{"id":20127,"date":"2012-02-23T21:42:08","date_gmt":"2012-02-24T02:42:08","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=20127"},"modified":"2012-02-23T21:47:22","modified_gmt":"2012-02-24T02:47:22","slug":"significant-iii","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2012\/02\/23\/significant-iii\/","title":{"rendered":"<em>significant<\/em> III&#8230;"},"content":{"rendered":"\n<p align=\"justify\">While the <strong><font color=\"#200020\">Treatment for Adolescents With Depression Study (TADS)<\/font><\/strong> involved only Prozac as a study drug, there were plenty of other companies invested in countering the FDA&#8217;s 2004 Warning about suicidality in adolescents on SSRIs:<\/p>\n<p align=\"center\"><img loading=\"lazy\" decoding=\"async\" width=\"334\" height=\"232\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/bttf-4.gif\" \/><br \/>          <sup>[patent life of the antidepressants]<\/sup><\/p>\n<p align=\"justify\">Now looking at the Financial Disclosures from the four key <strong><font color=\"#200020\">TADS<\/font><\/strong> articles that I mentioned in <em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/wp-admin\/..\/index.php\/2012\/02\/22\/significant-i\/\"><u><strong><font color=\"#200020\"><em>significant<\/em><\/font><\/strong><\/u><\/a><\/em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/wp-admin\/..\/index.php\/2012\/02\/22\/significant-i\/\"><u><strong><font color=\"#200020\"> I&hellip;<\/font><\/strong><\/u><\/a> and<em>&nbsp;<a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\/\"><u><strong><font color=\"#200020\"><em>significant<\/em><\/font><\/strong><\/u><\/a><\/em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\/\"><u><strong><font color=\"#200020\"> II&hellip;<\/font><\/strong><\/u><\/a><em>, <\/em>these companies were well represented:<\/p>\n<ol>\n<li>\n<div><a href=\"http:\/\/jama.ama-assn.org\/content\/292\/7\/807.long\" target=\"_blank\"><u><strong><font color=\"#200020\">Fluoxetine, Cognitive-Behavioral Therapy, and Their Combination for Adolescents With Depression<\/font><\/strong><\/u><\/a><br \/>                      by the Treatment for Adolescents With Depression Study (TADS) Team<u><br \/>                       <\/u><strong><font color=\"#200020\">JAMA<\/font><\/strong>. 2004 292(7):807-820.<\/div>\n<ul>\n<div align=\"justify\"><sup><u><strong><font color=\"#200020\">Financial Disclosures:<\/font><\/strong><\/u> Dr March has served on the  speaker&#8217;s bureau for <strong><font color=\"#000099\">Pfizer<\/font><\/strong> and <strong><font color=\"#990000\">Lilly<\/font><\/strong> and has received research support  from <strong><font color=\"#990000\">Lilly<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and                      <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>. Dr Findling has received research support  from Bristol-Myers Squibb, <strong><font color=\"#009900\"><strong><font color=\"#009900\">Forest<\/font><\/strong><\/font><\/strong>, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#990000\">Lilly<\/font><\/strong>, Nature&#8217;s  Herbs,                      Organon, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, Solvay, Somerset, and <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>; been a  consultant for Bristol-Myers Squibb, <strong><font color=\"#009900\">Forest<\/font><\/strong>, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#990000\">Lilly<\/font><\/strong>,                      <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, Somerset, and <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>; and served on the  speaker&#8217;s bureau for Bristol-Myers Squibb, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#990000\">Lilly<\/font><\/strong>, and  <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>.                      Dr Waslick has received research support from  <strong><font color=\"#990000\">Lilly<\/font><\/strong>. Dr Walkup has received research support and honoraria from <strong><font color=\"#990000\">Lilly<\/font><\/strong>.  Dr                      Kastelic has received honoraria from <strong><font color=\"#000099\">Pfizer<\/font><\/strong>. Dr  Kratochvil has received reseach support from <strong><font color=\"#990000\">Lilly<\/font><\/strong>, <strong><font color=\"#009900\">Forest<\/font><\/strong>, and  <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>;                      been a consultant for <strong><font color=\"#990000\">Lilly<\/font><\/strong>; and served on the  speaker&#8217;s bureau for <strong><font color=\"#990000\">Lilly<\/font><\/strong>. Dr Harrington has received research support  from <strong><font color=\"#990000\">                     Lilly<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and Astra-Zeneca. Dr Leventhal has  been a consultant, received research support, and served on the  speaker&#8217;s                      bureau for <strong><font color=\"#990000\">Lilly<\/font><\/strong>. Dr Emslie has received research  support from <strong><font color=\"#990000\">Lilly<\/font><\/strong>, Organon, and RepliGen; been a consultant for <strong><font color=\"#990000\">Lilly<\/font><\/strong>,                      <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#009900\">Forest<\/font><\/strong> Laboratories, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and  <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>-Ayerst; and served on the speaker&#8217;s bureau for McNeil.