Bitter Pill
A Portland doc flips on big pharma and reveals its “dirty little secret.”
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 DOC BITES MEDICINE: OHSU professor Erick Turner doesn’t expect the drug industry to run clinical trials. “They would not want to touch me with a 10-foot pole, unless it had a sharp end on it.” IMAGE: Vivian Johnson |
[April 2nd, 2008]
Ten percent of Americans—children, teens and adults—take antidepressants. Whether it’s Prozac, Paxil, Lexapro, Effexor or Cymbalta, 30 million of us take a pill daily in hopes it will keep dark moods at bay. Antidepressants are the most prescribed family of drugs in America, an $11.9 billion market in the U.S. in 2007.
In January, Erick Turner, a professor of psychiatry at Oregon Health & Science University and a clinician at the Portland VA Medical Center, shook up the medical community, provoked the pharmaceutical establishment and, perhaps, disappointed millions of depressed Americans. He published a paper in the New England Journal of Medicine that revealed antidepressants are not as effective as we’ve been led to believe. For years, he implied, pharmaceutical companies such as Pfizer (maker of Zoloft) and Forest Laboratories (Celexa and Lexapro) have vastly exaggerated the performance of their drugs.
Turner calls it the “dirty little secret” of the psychiatric world.
It was a disclosure that was felt ’round the medical world, and for the past two months Turner has fielded press inquiries by the dozens.
Turner’s “is the kind of a paper that makes you wonder why someone didn’t do it a long time ago,” says S. Nassir Ghaemi, an associate professor of psychiatry and public health at Emory University School of Medicine and a leading researcher on bipolar disorder.
“It’s damaging” to the reputation of antidepressants, says Peter Kramer, author of Listening to Prozac and a psychiatry professor at Brown University School of Medicine.
The paper has given Turner not rock-star status, perhaps, but at least a level of notoriety in a profession where physicians typically labor in anonymity. Since the paper’s publication, Turner has become a go-to source for reporters writing about depression and antidepressants.
But more important for Turner is how his work has shaken up the industry and raised questions about the integrity of the pharmaceutical industry and the weakness of the federal regulatory agency that’s supposed to protect the public from drugs that are dangerous or ineffective. It has also had the effect of raising an uncomfortable question: If antidepressants don’t work that well, why are so many Americans taking them?
The great irony of his discovery is that, for 18 months, Turner pimped for antidepressants. He wouldn’t put it that way, of course, as many doctors do the same thing. But starting in 2004, Turner, who is the
medical director of the Mood Disorders Program at the Portland VA and has worked at the Food and Drug Administration and the National Institute of Mental Health, became a speaker for Eli Lilly, one of the world’s largest pharmaceutical companies.
It’s not unusual in pharmaceutical marketing for doctors to be hired as “consultants”—or members of a company’s “speakers’ bureau” in industry parlance—and then hit the road doing “doctor talks.” These are typically lunches or dinners where area M.D.s are invited by a company to eat and drink while listening to a respected physician describe the benefits of a particular drug.
Lilly approached Turner around the time the FDA was set to approve a new Lilly antidepressant named Cymbalta. He was an especially good catch for the company because, in addition to his academic appointment at OHSU, Turner had spent seven years as a researcher at the prestigious National Institute of Mental Health and another three years as a clinical trials reviewer at the FDA.
“They’re using your reputation and political capital, as it were, as sort of a frontman for the drug,” says Turner, 54.
After training in Indianapolis in the summer of 2004, Lilly sent Turner out into the field in the Northwest, receiving anywhere from $500 to $750 per talk. He says he did about 12 talks for Lilly over the next 18 months.
He says his motivation wasn’t so much the money—he netted less than $10,000—as it was his desire to keep up his reputation as an expert on clinical trials.
“In the beginning, I think I got narcissistic gratification,” he says. “They fly you somewhere else in the country and pick you up in a limo, and you stay in a nice hotel you could never afford otherwise.”
Some critics believe these relationships between industry and doctors—long common in all branches of medicine—are little more than an example of the corrupting influence of Big Pharma and its ability to turn doctors into sales tools.
