Intended for healthcare professionals

Letters Long term use of psychiatric drugs

Corruption impairs discussion on long term use of psychiatric drugs

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2953 (Published 02 June 2015) Cite this as: BMJ 2015;350:h2953
  1. Robert Whitaker, journalist, former fellow1,
  2. Lisa Cosgrove, professor, University of Massachusetts, Boston, and fellow, Edmond J Safra Research Lab1
  1. 1Edmond J Safra Center for Ethics, Harvard University, Cambridge, MA 02138, USA
  1. robert.b.whitaker{at}verizon.net

While debating the important question of whether long term psychiatric drugs cause more harm than good,1 we must remember that results from longer term government funded studies of psychiatric drugs have often been reported in a manner that protects psychiatry’s guild interests, rather than being consistent with the dictates of good science. Here are two brief examples of this corruption.2

Firstly, in the TADS study of depressed adolescents, a National Institute of Mental Health (NIMD) funded trial that helped resurrect the prescribing of fluoxetine in paediatric patients, the researchers reported “no differences between groups in rates of suicidal events” at the end of 36 weeks.3 But careful perusal of figure 1 in a 2009 report shows that 17 of the 18 young people who attempted suicide during the 36 weeks were on fluoxetine at the time.4

Secondly, in the NIMH funded STAR*D study, which was touted as the “largest and longest study ever done to evaluate depression treatment,” the researchers never clearly reported how many patients remitted and did not relapse during the one year maintenance phase. The data presented suggested that 35-40% of the 4041 study patients fell into this best outcomes category.5 However, an independent researcher who used a Freedom of Information request to access the protocol and other study data determined that only 108 patients (3%) were still in remission and in the trial at the end of one year.6 7

Many examples of corruption can be detailed, and it is easy to see why this impairs any societal—or scientific—discussion about the longer term merits of psychiatric drugs.

Notes

Cite this as: BMJ 2015;350:h2953

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References

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