet again.  Actually, I have no ill will toward Liza Minnelli, and I hope she's able to beat her alcoholism.  However, I'm hoping (against hope) that her repeated failings will finally provoke some people into realizing that rehab doesn't work:

'Insane' Minnelli beat me in drunken rages, says husband

Trouble began when the couple [Minnelli and her husband, David Gest] visited the Villa D'Este on Lake Como in August, 2002.  The suit says Ms Minnelli became physically abusive after raiding the hotel mini-bar.

It happened again when the couple returned to New York to stay at the Hotel Plaza Athenee while their apartment was being decorated, the suit claims.  Mr Guest says he caught his wife drinking a bottle of vodka and that caused her to “fly into a rage.”  He adds: “She started beating me with her hands about the head until I ran into the other room.”

The pattern continued through last winter and in March this year, Mr Gest tried to have her checked into a rehabilitation centre she had visited before the wedding.  When staff from the centre arrived to pick her up, she allegedly became “uncontrollable”.

The suit says she flew into a “violent rage, beating plaintiff with her hands while shouting insults at him”.

But the Connaught eruption apparently was the last straw for Mr Gest.  The suit says Ms Minnelli said she “needed some air” and claimed she was going out for takeaway food.  Instead, she forced her limousine driver to buy her two bottles of vodka, one of which she immediately downed.


Friday, October 17, 2003

This article from British website Spiked nicely sums up some of the main reasons why we should be disillusioned with Prozac (as well as with all the other antidepressants):

Prozac's downer

At the height of the so-called Prozac Revolution in the early 1990s, fans of the drug made some grand claims for the new pharmaceutical marvel on the block.

It does not only eradicate depression, said the proselytisers, but can also combat a vast range of ills including bulimia nervosa, obsessive-compulsive disorder, panic attacks, obesity, alcoholism, PMT, sensitivity, lack of confidence, low self-esteem and jealousy.  It truly was a wonder drug.

Since those heady days, however, the reputations of Prozac and other selective serotonin reuptake inhibitors (SSRI) have taken a beating, not least when GlaxoSmithKlein was forced to abandon the claim that its SSRI, Seroxat [called “Paxil” in the U.S.], had no withdrawal symptoms.  Worse might be on the way – a growing number of people is beginning to suspect that rather than being panaceas, these drugs might be no more than glorified placebos.

(Emphasis added by me.)  Thanks go out to Psych Watch for finding this article.


British newspaper the Guardian has an excellent article about the ways in which the mental-health industry harms society.  The article is actually a review of a book called, Therapy Culture, by Frank Furedi:

But is there also a way in which we are overdoing all this [increased awareness of mental illness]?  Are we creating a climate where we are prone to pathologise our every thought and in the process persuade some of the mentally healthy into unhealthy introspection?  Where once people might have thought they were unhappy, nowadays they are more likely to worry that they are clinically depressed, or neurotic or manic, or suffering from any number of newer conditions, like shopping addiction or general anxiety disorder.  Then it's off to a GP to be diagnosed and perhaps prescribed antidepressants like Prozac.  “Put the patient on vitamin P,” as one American doctor put it to me.  [...]

[Psychologist Richard] Gist rails against what he sees as our obsession with the need for therapeutic or medical intervention in even the most extreme of situations.  “I'm just drafting a paper with a British colleague in which we suggest that most interventions that people respond to positively are likely to be the non-specific impacts of presence, concern, compassion and simple instrumental assistance – the kind of stuff you learn from grandma, not grad school.”

In other words the kind of support you can get from family and friends.  “There is a lot you can do that is helpful, supportive, valuable and even vital,” he says, “but you do not have to masquerade as indispensable saviours heading people off from inevitable disaster.”  The influence of Freud on society, Gist says, has meant that our discomforts in life are seen to require external professional intervention to resolve them.  They are not just simply aspects of living.  “We treat them as if they are injuries or illnesses.”

In Therapy Culture, Furedi argues that therapeutic culture now incites people to feel vulnerable and ill.  Certainly Patricia Turner feels that being referred to a therapist made her feel worse instead of better.  [...]

After a couple of sessions [of therapy] Turner says she began to realise that, as far as her therapist was concerned, anything and everything could be positioned as a problem.  “She seemed to pathologise everything I said.  To find something negative about it.”


Monday, October 13, 2003

The U.S. Food and Drug Administration (FDA) is scheduled to examine the possibility that antidepressant use is linked to suicide.  Unfortunately, the discussion will apparently be limited to pediatric use of antidepressants (why not throw the door open to the possibility that adult patients are at risk, too?):

Antidepressant Reports Of Suicidality In Children Will Be Topic Of FDA Cmte. Meeting In February

Reports of suicidal ideation and suicide attempts in pediatric patients receiving antidepressants for major depressive disorder will be discussed at a Feb. 2, 2004 joint meeting of FDA’s Psychopharmacologic Drugs Advisory Committee and the Pediatric Subcommittee of the Anti-Infective Drugs Advisory Committee.