“The practice of drug companies paying doctors to be their spokespeople is extremely problematic, because it creates a financial incentive for the physicians to intentionally be deceptive in their lectures to other doctors,” says Daniel Carlat, an assistant clinical professor of psychiatry at Tufts University School of Medicine. Carlat himself was once on the dole for Wyeth Pharmaceuticals, makers of Effexor, until he found the arrangement too compromising and quit.
“It provides incentives to tweak the data to tell only part of the truth,” Carlat says.
And indeed, Turner found he could say only what Lilly allowed him to say. He could use only Lilly’s overhead slides of results from clinical trials of the drug. He couldn’t offer his own expertise as a researcher and former FDA reviewer to his fellow doctors.
“I began to feel straitjacketed,” he says.
It was during this time that Turner began to rebel.
Depression didn’t just appear with the advent of Prozac in 1987. The condition has been known since ancient times, and is infamously difficult to treat. In modern times, the advances of psychoanalysis and psychotherapy did little to fend off what Winston Churchill once called the “black dog.” In the 1960s, two classes of antidepressants became available. Neither was particularly effective, and they were not widely used.
By the mid-1980s, however, researchers had hit upon the serotonin hypothesis of depression—too little of the chemical serotonin in the human brain leads to depression. New-generation drugs believed to boost serotonin levels could treat depression. The drugs were known as selective serotonin reuptake inhibitors, or SSRIs.
The first new-generation antidepressant to be sold in the U.S. was Prozac in 1987, manufactured by Eli Lilly. Lilly claimed Prozac not only worked, it was virtually free of side effects. The drug rocketed to blockbuster status. In 1990, a Prozac capsule appeared on the cover of Newsweek and was hailed as a “breakthrough drug.” A few years later, Kramer’s Listening to Prozac became a bestseller. The drug achieved iconic status in American culture in a way few drugs ever had before or have since. The message was clear: Take Prozac and beat the black dog to the ground.
Prozac was followed by Paxil and Zoloft, and a host of other new antidepressants such as Effexor and Wellbutrin, 12 new drugs in all. In 2007, 233 million prescriptions for antidepressants were written in the U.S., according to data-services company IMS Health, accounting for $11.9 billion in sales. So widely used are these drugs that a recent study found traces of Prozac in creekbed mud in Portland and a 2004 British study found traces of the same drug in the British water supply.
But another problem showed up in clinical trials that were never made public. These new antidepressants—which critics argued had turned America into a culture of the quick fix and that proponents praised as lifesavers—didn’t perform very well. Turner knew this. And he decided in 2004, at the very same time he was taking money from Lilly, that it was time to start telling the truth.
“I guess you could say I bit the hand that fed,” says Turner of his revelation.
The FDA requires that clinical trials—studies done on human test subjects—be done before the approval of a drug. These trials determine several things: what dose of a drug is safe, what dose creates an effect, what side effects crop up for patients. But the biggest question is efficacy: How well does the drug work compared to a placebo? Pharmaceutical companies often run as many as 10 clinical trials enlisting thousands of patients and costing tens of millions of dollars to find out just how much efficacy their drug possesses.
You’d think doctors and the public would be allowed to see the results of all these trials, but that’s often not the case. Only two clinical trials with positive results—meaning the drug performs better than a placebo—are required for FDA approval. It doesn’t matter if eight other studies show negative results. Typically, the two studies are published in peer-reviewed journals. The fate of any other pre-approval studies is left to the whims of the drug’s maker. There is no requirement that a pharmaceutical company make public all of its clinical trials.
In November 2004, Turner wrote a paper that was published in PLoS Medicine, an influential, peer-reviewed medical journal. In the article, Turner argued that all clinical trials submitted to the FDA should be published online by the agency, so doctors could know the breadth of a particular drug’s research base before prescribing it to a patient.
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The paper made him an official critic of the pharmaceutical industry and its long-standing practice of hiding data from public view.
Hardly anyone in the medical-publishing world listened.
Feeling as if his hands were tied, Turner quit doing doctor talks for the pharmaceutical industry in 2005, convinced he needed to make his case more strongly by collecting reports of pre-approval clinical trials for antidepressants that had not been published.
