Is Prozac, the wonder drug of the 1990s, just a jumped-up placebo?

As seen on the British website Spiked

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. [...] 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, 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. [...]

It is worth noting that to register a drug, the FDA requires that two trials show it to perform better than placebo. One of the drugs needed nine trials to return two positive ones, the other seven being rejected. 'The whole thing is a pseudo-science', says Kirsch. 'These trials do not show that the drugs are significantly better than placebos.' This is not isolated evidence.

Good article, worth reading. The evidence is building up on the scam behind these drugs.

Taking Seroxat is increasingly being used as a defence for criminal behaviour

Taking Seroxat is increasingly being used as a defence for criminal behaviour. In one case in England, a man had charges dropped against him after claiming the drug turned him into a robber. The drug has been linked to a number of suicides and is currently under review. But its makers - the drugs giant GlaxoSmithKline say that millions of patients around the world have taken it without suffering any ill-effects.

See the extended interview here on the BBC.

[To investigate the doubts surrounding Seroxat, BBC Breakfast's Luisa Baldini talked to Mark Hamilton, who claims that the drug turned him into a violent robber. Full transcript at the link]

Scientists reconsiders position recommending psych drug

As reported in the Guardian

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".

Obviously, they are right to reconsider their position. What are these people thinking? What are their priorities?

Parents of suicide victim sue Accutane maker

The parents of a 14-year-old Palo Alto boy who threw himself in front of a train last year are suing the manufacturer of Accutane, a popular prescription drug the freshman was using to treat his acne, but which the family claims led to his suicide. Barry and Laurie Wertheimer of Palo Alto filed the lawsuit this week in Santa Clara County Superior Court against Hoffmann-La Roche for negligence, fraud and deceit, and medical negligence, among other charges.

The family is seeking a jury trial and unspecified general and punitive damages. "Steven Wertheimer's suicide was yet another tragic consequence of the ingestion of the acne drug Isotretinion, more commonly known as 'Accutane,' which Steven had been prescribed and taken over a six-month period," the lawsuit reads.

Psychiatrist's license put on probation

Dr. Stephen Rodney Kirkham has had his psychiatrist's license put on probation for five years because of his history of alcohol and drug abuse, according to the state's medical licensing board.

Dismissed for inappropriate conduct

Dr Neil McQuire, 52, is under investigation by British Psychological Society conduct committee in central London for inappropriate conduct with a female domestic violence victim. He has said he did not believe his behaviour towards the patient was wrong in the context of therapy, but agreed some of his actions or comments could be “open to misinterpretation”. He says that many of the allegations made by the patient – referred to only by the initials SK – were simply “untrue”. He told the committee that from May 1998, he had been made aware that his approach and therapy had sometimes crossed personal boundaries.

Dr McQuire, an associate fellow of the BPS, was dismissed from his post as a consultant clinical psychologist with Rochdale Healthcare NHS Trust in February 2002 for gross misconduct after a series of complaints by female patients over “inappropriate touching and comments”.

Update

Dr Neil McQuire, has been found guilty of professional misconduct.

Among other things, he allegedly told a young Asian woman he could see her in a relationship with a “white man” and that he was sad it could not be with him.

The British Psychological Society’s conduct committee said the father-of-three, of Clay Lane, Norden, Rochdale, Lancashire, had “violated the boundaries of therapeutic relationships” with a number of woman, even after receiving oral and written warnings by his employers.

German Doctor denies mass euthanasia involvement

A German doctor under police investigation over the deaths of 76 people insisted in a newspaper interview that she was innocent. "I'm no angel of death," Mechthild Bach told the Neue Presse newspaper in Hanover, central Germany, where the investigation is being coordinated.

The 53-year-old denied allegations she had deliberately killed patients by injecting them with fatally high doses of morphine. "There is nothing true in these claims," she said, putting the blame on a health insurance company which she said wanted to close the clinic where she worked.

