According to a recent study published in the journal Psychiatric Services, black patients are almost twice as likely as their white counterparts to be diagnosed with schizophrenia, while white patients are significantly more likely to receive a diagnosis of anxiety or depression. The researchers also found that the likelihood of receiving psychotherapy for any diagnosis (34%), regardless of race or ethnicity, was much lower than the probability of receiving a psychotropic medication (73%).
In a new article for Scientific American, Diana Kwon reports on how the true risks for suicide and aggression in children and teens taking antidepressants have been suppressed by drug companies. “Taken together with other research—including studies that suggest antidepressants are only marginally better than placebos—some experts say it is time to reevaluate the widespread use of these drugs.”
According to new research, the United States spends over 200 billion annually on treatment and hospitalization for mental health issues, exceeding spending on heart conditions and cancer. Previous estimates of total healthcare spending by condition failed to account for costs associated with institutionalization but when this was factored into the latest research, the category of “mental disorders” moved to the top of the list by a substantial margin. More than 40% of spending on mental health issues are associated with institutionalization, the researchers found.
In his “Mind the Brain” blog for PLOS, well-known researcher James Coyne reviews the controversy surrounding the latest case of a fraudulently reported study on the antidepressant citalopram. “Access to the internal documents of Forest Laboratories revealed a deliberate, concerted effort to produce results consistent with the agenda of vested interests,” he writes, “even where prespecified analyses yielded contradictory findings.”
Ed Silverman at STAT reports that Congress has linked increased research funding to “fast-track” approval procedures. “By linking the extra funds to speedier approvals, Congress appears ready to undermine regulatory standards. And this is a misguided notion that, unfortunately, is more likely to help companies than patients.”
Researchers, Jon Jureidini, Jay Amsterdam and Leemon McHenry, have taken a closer look at the data from a randomized control trial of citalopram (Celexa) that was ghostwritten and then used by the manufacturers to support claims of the drug’s efficacy and safety in the treatment of child and adolescent depression. Their analysis used 750 recently-released court documents from a lawsuit against Forest Labs concerning the marketing and sales practices involved in the off-label promotion of Celexa. Drs. Jon Jureidini and Jay Amsterdam were expert witnesses in the case. The article is published, open-access, in the International Journal of Risk & Safety in Medicine.
In the past six years, I have had the opportunity to speak at several conferences or meetings that I felt had particular potential to stir some political activity that would challenge current psychiatric practices, and one of those events was the meeting convened in the U.K.’s Parliament on May 11th, which had this title for the day: Rising Prescriptions, Rising Mental Health Disability: Is There a Link?
When the CDC released data revealing an increasing suicide rate in the US, some experts, speaking to major media outlets, speculated that the increase could be tied to the FDA’s Black Box warning for teen suicides on antidepressants. It was suggested that the warnings may discourage some from taking antidepressants and that these drugs may prevent suicides. The research, however, does not appear to support these claims. A new review of studies on the role of antidepressants in suicide, published this month in the journal of Psychotherapy and Psychosomatics, concludes that there is no evidence that antidepressants prevent suicide and that the research may even suggest that the drugs increase the risk.
According to a new STAT-Harvard poll, the majority of Americans oppose new legislation that would speed up the approval of new drugs and medical treatments.
New findings from Harvard Medical School reveal that Pharma industry payments to physicians in Massachusetts are associated with higher rates of prescribing brand-name drugs that treat high cholesterol. “You want your doctors to be objective rather than doing something because there is a financial gain, be it subconscious or conscious,” the lead author told ProPublica. “That’s not the way we should be doing medicine.”
A new LA Times investigation finds that Purdue Pharma’s claims that OxyContin, a chemical cousin of heroin, could relieve pain for twelve hours led some patients to experience excruciating withdrawal, including intense craving for the drug. “Purdue has known about the problem for decades,” the investigators write. “Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief.”
Yesterday, the US Food and Drug Administration (FDA) released a warning that the antipsychotic drug aripiprazole or Abilify is associated with compulsive and uncontrollable urges. Research suggests that the drug may cause urges to gamble, binge eat, shop, and have sex but that the urges often stop when the drug is withdrawn or the dose is reduced.
When we set out to restore GSK’s misreported Study 329 of paroxetine for adolescent depression under the RIAT initiative, we had no idea of the magnitude of the task we were undertaking. After almost a year, we were relieved to finally complete a draft and submit it to the BMJ, who had earlier indicated an interest in publishing our restoration. But that was the beginning of another year of peer review that we believed went beyond enhancing our paper and became rather an interrogation of our honesty and integrity. Frankly, we were offended that our work was subject to such checks when papers submitted by pharmaceutical companies with fraud convictions are not.