He found some of them online, deep in the FDA’s website. Then he reached out to other researchers in the field, getting some records from a researcher at the University of Nevada at Las Vegas and other records from a researcher in Seattle, where Turner says, “I literally went down to a Kinko’s and photocopied them.”
When he was done, Turner had amassed findings from 74 clinical trials. Of the group, 51 percent were “positive”—in other words, the drug had performed better than a placebo. Forty-nine percent were negative or had mixed results. The bulk of these negative trials had never been published anywhere. It was almost as if those trials, and the thousands of patients who participated in them, had never existed.
Turner’s paper was published Jan. 17 in the New England Journal of Medicine, titled “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy.”
“As a result of selective reporting, the published literature conveyed an effect size nearly one-third larger than the effect size derived from the FDA data,” Turner wrote. “Effect size” means the amount by which a drug outperforms a placebo, and from the study it’s clear the pharmaceutical industry had gotten away with overstating the power of antidepressants for two decades. Put another way, the industry had made use of the drugs look more beneficial.
“By altering the apparent risk-benefit ratio of drugs,” Turner wrote, “selective publication can lead doctors to make inappropriate prescribing decisions that may not be in the best interest of their patients and, thus, the public health.”
In the calm language of science, Turner had declared war on Big Pharma.
“My wife and I were talking about going away for the weekend in January,” he recalls. “I said, ‘That’s right after my paper comes out, and then I’ll be busy with all sorts of interviews by the press.’ My wife said, ‘Now that you’ve gotten your paper published, you can relax.’”
There’s been no relaxing since the paper’s publication. Turner, who likes to play tennis, says he’s hardly had any free time for the game.
“The fact that the negative trials can just be hidden away means that practicing doctors can get a very false notion” of efficacy data for a drug, says Carlat of Tufts. “That’s the real crisis here.”
So startling was this news to the media that Turner has fielded dozens of press inquiries from the likes of The Economist and the Fox News Channel in the seven weeks since the study was published. “[Doctors] end up asking, ‘How come these drugs seem to work so well in all these studies, and I’m not getting that response?’” is how The New York Times quoted Turner explaining the implications of his study.
Among researchers, Turner’s study generated enthusiasm of the sober, academic variety.
“We’ve known for a long time that companies don’t always publish their findings,” says Bruce Psaty, a University of Washington cardiologist and expert on clinical trials, noting that these findings usually come to light only in references within FDA documents or in later court litigation over injuries allegedly caused by a particular drug. “It’s a terrific paper,” he says, especially for its ability to quantify “industry-friendly spin” created through the magic of selective publication. “It’s potentially a landmark paper.”
Carlat adds, “It sure told us something about how FDA research papers are treated by the pharmaceutical industry.”
George Keepers, chairman of the psychiatry department at OHSU, says Turner’s paper will play an important role in a simmering debate among U.S. psychiatrists about whether antidepressants or psychotherapies such as cognitive behavioral therapy should be first-line treatments for depression. “I don’t think you change the way you practice the next day” in the aftermath of a paper like Turner’s, Keepers says. “But it makes you more cautious about conclusions that have been drawn to this point” about antidepressants.
Pharmaceutical companies primarily left an industry trade group, the Pharmaceutical Research and Manufacturers of America, to respond on their behalf.
“There should be no doubt that America’s pharmaceutical research companies are committed to making available clinical trial information to make sure that patients and their physicians have access to relevant data from ongoing clinical testing,” said the group’s senior vice president, Ken Johnson, in a prepared statement. “The process—which includes clinical trial registries and databases—should be transparent and accessible.”
Turner’s paper leaves little question that antidepressants don’t work nearly as well as conventional wisdom would have it. Of the 30 million daily users in this country, many millions would be no worse off if they took a placebo every day. Yet doctors continue to prescribe the drugs, people continue to take them, and Big Pharma rings up the sales.
One could argue, “What’s so wrong with that?” If people are helped by believing that something works, even if it is not medically true, doesn’t it still work?
Carlat, who called Turner’s work important, nevertheless argues that the question may not matter.