She said she had instead "accompanied people into death," but only after consultations with the patient and their family. The goal was to allow them to die "without pain, fear or suffering".

It is still not clear whether the patients had voiced any wish to die.

The prosecutor's office in Hanover has said it is unclear whether the high dosages were given deliberately or accidentally, or without Bach having told the patients of the potential deadly side-effects. Two bodies have been exhumed so far for further examination.

According to weekend press reports, several of those who died in her care had been admitted with ailments that were not terminal, and had not previously reported suffering. Helping someone to die at their own request is punishable under German law by between six months and five years in prison.

Over Medicating the USA

Lou Dobbs recent column raises questions about overmedicating in the USA.

American consumers, mostly children, account for more than 90% of global consumption of such stimulants. "If we have four or five times the learning disability or depression or other neurotic illnesses that the Europeans do," Caplan says, "then either we got a really bad gene pool through immigration or we're overmedicating."

and, of course, the other answer is that everyone else is crazy.....

yeh, that's the answer ....

right

Prozac blamed for suicide, again

As reported in many Newspapers

A woman who blames her husband's suicide on Prozac has filed a lawsuit claiming that Eli Lilly & Co. should have warned patients that some people's bodies cannot metabolize the drug's active ingredient. The lawsuit filed against the Indianapolis-based drugmaker Thursday in Marion County Superior Court is the second to make such a claim. Lilly, which contends the drug is safe, settled a similar case in Georgia this spring.

But Houston attorney Andy Vickery, who has filed more than 20 lawsuits against the drugmaker including the Georgia suit, said this case is different. "This is the first case involving Lilly that we have hard scientific proof that our client had a hard time metabolizing Prozac," he said. A blood test found high levels of fluoxetine, Prozac's active ingredient, in the body of Clarkston, Mich., police officer Daren Alli following his May 23, 2001 suicide, alleges the lawsuit.

Alli had taken Prozac for three days to alleviate a "mild" case of depression, but threw the pills in the toilet after they made him "jumpy" and "jittery," said his widow, Michele.

Four days later, the SWAT team captain shot himself in the head with a .38-caliber revolver.

Two Psychologists under the gun

Psychological testing for the Broward Public Defender's Office is in disarray after the procedures of two prominent psychologists in murder cases have come into question. Another psychologist, Sherrie Bourg Carter, alleged that William Vicary and David Shapiro either deliberately contaminated tests by coaching murder defendants or manipulated answers to help the defense attorneys who hired them. Also, Shapiro was criticized for using unlicensed student interns to conduct tests in first-degree murder cases such as Polanco's.

Drugs, lies, and half-truths

Good article in the Christian Science Monitor looks at the problems in fighting drug addiction, and the messages that get sent to kids.

"The whole psychiatry movement basically got hijacked by the pharmaceutical industry in the late '80s," he [Dr Lawrence Diller] charges. "The discovery of certain drugs and the power of certain drug companies actually altered the way we think of ourselves."

"I worry that Ritalin becomes a substitute for other important factors, such as parents parenting better and teachers teaching better," he says. When that happens, he says, "the doctor winds up being complicit with values that are not good for children."

Society is normalizing the use of self-improvement drugs, and kids are acutely aware of that, says Peter Kramer, a professor at Brown University in Providence, R.I., and author of "Listening to Prozac."

"There's a phenomenon of giving medication to people who are fairly healthy," he says, "and having them overshoot to a point where they are more culturally rewarded."

That may be one reason why it's hard for today's adolescents to absorb the message when adults want them to understand that drugs can also be dangerous.

well, duh ...

Psychologist calls for Selective Breeding of Humans

A leading Danish psychologist has caused outrage by calling for the state to encourage the selective reproduction of children from intelligent parents and try to stop less gifted groups having children. "Intelligence is hereditary," said Professor Helmuth Nyborg, the dean of the psychology institute at Aarhus University.

