Fiddamans blogby Bob FiddamanJanuary 31, 2014You’d have to be from the planet Zog if you didn’t know who Karen Wagner was.
Her name is synonymous with antidepressant pediatric studies. She added her name to the Paxil 329 ghostwritten paper without actually looking at the raw data [which showed an increased rate of suicidal thoughts in kids taking Paxil] – The result of that piece of Pharmafia fraud told millions of prescribing physicians that Paxil was safe to use in children and adolescents…when in actual fact it wasn’t. Wagner has been relentless to disprove those who believe antidepressant use in kids is wrong. She sees no problem with it…despite overwhelming evidence that shows just how dangerous antidepressant use in kids can be.
An article published in Clinical Psychiatry News [Treating youngsters’ depression means going off the FDA grid] a couple of days ago shows Wagner, once again, promoting the use of SSRi medication in children and adolescents. Wagner was present at a psychopharmacology update held by the American Academy of Child and Adolescent Psychiatry where she claimed that "…60% of youngsters will respond favorably to their first antidepressant medication – generally a selective serotonin reuptake inhibitor (SSRI)" Wagner also went on to claim that Switching to a different antidepressant will help about 50% of those who don’t respond. But adding psychotherapy will grab about 10% more – bringing the total response rate up to around 70%". She was referring to a 2008 study, TORDIA [Treatment of Resistant Depression in Adolescents].
So, Wagner hits the stage at these types of events, she’s a key opinion leader, in other words, those employed in the same field as her look up to her, respect her, hang on to her every word. She is the Geldof of the pop world, pushing her message at every given opportunity. Quite why she sticks her middle finger up at evidence that shows kids kill themselves whilst on these drugs kind of alarms me.
So, is Wagner on a mission to help depressed children and teens, does she genuinely care about this population or are there more sinister undertones? It would help if she and the article published in Clinical Psychiatry News was actually more transparent about her relationship and financial ties to the pharmaceutical industry [Pharmafia]. Upon reading the article I had to do a double take at the end… "Dr. Wagner has no financial relationships with pharmaceutical companies"…
Venlafaxine is one of many antidepressants that are not approved for use in children and teens. Treating depression in youngsters almost always means off-label prescribing. Only two antidepressants – fluoxetine and escitalopram – are Food and Drug Administration–approved for children and teens, and only fluoxetine is approved for children younger than 12 years. And data are actually mixed about fluoxetine; a recent published study showed it was no different from placebo over 6 months. Of the older, more well-known antidepressants, only two have positive data for youngsters. One randomized study of citalopram posted positive findings for its primary endpoint [American Journal of Psychiatry 2004;161:1079-83]. The other is sertraline, which had positive overall findings in a pooled analysis, although the individual studies were negative [JAMA 2003;290:1033-41].
Studies on all of the other drugs were negative, including mirtazapine [two studies], nefazodone [two], paroxetine [three], and venlafaxine [two].
This doesn’t mean the medications won’t work – they do benefit some children, Dr. Wagner said. But parents need to know that the studies in children were not positive. However, she added, the safety profiles were all reasonably good…
The newest evidence for duloxetine in youngsters with depression looks lousy. In two highly anticipated, yet-unpublished, phase III trials, duloxetine and fluoxetine – which is already approved for kids – completely fell apart relative to placebo, Dr. Wagner said…
That leaves the Treatment of Resistant Depression in Adolescents [TORDIA] study, one of those NIMH funded clinical trials contemporary with many of the other industry funded trials she mentions. She was an author on that one too. I’ve never commented on that study – for a reason. It’s super-convoluted and reported in pieces in a bunch of different journals. But since it’s the center of her talk, I expect I’ll dig up those papers and go through it soon [but don’t hold your breath for great clarity].
I emailed the author of the article, asked her if she was going to rectify the claim that Wagner wasn’t on the pharmafia payroll.
She never replied.
Pharma HO.
Then we have this just released gem:
http://brodyhooked.blogspot.com/2014/02/reps-on-safety-issues-or-sounds-of.html
Drug reps lie! Who would have thought such a thing?
Steve Lucas
Children are the most powerless people the “it” of psychiatry can feed on. That the biological supposition is so thoughtlessly dominant that psychiatrists aren’t questioning parents and their relationships with children before giving children drugs evidence that their religion is dehumanizing. It’s also cut from the same fabric that requires universities to be surrogate parents for people who should be treated like adults and expected to behave as adults— students and their parents, are now seen as “consumers”.
Ka-ching.