{"id":37029,"date":"2013-06-05T14:03:43","date_gmt":"2013-06-05T18:03:43","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=37029"},"modified":"2013-06-05T14:03:43","modified_gmt":"2013-06-05T18:03:43","slug":"anecdotes","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/06\/05\/anecdotes\/","title":{"rendered":"anecdotes&#8230;"},"content":{"rendered":"<div align=\"justify\"><em><sup><strong>Healy was born in Raheny, Dublin. He completed an MD in neuroscience and studied psychiatry during a clinical research fellowship at <span class=\"mw-redirect\">Cambridge University<\/span> Clinical School. In 1990, Healy became a Senior Lecturer in Psychological Medicine at North Wales&#8230;<\/strong><\/sup><\/em><\/div>\n<div align=\"right\"><sup><strong>David Healy &#8211; in <a href=\"http:\/\/en.wikipedia.org\/wiki\/David_Healy_%28psychiatrist%29#Background_and_research\" target=\"_blank\"><em>Wikipedia<\/em><\/a><br \/>                 <\/strong><\/sup><\/div>\n<p>                <\/p>\n<div align=\"justify\"><a target=\"_blank\" href=\"http:\/\/pharmagossip.blogspot.com\/2013\/06\/meet-doctor-big-pharma-can-shut-up.html\">Pharmagossip<\/a> recently linked to a good article on Alternet that tell an abbreviated version of the story of <strong><font color=\"#200020\">Dr. David Healy<\/font><\/strong>&#8216;s web-based database of adverse drug effects &#8211; <a href=\"https:\/\/www.rxisk.org\/Default.aspx\">Rxisk<\/a> &#8211; and why he created it:<\/div>\n<blockquote>\n<div align=\"center\"><a target=\"_blank\" href=\"http:\/\/www.alternet.org\/meet-doctor-big-pharma-cant-shut\">Meet the Doctor Big Pharma Can&#8217;t Shut Up<\/a><br \/>              <strong><font color=\"#200020\">AlterNet<\/font><\/strong><br \/>              By Tamara Straus<br \/>              May 30, 2013<\/div>\n<div align=\"justify\"><sup><strong>         \t     \t\t                                           <\/p>\n<p>For  the last 33 years, David Healy, an Irish&nbsp;psychiatrist and  professor at  Cardiff University School of Medicine in Wales, has written  heavily  researched university press books and academic journal articles  on  various aspects of psychopharmaceuticals. His output includes&nbsp;20  books,  150 peer-reviewed papers and 200 other published works. He&nbsp;is not  only  well-pedigreed,&nbsp;with degrees and fellowships from Dublin, Galway   and&nbsp;Cambridge medical schools, he is a widely recognized expert in both   the history and the science of neurochemistry and psychopharmacology.<\/p>\n<p>Yet   Healy says his output and reputation have had little to no effect &mdash; both   on the pharmaceutical industry he argues buries relevant information   about prescription drug harms, and on the psychiatric and medical   professions he claims are being &ldquo;eclipsed&rdquo; by drug companies. &ldquo;It&rsquo;s   been clear to me that writing books or articles banging on the risks   and hazards of drugs is just going to increase the sale of drugs,&rdquo; said   Healy, who speaks calmly, dresses mostly in black and looks a bit like   Rod Serling.<\/p>\n<p>Rather than write another university publication,   Healy has taken his frustration to the street. In November, he launched a   nonprofit website called <a href=\"https:\/\/www.rxisk.org\/Default.aspx\">Rxisk.org<\/a>   with a group of like-minded and highly credentialed international   colleagues. The site aggregates FDA data about prescription drug side   effects and urges patients to submit a detailed report on their own   pharmaceutical drug reactions.<\/p>\n<p>Healy is not the first psychiatrist   to express boiling frustration with the pharmaceutical industry or to   pen dire warnings about drug-based healthcare. He is joined by people   like American psychiatrist Peter Breggin, who has written several books   critical of &ldquo;biological psychiatry,&rdquo; and&nbsp;Irving Kirsch, who directs the   Program in Placebo Studies at Harvard Medical School\/Beth Israel   Deaconess Medical School and is best known for&nbsp;<em>The Emperor&rsquo;s New Drugs: Exploding the Antidepressant Myth<\/em>. Healy is the author of such dire sounding titles as&nbsp;<em>Pharmageddon<\/em>&nbsp;and&nbsp;<em>Let Them Eat Prozac:&nbsp;The Unhealthy Relationship Between the Pharmaceutical Industry and Depression<\/em>.