"The 15 to 20 per cent of those at the lower levels of society - those who are not able to manage even the simplest tasks and often not their children - should be dissuaded from having children. "The fact is that they are having more children and the intelligent ones are having fewer."

He insisted his proposals could not be likened to policies under the Nazis. "Hitler didn't believe in eugenics. He just wanted to exterminate individual groups, and in fact exterminated the most intelligent among them," he said.

Florida Department of Children & Families trying to hide something?

As reported in the Sarasota Herald-Tribune

A watchdog group created by the Florida Legislature to help disabled and vulnerable Floridians claims that the state Department of Children & Families is retaliating for its report on drugged foster children. The Statewide Advocacy Council issued an analysis of DCF records this month indicating that more than half the state's emotionally disturbed foster children were prescribed mind-altering medication, and nearly half of them had no medical evaluation. Seventeen were 5 or younger.

After that analysis, the agency stopped sharing records with the panel for the first time in 28 years. DCF attorneys also have begun screening all calls to the council's toll-free complaint hot line.

"Someone is trying to hide the facts," said state Sen. Walter G. "Skip" Campbell, D-Tamarac, who has tried twice to curb the use of psychiatric drugs among children in state care. "They don't want us to know what is actually happening to kids in foster care."

British Government accused of trying to suppress report on psychiatric racism

The author of a damning report, which brands Britain's mental health services institutionally racist, has accused the British Government of trying to suppress its findings.

The Conservatives are now calling for an independent inquiry into ethnic-minority care following the publication of Professor Sashidharan's study, called Inside Outside (download link).

Published in April, the findings were damning. The report concluded that mental health services were institutionally racist, that the whole issue of ethnicity within mental health services had become marginalised or even ignored and that these problems were getting worse. Inside Outside also revealed that mentally distressed black people are more likely to be locked away, that rates of compulsory admission are markedly higher and that black and minority patients are more likely than white people to be assessed as requiring greater degrees of supervision, control and security.

Insurer Seeks Return of Fees for Therapy

As reported in the New York Times

For years, health insurers have occasionally demanded a look at psychotherapists' notes of their sessions with patients, to ensure that the care they were paying for was appropriate, or that it actually took place.

But now one insurer, Oxford Health Plans, is saying that in many cases, the notes are not enough evidence that the patients received what Oxford paid for. Oxford has audited hundreds of psychiatrists, psychologists and social workers in the New York metropolitan area, deemed their notes inadequate documentation of the sessions, and demanded repayment of thousands of dollars from each provider — in some cases, more than $100,000. [...]

Oxford audited 300 psychiatrists, psychologists and social workers in the metropolitan region, out of what it says are about 5,000 therapists in its system. The audits, which began last year, reached back to 1997, and the company sent letters seeking repayment this summer.


The crux of the problem, from the therapists' view, is that there are no generally agreed-on rules for session notes. "No one has ever told me what my notes had to contain or how long they had to be," said one audited psychologist, who has been told to return more than $40,000. "On rare occasions, I don't take any notes at all, if the patient says they're uncomfortable with it."

They are getting roasted over a spit slowly because there is no scientific or administrative standard that they adhere to. You can't go back into the notes, apparently, and see what really happened. At least according to Oxford.

Not that I'm going to give them any suggestions. ;-)

British Watchdog bans 14 prescription drugs over fear of multiple deaths

As seen in the Observer, in a follow up to the earlier story on the ban of Efexor:

Britain's drug watchdog has been forced to ban the use of 14 prescription drugs in the last five years after they were suspected of killing hundreds of people in the UK or harming thousands through serious side effects. Official figures released for the first time highlight the growing number of controversial decisions made by the Medicines and Healthcare Regulatory Agency (MHRA), which gave the green light to the drugs in the first place. In some cases, concerns about the drugs' safety records were already known.