“The fact is, we’re not allowed to prescribe placebos in our practices, and we have patients coming to us and banging down our doors because they are miserable,” says Carlat. “We can’t offer them a sugar pill, but we can offer an antidepressant even if its effect is 80 percent sugar pill. A lot of our patients are getting better. That’s why we prescribe antidepressants even in the face of this recurrent data.”
However, there is evidence that taking antidepressants can be harmful to some people’s health. In recent years, the FDA has mandated warnings on all antidepressants due to elevated risks of suicide and suicidal thinking in some people under the age of 25 who take the drugs. In addition, antidepressants can cause very intense withdrawal problems for some patients, most notably with Effexor and Paxil. The drugs can also cause internal agitation—akathisia—in some patients, and, tragically, antidepressant use sometimes has been connected, however peripherally, to school shootings, most famously at Columbine High School in 1999, where one of the shooters, Eric Harris, had been taking Luvox.
There is also the not-insignificant cost of the drugs. No one will hazard a guess as to how much of America’s investment in antidepressants may be money down the drain, but it’s obvious that at least a portion is.
Just three weeks ago, Emory University’s Ghaemi wrote an editorial in the American Journal of Psychiatry that openly questioned antidepressant use. He wrote about a long-term study of antidepressant use in bipolar disorder, and its finding that a placebo was more effective than the drugs, calling it “one more nail in the coffin of antidepressant use in bipolar disorder.”
As much as 20 percent of all antidepressant sales are to treat bipolar disorder, suggesting billions of dollars are perhaps being spent needlessly.
That said, there are some people for whom antidepressants are highly effective and who view them as lifesavers.
Turner himself still prescribes antidepressants but admits he is careful not to overplay their benefits to patients in order not to give them false hope after decades of hype around the drugs.
“There are some people who seem to get a great response and a lot who don’t seem to get much response at all,” says Turner. He says he probably won’t be asked by the industry to run clinical trials on antidepressants anytime soon.
“I don’t think they would want to risk it after this paper,” he says. “They would not want to touch me with a 10-foot pole, unless it had a sharp end on it.”
U.S. sales of antidepressants actually dropped in 2007 to $11.9 billion from $13.6 billion in 2006. Prescriptions rose about 3 percent—but sales fell because some patented antidepressants have become generic drugs in recent years.
Antidepressants fell to the fourth-biggest revenue producers for the pharmaceutical industry in 2007, preceded by lipid regulators, proton pump inhibitors and antipsychotics, according to IMS Health.
Antipsychotics such as Abilify, Risperdal and Seroquel may soon become the hot new treatments for depression, despite well-known side effects that include diabetes and noticeable weight gain.
About 80 percent of all antidepressant prescriptions are written by primary care providers and other non-psychiatrists. Before the introduction of SSRIs in the late 1980s, almost all antidepressant prescriptions were written by psychiatrists.
Clinical test subjects sometimes receive small stipends for participating in trials, in addition to receiving the drug being studied and medical care. Many clinical trials for FDA approvals are now being done abroad in countries like India and Russia.
Editor’s note: Philip Dawdy has been prescribed eight different antidepressants over the past 20 years. At times, the results were good but not lasting. At others, the side effects were devastating.
Philip Dawdy, a former WW and Seattle Weekly reporter, is a freelance reporter in Seattle. His reporting on mental health issues has won awards from the National Mental Health Association (now called Mental Health America) as well as numerous local and regional journalism awards. He writes the popular mental health blog furiousseasons.com.
Great article. Such truth. As a Retired Nurse and curent Limousine compaany owner there is a great deal of truth in this article. I have seen the way drug companies use their ploys to get physicians to use their drugs and the incentives which they receive for doing so. It is substantial in nature.
Drug companies will do anything to sell their product regardless of the ability of the drugs to be useful as it is all about the bottom line and not the patients. They must recoup the research and it is a huge game they play from free dinners to clinic nurses and Dr's to perks. It is written off as the cost of doing business and introducing a new drug to the market or bulstering an older established drug which has slipped in the market place.
Hospitals get incentives to use certain drugs and pharmicies get incentives to substitute drugs to fulfil contracctual agreements which are under the table.