<\/sup><\/div>\n<\/ul>\n<\/li>\n<li>\n<div><a target=\"_blank\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17135989\"><u><strong><font color=\"#200020\">Treatment for Adolescents with Depression Study (TADS): SafetyResults<\/font><\/strong><\/u><\/a>.<br \/>                                               <sup>by Emslie G, Kratochvil C, Vitiello B, Silva S, Mayes T, McNulty S, Weller E, Waslick B, Casat C, Walkup J, Pathak S, Rohde P, Posner K, March J; Columbia Suicidality Classification Group; TADS Team<\/sup><br \/>                                               <strong><font color=\"#200020\">Journal of the American Academy of Child and Adolescent Psychiatry<\/font><\/strong>. 2006  45(12):1440-55<\/div>\n<ul>\n<div align=\"justify\"><sup><u><strong><font color=\"#200020\">Disclosure:<\/font><\/strong><\/u> Dr. Emslie receives research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, Organon, and <strong><font color=\"#009900\">Forest<\/font><\/strong> Laboratories; is a consultant for <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#009900\">Forest<\/font><\/strong> Laboratories, <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>-Ayerst, and <strong><font color=\"#000099\">Pfizer<\/font><\/strong>; and is on the speakers&rsquo; bureau of McNeil. Dr. Kratochvil is a consultant or scientific advisor to<strong><font color=\"#990000\"> Eli Lilly<\/font><\/strong>, Shire, Cephalon, Organon, AstraZeneca, Boehringer-Ingelheim, Abbott and <strong><font color=\"#000099\">Pfizer<\/font><\/strong>; receives research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, McNeil, Cephalon, and Abbott; receives study drug for an NIMH-funded study from <strong><font color=\"#990000\">Lilly<\/font><\/strong>; and is on the<strong><font color=\"#990000\"> Eli Lilly<\/font><\/strong> speakers&rsquo; bureau. Dr. Silva is a consultant to <strong><font color=\"#000099\">Pfizer<\/font><\/strong>. Dr. Weller is a consultant to and receives grants from Otsuka, Johnson &amp; Johnson, AstraZeneca, Organon, Pharma, Shire, and <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>. Dr. Waslick receives research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>. Dr. Casat receives research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, Shire, Bristol-Myers Squibb, AstraZeneca, Sanofi-Synthelabo, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and McNeil; is on the Advisory Board and the speakers&rsquo; bureaus of <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong> and <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>. Dr. Walkup receives research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and Abbott; is a consultant to <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, Jazz, and Cephalon; and has received honoraria from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong> and <strong><font color=\"#000099\">Pfizer<\/font><\/strong>. Dr. Pathak receives research support from <strong><font color=\"#009900\">Forest<\/font><\/strong>. Dr. Posner has received research support from <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#009900\">Forest<\/font><\/strong>, Eisai, AstraZeneca, Johnson &amp; Johnson, Abbott, <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>, Organon, Bristol-Myers Squibb, Sanofi-Aventis, Cephalon, Novartis, Shire, and UCB Pharma. Dr. March is on the speakers&rsquo; bureaus of <strong><font color=\"#000099\">Pfizer<\/font><\/strong> and <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong> and has received research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, and <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>. The other authors have no financial relationships to disclose.<\/sup><\/div>\n<\/ul>\n<\/li>\n<li>\n<div><a href=\"http:\/\/archpsyc.ama-assn.org\/cgi\/content\/full\/64\/10\/1132\" target=\"_blank\"><u><strong><font color=\"#200020\">The Treatment for Adolescents With Depression Study (TADS)<\/font><\/strong><\/u><\/a><br \/>                                               <strong><font color=\"#200020\"><sup>Long-term Effectiveness and Safety Outcomes<\/sup><\/font><\/strong><br \/>                                               <sup>by The TADS Team<\/sup><br \/>                                               <strong><font color=\"#200020\">Archives of General Psychiatry<\/font><\/strong>. 