While clinical trials make up the “bedrock of evidence-based medicine” in other specialties, psychiatry faces a number of both ethical and scientific problems related to its use of randomized control trials. According to a new editorial in The Lancet Psychiatry, the field of psychiatry research has particular challenges with ethical issues in recruitment, inaccurate classification systems, and problematic placebo comparisons, and then, once the studies are finished, it often remains unclear what the “outcomes actually mean for people’s lives.”
For the New York Times, Cornell psychiatrist Richard Friedman proposes new regulations to make direct-to-consumer drug ads reveal the relative price and effectiveness information that is currently hidden. “Drug companies might legitimately complain that there are many reasons a drug might fail to outperform a placebo besides ineffectiveness: quirks in the design of a trial; patients who were not typical of those with the disease; a dosage that was too low. But then the company should be happy to explain this to the public, since the goal is education, right?”
Multiple media sources are reporting on new data from the CDC revealing a substantial increase in the suicide rate in the United States between 1999 and 2014, with a steep increase in rates among girls and women. Few report, however, that the percentage of Americans on antidepressants has nearly doubled over this period.
For The Week, Pascal-Emmanuel Gobry comments on the current state of Science: the replicability crisis, the failure to self-correct, outright fraud, the inadequacy of peer review, and the tendency to cling to regnant paradigms. “All of this suggests that the current system isn't just showing cracks, but is actually broken, and in need of major reform," Gobry writes. “There is very good reason to believe that much scientific research published today is false, there is no good way to sort the wheat from the chaff, and, most importantly, that the way the system is designed ensures that this will continue being the case.”
William A. Wilson presents shocking evidence that a lot of published research is false and that science’s self-correcting mechanisms are broken. “There is no putting it nicely, deliberate fraud is far more widespread than the scientific establishment is generally willing to admit.”
In this video from CBC News, BMJ editor Fiona Godlee takes on “corruption of the scientific process.” "There will be commercial pressures, academic pressures, and to pretend otherwise is absurd. So we have to have many more mechanisms, much more skepticism, and much more willingness to challenge."
The Roanoke Times medical column takes on the question, “Can antidepressants lead to suicidal thoughts and actions?” concluding that “it is crucial for patients and their families to be alerted to this potentially deadly side effect.”
From STAT: “Imagine that someone offers to give you a guard dog. When the wretched creature arrives, you find out that she is calf-high, arthritic, blind, nearly deaf, and toothless. Oh, and she can’t bark, either . . . So it goes with peer review.”
The U.S. Preventive Services Task Force (USPSTF) recently issued a controversial recommendation that all adolescent and adult patients undergo depression screening in primary care. The Wall Street Journal has published a back and forth on this issue between Richard Chung, a pediatrician, and Allen Frances, the well-known academic psychiatrist, entitled “Should All Teens Be Screened for Depression?”. While Chung argues that early diagnoses may lead to better outcomes, Frances insists that screening will lead to the medicalization of normal adolescence and worries that “teens may be haunted for life by carelessly applied labels.”
A new analysis of the information that the National Institute of Mental Health (NIMH) publishes for parents about attention deficit hyperactivity disorder (ADHD) concludes that the children’s experiences and contexts are ignored and that medication is presented, misleadingly, as the only solution supported by research evidence. The researchers also point out that “cause and effects of ‘ADHD’ are intertwined through circular argumentation,” with the materials describing certain behaviors as a disorder and then later asserting that those same behaviors are caused by that disorder.
Students from Harvard Medical School joined students from Tufts University to protest Joseph DiMasi, who recently published a study that the students claim is biased by funding from Big Pharma. “DiMasi’s figures are used by pharmaceutical companies to preserve the status quo and their bottom line,” a press release for the protest read, claiming his relationship with the pharmaceutical companies presents a conflict of interest for his research.
A new study finds that prenatal exposure to antidepressant drugs, known as selective serotonin reuptake inhibitors or SSRIs, is associated with higher rates of depression in early adolescence. According to the research, published this month in the Journal of the American Academy of Child & Adolescent Psychiatry, children exposed to SSRIs during pregnancy were diagnosed with depression by age 14 at more than quadruple the rate of children whose mothers were diagnosed with a psychiatric disorder but did not take the drugs.
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