You gamble with your life on a daily basis all to bolster the Major drug companies and their bottom line.
Not only do they do that but then have the gaul to advertize their drugs on TV and print all with glowing and beautiful pictures and makeing them to be the go to drug of choice attempting to influence buyers.
Marketing 101 is alive and well even if the drug is and has Minimal impact it is made to believe that it is a cure all by implication just watch TV for 2 hours and count the ad's...
Yes, really well done, and certainly the subject du jour: there's an editorial in today's NY Times about the lack of transparency concerning statins, and any number of 2008 books on the fear-peddling of Big Pharma and Americans' seemingly endless quest for a quick fix, damn the torpedos, including Melody Petersen's "Our Daily Meds" and Charles Barber's "Comfortably Numb."
As a health care professional dedicated to the highest ethics, I hope such disclosures lead to more exposing of Big Money's overt and covert influence upon medical decision-making. Well done!
So the former corporate whore is now an anti-corporate whore? Either way, he gets the same "narcissitic gratification".
I would bet that many of these "failed" studies were used to arrive at the approporiate dosage and addressable population. Clearly, more data is better than less data, but I certainly don't look to WillyWeek, the U.S. Congress, or the anti-Pharma zealot, to tell other practioners which drugs are effective (or not). For many mental health drugs/conditions the actual follow on effects in the brain are not clearly defined: does that mean they don't work? Certainly not.
I have taken two anti-depressants, and found them to be very helpful. I quit taking one of them due to libido side effects: the replacement worked even better, without noticeable side effects.
I'm not taking them any longer, but was thankful to Big Pharma for spending billions to develop them AND spread the word to the physicians who prescribed them.
And I've seen plenty of talk therapists bill patients once a week for a decade or more (without tangible progress): if Big Pharma is a scam, then some of those "failed" therapists are too!
Better start retaking those little pills, grouchy. Your lack of admiration for someone who had seen the error in their ways and became an advocate for change regarding the release of clinical trial information says a lot about your current emotional/psychological needs. I imagine you're the guinea pig that became addicted to the sugar pills and will defend-to-the-death your right to eat them... Good luck with that
"In the calm language of science, Turner had declared war on Big Pharma."
Very well-put. What a fantastic article; I'm going to pass it around like none other.
Dear Philip,
“He published a paper in the New England Journal of Medicine that revealed antidepressants are not as effective as we’ve been led to believe.” --- Philip Dawdy
Thanks. That was a wonderful article you wrote except for the fact that I could’ve told the kind doctor starting some four decades ago what it is he appears to be uncovering recently.
As always, keep up the outstanding work.
Warmly,
Herb
Finally the truth is being confronted by the Medicos. When they are willing to look further, and deeper, they will find Big Pharma is beyond just irresponible with its false claims. It is downright destructive with its unreported side-effects.
How about some good old-fashioned lawsuits about "false advertising". That might be a start.
Wonderful article. Falls right in line with the recent WSJ article regarding a neuropsychologist, who is attributing symptoms of poisoning after an environmental exposure to psychological problems. He is so sure of it, he is willing to testify to that fact under oath while being paid handsomely by the defendant in the cases. It also falls in line with a recent ABC Nightline program in which a "board certified" allergist has determined 30,000 people that are patients of an environmental doctor are just having psychological problems. Wonder why these antidepressants are not working? Gee, do you think it could be because the symptoms are not caused by depression? There is mass quackery going on in the US, driven by the desire to limit financial liability for those who are the proximate cause of slow poisoning thru manmade and natural chemicals in our environment. One out of every 160 children in the US are now diagnosed with autism.
Depression my eye! Mass, financial driven, quackery. Sad to say, some of Dr. Turner's collegues at OSHU are at the core of the national problem. High paid expert witnesses for the defense in toxic tort litigation. Whatever happened to "physician, fist do no harm"?
As a retired psychiatric nurse practitioner, I was thrilled to see this article, and I applaud Dr. Turner for finally shining the light on a problem that jeopardizes public health. People trust their health care provider to be objective and science based. Little do they know the power of big Pharma money to corrupt professionals (not to mention politicians!).During my career right here in PDX, I witnessed a rising tide of well known docs-many at OHSU-succumb.Sad!