2007 64(10):1132-1143.<\/div>\n<ul>\n<div align=\"justify\"><sup><u><strong><font color=\"#200020\">Financial Disclosure:<\/font><\/strong><\/u> Dr Findling has received research support, acted as a consultant, and\/or served on a speaker&#8217;s bureau for Abbott Laboratories, AstraZeneca Pharmaceuticals, Bristol-Myers Squibb, Celltech-Medeva, <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong> and Company, <strong><font color=\"#009900\">Forest<\/font><\/strong> Laboratories, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, Johnson &amp; Johnson, New River, Novartis, Otsuka, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, Sanofi-Aventis, Shire Pharmaceuticals, Solvay, and <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong> Research. Dr Posner has received funding from the US Food and Drug Administration (FDA) to develop the suicidality classification system used in their antidepressant safety analysis. Subsequently, as part of an effort to help execute the FDA suicidality classification mandates, Dr Posner has had research support from Abbott Laboratories, AstraZeneca Pharmaceuticals, Bristol-Myers Squibb, Cephalon, Eisai Inc, <strong><font color=\"#009900\">Forest<\/font><\/strong> Laboratories, <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, Johnson &amp; Johnson, Novartis, Organon USA, Sanofi-Aventis, Shire Pharmaceuticals, UCB Pharma, and <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong> Research.<\/sup><\/div>\n<\/ul>\n<\/li>\n<li>\n<div><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2702701\/\" target=\"_blank\"><u><strong><font color=\"#200020\">Suicidal Events in the Treatment for Adolescents with Depression Study (TADS)<\/font><\/strong><\/u><\/a><br \/>                                             <sup>by Benedetto Vitiello, Susan Silva, Paul Rohde, Christopher Kratochvil, Betsy Kennard, Mark Reinecke, Taryn Mayes, Kelly Posner, Diane E. May, and John S. March<\/sup><br \/>                                             <strong><font color=\"#200020\">Journal of Clinical Psychiatry<\/font><\/strong>. 2009 70(5): 741&ndash;747<\/div>\n<ul>\n<div align=\"justify\"><sup><u><strong><font color=\"#200020\">Financial Disclosure:<\/font><\/strong><\/u> Susan  Silva is a consultant with <strong><font color=\"#000099\">Pfizer<\/font><\/strong>. Christopher Kratochvil receives  research support from <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>, Somerset, Abbott, Shire, McNeil, and  Cephalon, is a consultant for <strong><font color=\"#990000\">Eli Lill<\/font><font color=\"#990000\">y<\/font><\/strong>, <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, Cephalon, AstraZeneca,  Organon, and Shire, and is on the Speaker&rsquo;s Bureau of <strong><font color=\"#990000\">Eli Lilly<\/font><\/strong>. Dr.  Posner has been consultant and\/or received research support from  <strong><font color=\"#c000c0\">GlaxoSmithKline<\/font><\/strong>, <strong><font color=\"#009900\">Forest<\/font><\/strong>, Eisai, AstraZeneca, Johnson&amp;Johnson,  Abbott, <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>, Organon, Bristol-Myers Squibb, Sanofi-Aventis, Cephalon,  Novartis, Shire, and UCB Pharma. John March is a consultant or  scientific advisor to <strong><font color=\"#000099\">Pfizer<\/font><\/strong>, <strong><font color=\"#990000\">Lilly<\/font><\/strong>, <strong><font color=\"#ff6000\">Wyeth<\/font><\/strong>, <strong><font color=\"#c000c0\">GSK<\/font><\/strong>, Jazz, and MedAvante and  holds stock in MedAvante; he receives research support from <strong><font color=\"#990000\">Lilly<\/font><\/strong> and  study drug for an NIMH-funded study from <strong><font color=\"#990000\">Lilly<\/font><\/strong> and <strong><font color=\"#000099\">Pfizer<\/font><\/strong>. The other  authors have no financial relationships to disclose.<\/sup><\/div>\n<\/ul>\n<\/li>\n<\/ol>\n<div><strong><font color=\"#200020\">My thanks to Rob Purssey for his comments about the conflicts of interest in the TADS articles <sub>[<u><a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\/#comment-218906\" target=\"_blank\">1<\/a><\/u>][<u><a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\/#comment-218907\" target=\"_blank\">2<\/a><\/u>][<u><a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\/#comment-218908\" target=\"_blank\">3<\/a><\/u>]<\/sub> on <\/font><\/strong><em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\"><u><strong><font color=\"#200020\"><em>significant<\/em><\/font><\/strong><\/u><\/a><\/em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\"><u><strong><font color=\"#200020\"> II&hellip;<\/font><\/strong><\/u><\/a>.