The committee will review the reports of suicidality from clinical trials of antidepressants and consider optimal approaches to analysis of the data.

The group will also consider what regulatory action may be needed for clinical use of these products in pediatric patients and what further research is needed to address questions on the topic.  [...]

Data from pediatric studies with Glaxo SmithKline’s Paxil (paroxetine) have also shown increases in suicidality. In a June “Talk Paper”, FDA said that it was reviewing reports of a possible increased risk of suicidal thinking and suicide attempts in children and adolescents for the treatment of MDD [major depressive disorder] with Paxil.

Saturday, October 11, 2003

Here's the latest in the infamous “Prozac by mail” case:

Doctor admits signing Prozac letter

Unaware samples going to patients, physician says; Lawsuit filed over privacy issues

A Florida doctor questioned in a lawsuit over an effort to market Prozac by mail admitted supplying her signature to a pharmaceutical company's representative but was surprised it was used to send samples of the antidepressant.

“I didn't expect any medication to be mailed to patients,” Dr. Lise Lambert said in her deposition, which was filed yesterday and is the first by a doctor in the case.  “I never authorized it.”

Lambert acknowledged signing papers related to the promotion for an Eli Lilly & Co. sales representative.  But she said she was unaware it involved mailing out unsolicited samples.

In the widely criticized marketing scheme, hundreds of people in Florida who were using antidepressants last year received a month's supply of a new weekly form of Prozac.

The episode sparked outrage by consumer advocates, who said it exemplified the pharmaceutical industry's aggressive marketing techniques and the cozy relationships between doctors and sales representatives.


Friday, October 10, 2003

The BBC website has a skeptical article about antidepressants:

Anti-depressant doubts

For many sufferers of depression, the drug Seroxat [Paxil in the U.S.] has been a lifeline.  It's been hailed as miracle cure for anxiety and even for shyness – and it's now the best-selling anti depressant in the UK.

But doubts are beginning to surface about its effects on some patients – particularly when they try to come off the drug.  [...]

The drug has been linked to a number of suicides and is currently under review.

It's actually not a very good article.  The story does address issues of safety, but the journalist incorrectly implies that the drugs can be highly effective.  The dangerous side-effects are not the worst thing about antidepressants.  The worst thing about antidepressants is that they don't work any better than a placebo.


Friday, October 3, 2003

Oh, remember the Zoloft-for-children study that was widely publicized recently?  Seems that one of the authors is expressing some doubts about antidepressants:

Scientist in rethink over drug link to suicide

The scientist who led the latest trial of an antidepressant drug given to children, which claimed that it was effective and safe, has conceded to the Guardian that the drug's potential to cause suicidal thinking needs to be investigated.

Last month the Journal of the American Medical Association published results from two trials of children treated with Pfizer's antidepressant drug Lustral, known in the US as Zoloft.

Seventeen children who were given the drug were pulled out of the trial because of side effects, compared with five who were given a placebo.  Only 10% more children improved on the drug than improved on a placebo.

The researchers nonetheless concluded that “the results of this pooled analysis demonstrate that sertraline (Lustral) is an effective and well-tolerated short-term treatment for children and adolescents with major depressive disorder”.

The lead author of the study was Karen Wagner of the department of psychiatry at the University of Texas.  [...]  Asked whether she still believed both drugs were safe, after the MHRA ban on Seroxat and the inquiry that has now been launched by the US regulator, she replied:  “I think it requires further investigation and looking at the entire database of these medications.”

(The emphasis was added by me.)  OK, so it's not exactly a mea culpa, but it's about the best we can reasonably expect.


So nutritional supplements may actually do more harm than good (see, in particular, the last sentence in the excerpt below).

Task Force Finds Little Evidence To Support Use Of Vitamin Supplements To Prevent Cancer Or Heart Disease

The U.S. Preventive Services Task Force today concluded there was insufficient scientific evidence to recommend vitamin supplements as a way to prevent cancer or heart disease and recommended against the use of beta carotene supplements in smokers because of a possible increased risk of lung cancer and death.  The Task Force conclusions are based on a review of studies on the use of vitamins A, C, or E, multivitamins with folic acid, or antioxidant combinations to reduce the risk for cancer or cardiovascular disease in adults. These findings are published in the July 1 issue of the Annals of Internal Medicine.  [...]

The Task Force reviewed the results of four clinical trials that found that taking beta carotene did not decrease the risk for lung, prostate, colon, breast, or non-melanoma skin cancer in middle-aged and older adults.  Two of these clinical trials found that individuals who take beta carotene and smoke have an increased risk of lung cancer and death.

(Emphasis was added by me.)