The Influence of Paid Opinion Leaders on Antidepressant Prescribing in the UK


From Hole Ousia: “I see that there have been a number of responses to this letter: Reversing the rate of antidepressant prescribing. I worked as an NHS psychiatrist for over 25 years and as part of my continuing medical education regularly came across the work of a number of the respondents.

British Psychiatry is heavily influenced by opinion leaders who are often paid by industry. These opinion leaders are in positions where they can significantly influence prescribing of psychiatric drugs. Furthermore, this group determinedly shape and form the overall narrative arguing that they are free from ‘ideology.’ Yet, the exact basis of their ‘joint working’ is generally opaque. This may reflect a wish to maintain a position of medical authority that comes from science that is perceived as independent from outside interests.

I have submitted a response titled ‘The influence of paid opinion leaders (POLs) on the prescribing of antidepressants in the UK – a timeline of some key publications’ [taken from the public domain and with all available citations provided].

In October 2018, the Editor-in-Chief of the BMJ, Fiona Godlee said: ‘We don’t let judges or journalists take money from the people they are judging or reporting on: we shouldn’t let doctors do this either. Paid opinion leaders are a blot on medicine’s integrity, and we should make them a thing of the past.’ However POLs who generally control the narrative in relation to psychiatric drug prescribing continue to be very much of the present.”

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    • From the linked article, same individual statements, a payed opinion leader in psychiatry, apparently:

      2014: “Antidepressants have an impressive effect size in the treatment of acute cases of depression” and “antidepressants have an impressive ability to prevent recurrence of depression … which makes them one of the most effective of all drugs”.

      2022: “Even the best-performing antidepressant drugs show modest efficacy, non-negligible side effects, discontinuation problems and high relapse rates, highlighting the need for new, improved treatments”. This one apparently for promoting an hallucinogen to treat depression.

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