<\/div>\n<p align=\"justify\">I think we&#8217;re so used to this kind of thing that it doesn&#8217;t occur to us how really bizarre having a rainbow coalition of Investigators with personal financial ties to pharmaceutical companies with an investment in the outcome of the study actually involved in the study itself. It&#8217;s hard to imagine that the connections are unrelated to, for example, publishing this figure in an article titled <strong><font color=\"#200020\">Suicidal Events in the Treatment for Adolescents with Depression Study<\/font><\/strong>&#8230; <\/p>\n<p align=\"center\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"285\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/vitiello.gif\" \/><br \/>         <sup>[reformatted for clarity]<\/sup><\/p>\n<div align=\"justify\"><img decoding=\"async\" align=\"right\" width=\"180\" hspace=\"4\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/vitiello-6.gif\" \/>&#8230; and failing to mention that 82% of the suicidal events were in kids on Prozac and 94% of the suicide attempts were by kids on Prozac. What other explanation is there besides those conflicts of interest for leaving out the most obvious thing in their data? Where are the graphs in the article that look like these? Raw numbers. One doesn&#8217;t even need any statistics to see the point. Like all &#8216;good data,&#8217; it&#8217;s just there.       <\/div>\n<div align=\"center\"><img loading=\"lazy\" decoding=\"async\" width=\"286\" vspace=\"7\" height=\"253\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/vitiello-5.gif\" \/><\/div>\n<div align=\"justify\">And as long as we&#8217;re in the neighborhood, what did the treatment do <u>for<\/u> the kids in the study? We have to look at two papers for that answer. First, the 12 week outcome data published in 2004:<\/div>\n<p align=\"justify\"><a target=\"_blank\" href=\"http:\/\/jama.ama-assn.org\/content\/292\/7\/807.long\"><u><strong><font color=\"#200020\">Fluoxetine, Cognitive-Behavioral Therapy, and Their Combination for Adolescents With Depression<\/font><\/strong><\/u><\/a><br \/>                                    <sup>by the Treatment for Adolescents With Depression Study (TADS) Team<\/sup><br \/>                                    <strong><font color=\"#200020\">JAMA<\/font><\/strong>. 2004 292(7):807-820. <strong>[<a target=\"_blank\" href=\"http:\/\/jama.ama-assn.org\/content\/292\/7\/807.long\"><font color=\"#200020\">full text on-line<\/font><\/a>]<\/strong><\/p>\n<p align=\"justify\">This is their outcome graph reformatted by doing that thing I do about making the ordinates start with zero. The absent [B] was another Depression Scale that looked the same as the CDRS-R.<\/p>\n<p align=\"center\"><img decoding=\"async\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/vitiello-8.gif\" \/><\/p>\n<p align=\"justify\">It terms of depression, Prozac helped some. CBT didn&#8217;t add much. By this suicidal ideation rating scale, Placebo&nbsp; and Prozac came out close to the same. CBT did seem to decrease suicidal ideation. <\/p>\n<p><a target=\"_blank\" href=\"http:\/\/archpsyc.ama-assn.org\/cgi\/content\/full\/64\/10\/1132\"><u><strong><font color=\"#200020\">The Treatment for Adolescents With Depression Study (TADS)<\/font><\/strong><\/u><\/a><br \/>                              <strong><font color=\"#200020\"><sup>Long-term Effectiveness and Safety Outcomes<\/sup><\/font><\/strong><br \/>                              <sup>by The TADS Team<\/sup><br \/>                              <strong><font color=\"#200020\">Archives of General Psychiatry<\/font><\/strong>. 2007 64(10):1132-1143. [<strong><a target=\"_blank\" href=\"http:\/\/archpsyc.ama-assn.org\/cgi\/content\/full\/64\/10\/1132\"><u><font color=\"#200020\">full text on-line<\/font><\/u><\/a><\/strong>]<\/p>\n<p align=\"justify\">The long-term results only covered the treatment groups [the placebo group was no longer in the study]. The results are harder to interpret because the study was unblinded at 12 weeks and they did all kinds of things thereafter. I will admit to having low libido for trying to make sense of it after about an hour and chose playing with my dogs as a more productive use of time on this gorgeous afternoon. That said, here&#8217;s the outcome they reported [adjusted to start at zero]:<\/p>\n<p align=\"center\"><img loading=\"lazy\" decoding=\"async\" width=\"480\" height=\"308\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/vitiello-7.gif\" \/><\/p>\n<p align=\"justify\">My take by inspection is that one could say that the kids treated with Prozac got better faster, and that depressed kids get better over time anyway [with the reservations that what happened in the second part of the study is not totally clear].