My name is Josephine and I am a member of LeapforPatientSafety.org. We are having a "Walk for Patient Safety" on Saturday, April 19, 2008 in Rockville Centre, New York. Please visit our website: www.leapforpatientsafety.org for details. Our goal is to significantly reduce the hundreds and thousands of deaths and injuries each year that are due to medical errors. Please help us by joining our "Walk for Patient Safety" and/or telling everyone about it. There is no fee to register and there is no fee to "Walk." Many thanks for your attention and support.
Kind regards,
Josephine Carol Cicchini
516-746-3310
I used to sell anti-depressants and I salute Dr. Turner's findings. I don't want research and development to stop, however, and the fact that doctors have to use prepared slides comes from FDA strict guidelines and fines not because we are putting a "straight" jacket on the doc. In fact if asked a question the doctor is free to answer. We talk of big Pharma all the time, but what about insurance companies restricting care, what about hospitals hiding medical mistakes to cover their butts. Sorry scape goats can be created everywhere. Pharma should only be one part of the equation, reading peer reviewed journal articles, and just plain keeping up should be the standard.
Regarding "reading peer reviewed journal articles, and just plain keeping up", that only works if the studies are PUBLISHED. The whole point of this article is that Big Pharma is HIDING the studies. And to "if asked a question the doctor is free to answer", I'm sure if the doctor answers too honestly he will dropped from the rotation.
Go ahead and spread the blame around, but that doesn't mean the blame on Big Pharm is lessened.
{fake suprise} You mean politicians and corporations lie?! {/fake surprise}
Your so on top of things W.
{sarcastic fake surprise} Elvis is dead?!! {/sarcastic fake surprise}
Kudos, kudos, kudos!
It is SO about time that someone had enough balls and credentials to speak out against big pharma.
This makes me so happy!
CONSUMERISM.
Our economy is a consumer economy and whatever can be created to sell is the norm.
Began with "Freedom Sticks," sold to women by Sigmund Freud's nephew, for his tobacco clients.
Nothing is sacred.
Unless we can be experimented on by those who trade digital entires known as SHAREHOLDER STOCKS.
Far too many a portfolio needs those stocks to retire with a comfortable living.
Unintelligent consumers basically invest in their own demise, one way or another.
SEEDS OF DESTRUCTION, by F. William Engdahl.
Education is the most powerful wisdom with respect to CONSUMERISM.
aka GLOBALISM.
There have been so many scandals lately about mental health here in Oregon.
Meanwhile, consider this. This is the 5th year that the Governor has had a budget with zero -- nothing -- for the state-wide voice of mental health consumers and psychiatric survivors.
Most USA states at least have some kind of token support for the voice of mental health clients. But since 2003, Oregon has zeroed that out.
Ask Governor Kulongoski why in the last legislative session he OVERRODE his own mental health systems request for funding for the statewide voice of mental health consumers and psychiatric survivors.
For more information go to www.mindfreedom.org. Use the internal search engine (upper right hand corner) to look up OCSC, which is the Oregon Consumer/Survivor Coalition.
You can also phone our office based in Eugene, Oregon for more info at 541-345-9106.
i love pills they taste like happy
THANK YOU for the exposee, WW! A psych recommended that my son be given "anti-anxiety" meds for his constant nausea when he suffered from several (undiagnosed) gastrointestinal disorders. So he would have ended up with stomach cancer, but he wouldn't have been anxious about it (grrrrr). Let's insist that our doctors find the REAL biological sources of illnesses/emotional behaviors with real lab tests (vitamin/mineral deficiencies, to start) instead of reaching for the prescription pad FIRST. When you see the "Adderall" clock on the wall of the doctor's office (another freebie from the pharmaceutical rep), run don't walk to the nearest exit...
If you don't want to take meds (for any condition), then don't.
If you're a doc who thinks certain drugs are dangerous, or overpriced or overprescribed and/or ineffective, then don't prescribe them.
But you do the rest of a society a disservice when you suggest that Big Pharma is more interested in the almighty dollar than they are in improving human health.