Last week the MHRA released data to The Observer confirming that the 14 drugs it has banned since 1997 have been cited as a possible cause in at least 71 deaths in Britain and more than 3,000 injuries. Because these 'adverse' incidents are only reported on a voluntary basis by a hospital or doctor, experts believe the true number of people killed by these drugs probably runs into several hundreds, with thousands more injured.

The disclosure of these figures will put further pressure on the agency, which was forced on Friday to announce a ban on the anti-depressant Efexor for children and adolescents with depression. The move came within months of a ban on under-18s taking another anti-depressant, Seroxat, after concerns that it increased the risk of suicide. [...]

Consumer groups and other critics of the drug-licensing system are alarmed at how many dangerous drugs win approval in the UK and are later withdrawn after being linked to serious side- effects. In the five years prior to 1997, only six drugs had to be taken off the market.

Many of these are not psych oriented, but are indicators of a larger ongoing situation

Typical antipsychotic therapy increases cravings for cocaine and amphetamines in Psych patients

A study has found that

Discontinuation of typical antipsychotic therapy reduced craving for cocaine and amphetamines in patients with psychiatric illness,

but did not change drug use or psychiatric symptoms. Link goes to a review of the study.

So can we conclude the opposite, that typical antipsychotic therapy increases cravings for cocaine and amphetamines in Psych patients? Sound reasonable to me.

See the study abstract here Brown ES, Nejtek VA, Perantie DC, Rajan Thomas N, Rush AJ. in the Journal of Clinical Psychopharmacolology 2003 August.

Psychologist accused of sexually harassing patients

As seen in this report from Iowa

A psychologist who worked at the state-run Mental Health Institute in Independence is accused of sexually harassing patients.

Joshua Rosenberg, who now lives in New York, was an Iowa-licensed psychologist from 1978 to 2002. According to state records, he was employed by the Iowa Department of Human Services for at least nine years, from 1993 to 2002.

In August 2000, when he was living in Waterloo and working at the Mental Health Institute, a patient filed a complaint against Rosenberg with the Iowa Board of Psychology Examiners. The complainant alleged Rosenberg had inappropriate physical contact with him or her. A female patient of the institute filed a second complaint, alleging Rosenberg had sexually harassed her.

According to records of the psychology board, a staff investigator made several attempts to contact Rosenberg to arrange for an interview, and Rosenberg did not respond or refused to cooperate. He then moved without notifying the licensing board of his whereabouts.

The board has charged Rosenberg with engaging in practices harmful to the public, violating his profession's ethics and failing to cooperate with an investigation. Rosenberg has 20 days to respond. A hearing is scheduled for February 2004.

Vermont State Hospital loses Federal Psych funding

The Vermont State Hospital will not challenge a federal decision to withhold funding for patients at the state psychiatric facility effective Sept. 30.

The Centers for Medicare and Medicaid Services decided last week to stop paying roughly $700,000 a year to the 54-bed hospital in Waterbury because its inspectors found a list of deficiencies in treatment, staffing, leadership and patient safety during repeated inspections since March.
Federal officials concluded this month that the hospital wouldn’t be able to remedy everything by a Sept. 30 deadline.

Helen Mulligan, spokeswoman for the agency, said that when the second suicide in a month took place after the hospital said it was making corrections, “we concluded that either the plan of correction wasn’t adequate or it wasn’t being followed.” Besio said the problem wasn’t with the proposed changes, but the ambitious schedule.

A female patient committed suicide Sept. 16. A male patient committed suicide Aug. 8. Shaw wrote that inspections following each of these events noted deficiencies “of such a serious nature as to constitute an immediate threat to the health and safety of patients receiving inpatient services.”

A German psychologist specialising in treating chickens

A German psychologist is specialising in treating chickens and is helping them deal with problems ranging from gender issues to neurosis. Barbara Luetzeler, from Bonn, is the country's only chicken psychologist. She says one of her cases involved a hen named Lucie who always wanted to be a cock.

You just can't make this stuff up