<\/p>\n<p align=\"justify\">In each of the four papers in the list being looked at from the <strong><font color=\"#200020\">The Treatment for Adolescents With Depression Study<\/font><\/strong>, I had the feeling that there was some level of bias in favor of SSRI effectiveness in adolescent depression and definitely in downplaying emergent suicidality. I&#8217;ve tried to show examples in <em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-i\"><u><strong><font color=\"#200020\"><em>significant<\/em><\/font><\/strong><\/u><\/a><\/em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-i\"><u><strong><font color=\"#200020\"> I&hellip;<\/font><\/strong><\/u><\/a>, <em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\"><u><strong><font color=\"#200020\"><em>significant<\/em><\/font><\/strong><\/u><\/a><\/em><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/22\/significant-ii\"><u><strong><font color=\"#200020\"> II&hellip;<\/font><\/strong><\/u><\/a>, and this post, but the concrete examples don&#8217;t capture it all. For example, I joked around about the difficulty following what happened after the unblinding at 12 weeks, but what I actually felt was that it had been so obfuscated that I&#8217;d never figure it out. And there were examples like that in each of the papers. There&#8217;s little question that there was a lot more of that when it came to suicidality, the grossest example is illustrated above. If you read paper number 4. [<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2702701\/\" target=\"_blank\"><u><strong><font color=\"#200020\">Suicidal Events in the Treatment for Adolescents with Depression Study (TADS)<\/font><\/strong><\/u><\/a>], it seems to have been written to &quot;shoot down&quot; the idea of akathisia as the cause of Prozac&#8217;s suicidality. Since there was no actual clinical material but only rating scales, that effort failed from my perspective. But the point is that there&#8217;s bias in that orientation, just like there&#8217;s BIAS in failing to show the graphs I&#8217;ve included above about suicidality.<\/p>\n<div align=\"justify\">With the kind of thing that was being published at that time, this was actually a &#8216;good study&#8217; compared to something like Dr. Martin Keller et al&#8217;s <strong><font color=\"#200020\">Study 329<\/font><\/strong> using Paxil in Adolescents [<a href=\"http:\/\/www.healthyskepticism.org\/global\/news\/int\/hsin2010-01\" target=\"_blank\"><u><strong><font color=\"#200020\">Healthy Skepticism<\/font><\/strong><\/u><\/a>, <u><strong><a href=\"http:\/\/1boringoldman.com\/index.php\/2011\/05\/07\/retract-study-329\" target=\"_blank\"><font color=\"#200020\">retract study 329&hellip;<\/font><\/a><\/strong><\/u>] which was a &#8216;very bad study.&#8217; But where have we come to if a &#8216;good study&#8217; is one where the rainbow of financial ties up top suggests to me that a rigorous interpretation of the scientific findings would be impossible by these investigators &#8211; repeat <u>impossible<\/u>? A &#8216;good study&#8217; on this scale means a &#8216;not as bad study&#8217; as the one that was an outright lie. One might say, &quot;<strong><font color=\"#200020\">What could the NIMH do? Everybody that was anybody in those days had financial entanglements like that!<\/font><\/strong>&quot; The answer isn&#8217;t that hard, either don&#8217;t do the study, or find a somebody who isn&#8217;t yet compromised to do the study. To my way of thinking, all of these authors, unencumbered by the rainbow of financial ties, were capable of doing this trial correctly. The design is hardly rocket science. The results are fairly clear-cut. This would&#8217;ve been a good research question for some young industry-naive neuroscientist type to cut his\/her teeth on. It didn&#8217;t happen and we&#8217;re left to endlessly try to sort it out after the fact. They took something that could&#8217;ve made a <strong><font color=\"#200020\">significant<\/font><\/strong> contribution to an important question on the table at the time and rendered their efforts <strong><font color=\"#200020\">insignificant<\/font><\/strong>. There&#8217;s just too much jury-rigging, spin, and omission to trust what they said&#8230; <\/div>\n","protected":false},"excerpt":{"rendered":"<p>While the Treatment for Adolescents With Depression Study (TADS) involved only Prozac as a study drug, there were plenty of other companies invested in countering the FDA&#8217;s 2004 Warning about suicidality in adolescents on SSRIs: [patent life of the antidepressants] Now looking at the Financial Disclosures from the four key TADS articles that I mentioned [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-20127","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/20127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=20127"}],"version-history":[{"count":29,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/20127\/revisions"}],"predecessor-version":[{"id":20156,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/20127\/revisions\/20156"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=20127"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=20127"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=20127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}