If the drugs didn't work, people wouldn't take them. If you encourage the FDA to move any slower than they already are, people will suffer while the approval of breakthrough medications is further delayed.
A much larger issue is the utter lack of self-policing amongst the medical establishment (AMA and state regulators) that shields the bad doctors from public scrutiny and fails to punish or decertify those with substance abuse problems, high complication rates, and recurrent claims of malpractice.
"If the drugs didn't work, people wouldn't take them."
Try telling this to anyone withdrawing from their own personal pharmaceutical hell under the influence of a quick-to-prescribe-you-something psychiatrist or doctor being backed by Big Pharma. If you consider the vast majority of individuals who have had to find out the hard way that these drugs don't work, many of them being children, you would probably reconsider this point.
Some of those people who may not want to take psych drugs but who ARE include over 6,000,000 children in this country. In his book, "How Doctors Think," oncologist Jerome Groopman devotes an entire chapter to the pressures doctors experience from the Pharm reps and their own peers to prescribe a certain number of drugs per day/per week. He also says that the Pharms have access to these numbers. "People wouldn't take drugs if they didn't work" - if a drug has negative side effects, additional drugs are often prescribed to counteract the side effects - on "The Medicated Child" program on PBS, the psych was seen prescribing a 9th drug to a child under 6 (to deal with the side effects of the other 8 drugs).
You are right-on regarding bad doctors and psychs and the lack of accountability ("Dr. Death" at Kaiser Permanente comes to mind). Last fall, the House Interim Committee on Health Care was shocked to discover that the state health boards that regulate doctors, psychs, dentists, etc. are not accountable to ANYONE, and some of them have disciplinary action rates of less than 5% (95% of consumer complaints are dismissed), although their websites claim their "number one priority" is to "protect the public". The disciplinary action rates suggest their number one priority is to protect their own FROM consumers.
I'm glad there is finally an individual at OHSU who has the balls to speak out against the corporate domination of medical care.
Why did Dr. Turner wait 3 years to speak up if he felt this way? Not only does he work at the OHSU he runs the mood disorders clinic at the VA. As a VA patient I am shocked at how freely psych meds are prescribed there. I can not help but wonder how many people his actions have hurt. Ok, better late than never but a lot of people could have been saved a lot of pain if he spoke up sooner
As a retired pharmacist who worked in state psychiatric hospitals, a VA psychiatric hospital in West LA, and the psychiatric floor at a hospital in San Diego (and a board certified pharmacist in psychiatric medicine), I applaud Dr. Turner and his expose. This news comes as no surprise to me, as I monitored thousands of prescriptions for antidepressants, often prescribed in doses above the FDA recommended dosage, for off-label diagnoses, and often combined with other antidepressants. My patients complained of side effects and I would have to give the official explanation that the drugs took six to eight weeks to be fully effective, and they would just get used to the side effects eventually.
Since I worked for public institutions for most of my career, I gained no remuneration for all the antidepressant medication orders I filled.
Too bad the U.S. government, and the U.S. media, is far behind the British government in recognizing this horrific corporate behavior by Big Pharma. See current articles in The London Times:
www.timesonline.co.uk/tol/life_and_...
and The London Guardian/Observer:
I'm Brazilian and want to remember that a 19 years old girl, Traci Johnson, who never had a mental problem volunteer to Cymbalta trial and hanged herself in Eli-Lilly Facilities. Other 4 people died in previous trials.
www.antidepressantsfacts.com/duloxe...
www.teenscreentruth.com/psychiatry_...
Antidepressants SSRIs are making o people having side effects even when they stop the drug.
Search for PSSD in Wikipedia. All these drugs are on Brazilian market and other poor countries.
Pharmaceutical Industry uses people from poor countries to make trials in hospitals without the knowledge or the consent of the patient. These highly addictive drugs causes hideous hams and no benefits whatsoever.
The UK Parliament has made a review on this "The Influence of Pharmaceutical Industry" www.publications.parliament.uk/pa/c....
But I doubt that you will stop selling these drugs. Too much money. Medicine does not care about HEALTH.
It's a complete lack of ethics. Vioxx and so many other drugs. BigPharmas are murderers. With the help of FDA and politicians.
You call it "Little Dirty Secret"?
You must be joking.
106,000 people die EVERY year from legally prescribed drugs, after taking them as directed, not abuse. This is from adverse reactions, oft times the drugs are administered by health care professionals while in treatment/hospital.
17,000 die EVERY year from OTC's.
Compare those numbers to the 17,000 total deaths from ALL illegal drugs combined. Deaths from Legal drugs; caffeine, alcohol and tobacco? A staggering 536,000 people. Add to that the 106,000 dead from prescribed drugs and we are way over 600,000 deaths.
www.mamas.org/Images/HazardsMortali...
DDT, I understand is the "mother molecule" in Acetaminophen. That is indeed scary.
Where is the Media? Where is the outrage?
KUDO's to this Dr. Now there is a REAL doctor who understands BS and is NOT afraid to say so.
WE are the ones who have to work towards reform and harm reduction through education. Education about the substances we consume allows US to make informed decisions BEFORE we consume anything, weighing benefit VS. risk. Part of the problem is that our doctors and pharmacists are NOT getting full disclosure re: the risks associated with Pharmaceuticals. We are on our own, pretty much, to find this information.
Who will hold the FDA's feet to the fire for approving these treatments and who will hold BIGPharmaCo's feet to the fire for knowingly harming people who either die or develop some sort of permanent damage from these poisons?
We will, collectively and loudly.
How I wish freidaMae we had this power.
The SSRIs harms are well known for more than a decade. The number of sites that approach all the side effects, the withdrawal symptoms, people who cannot get out off the drug; people who are on drugs but don't need them... are out in the open. Everything is already well documented. I cannot understand how a drug that kills on test trials can go to the market.
In 2006 test trials of TGN1412 left 6 people invalid for the rest of their lives. It was in London. You can find all this story searching the web. BBC has reported it: .This is one of the articles:
news.bbc.co.uk/go/pr/fr/-/2/hi/heal...
Can you imagine what has already happen in India, Africa and God know where with people who does not know that they are taking a drug that is on trial? These cases are not on BBC. They will never be reported.
Although the UK Parliament had made the review on "The Influence of Pharmaceutical Industry" in 2005 nothing was done. We would have to fight against the world to have tiny result.
At least they should save the children. Columbine and many other violent crimes were committed by people that were on SSRIs. Phill Hartman, the Saturday Night actor, was killed by his wife that was on antidepressant. You can check on this site: www.ssristories.com/index.php
I'm not optimistic either pessimist. Just realistic. We cannot fight the "people" who make profit with this.
That would be possible with people who have a heart. History has already proven that they seems to be human but are machines who only think about making money and more money. No matter at what expenses.
The irony is that they don't have time to enjoy the money for they have to work hard killing people to make more and more money.
Recently, my friend's wife died of a bad dosage, heart drug experiment, in her early 40's. Not only did the newspaper call it a drug overdose death, when she had taken it exactly as prescribed, but the pharmi co. sued my grieving & broke friend for abuse just to keep him silent. Of course the drug companies are already immune from lawsuits over such deaths anyway. As the tv ads say, "be sure to ask your doctor if XXXX is right for you" so you too can die!
Some doctors have shares in the Big Pharma companies and have become their drug pushers, to be able to retire rich at 55. Free post secondary education would end a lot of doctor greed, for as it is now, mainly only greedy rich men's kids can afford to become doctors. It's all so corrupt.
In this new age where transparency has entered in many aspects of health care, I applaud Dr. Turner for bringing this issue to light on the national platform. Being able to find all the clinical study results for a drug is a huge step in the right direction. Hopefully in time it won’t be hidden or buried on the FDA’s website. Maybe it will actually be shared by the drug makers so that both consumers and healthcare professionals can make well informed decisions using all of the information available, not just what is chosen for people to know (wishful thinking). This type of transparency is now being used by many health care institutions. Providing the data, both good and bad, should be the standard for any organization providing healthcare. Hopefully more health care professional will follow Dr. Turner’s lead for their own and their patients’ sake.