<\/p>\n<p>For   years, it was fairly easy for people in the pharmaceutical and medical   industries to label Healy, Kirsch and Breggin as alarmists. But two   summers ago, one of the most prominent members of U.S. medical   establishment, Marcia Angell, former&nbsp;editor-in-chief of&nbsp;<em>New England Journal of Medicine<\/em>, published an article damning the over-prescription of psychoactive drugs. In two essays in the&nbsp;<a href=\"http:\/\/www.nybooks.com\/articles\/archives\/2011\/jun\/23\/epidemic-mental-illness-why\/?pagination=false\" target=\"_blank\">June 23, 2011<\/a>&nbsp;and&nbsp;<a href=\"http:\/\/www.nybooks.com\/articles\/archives\/2011\/jul\/14\/illusions-of-psychiatry\/?pagination=false\" target=\"_blank\">July 14, 2011<\/a>&nbsp;<em>New York Review of Books<\/em>,   Angell backed arguments by the university clinician Kirsh, the mental   heath journalist Robert Whitaker, and Boston psychiatrist Daniel Carlat   that there is something extremely suspicious about the following  trends:  the number of people treated for depression has tripled since  the  launch of Prozac&reg; in 1987; 10 percent of Americans over age six are   taking antidepressants; and 30 antipsychotics like Risperdal, Zyprexa   and Seroquel are replacing cholesterol-lowering agents as the   top-selling class of drugs in the U.S., largely because they are being   prescribed to children.<\/p>\n<div>Angell&rsquo;s articles should have been a bomb on the medical establishment. She wrote:<\/div>\n<ul>\n<div>&ldquo;The   industry-sponsored studies usually cited to support psychoactive   drugs&mdash;and they are the ones that are selectively published&mdash;tend to be   short-term, designed to favor the drug, and show benefits so small that   they are unlikely to outweigh the long-term harms. &hellip; Both the   pharmaceutical industry and the psychiatry profession have strong   financial interests in convincing the public that drug treatment is safe   and the most effective treatment for mental illnesses, and they also   have an interest in expanding the definitions of mental illness.&rdquo;<\/div>\n<\/ul>\n<div>But   like Healy, Angell&rsquo;s warnings have fallen on deaf ears. Recent data   indicates that U.S. prescription drug use is growing.&nbsp;The September 2012   Consumer Reports National Research Center&nbsp;<a href=\"http:\/\/www.prweb.com\/releases\/2012\/9\/prweb9892917.htm\" target=\"_blank\">report<\/a>&nbsp;found   that among the 46 percent of American adults taking prescription  drugs,  a fourth of those ages 18 to 39 regularly take two prescription  drugs,  indicating that multiple drug use is no longer confined to older   Americans. Congressional testimony in 2012 by the American Society of   Interventional Pain Physicians&nbsp;<a href=\"http:\/\/www.asipp.org\/documents\/ASIPPFactSheet101111.pdf\" target=\"_blank\">revealed<\/a>&nbsp;that Americans consume 80 percent of opiate painkillers produced in the world. And a January 2011&nbsp;<a href=\"http:\/\/med.stanford.edu\/ism\/2011\/january\/antipsychotics.html\" target=\"_blank\">report<\/a>&nbsp;from   Stanford University Medical School warned that antispychotics are now   regularly being prescribed to treat conditions for which they have not   been approved, including anxiety, attention-deficit disorder, sleep   difficulties, behavioral problems in toddlers and dementia.<\/div>\n<p>                          <\/p>\n<p>According to a Feb. 7, 2013&nbsp;<a href=\"http:\/\/www.drugs.com\/news\/releases-q4-sales-top-100-u-s-abilify-overtakes-nexium-top-sales-43016.html\" target=\"_blank\">report<\/a>&nbsp;from   Drugs.com, the No. 1 best-selling U.S. drug [in dollar volume] is an   atypical antipsychotic for schizophrenia treatment called Abilify. Sales   for the last quarter of 2012 soared to $1.5 billion, because Abilify  is  widely prescribed off-label&mdash;i.e., not for schizophrenia in adults,  but,  for example, for irritability in children. Although Bristol-Myers   Squibb, the maker of Abilify, was fined $515 million in September 2007   for recommending off-label uses of Abilify, doctors are still doling  out  the drug. Why?&#8230;<\/p>\n<p>           <\/strong><\/sup><\/div>\n<table cellspacing=\"0\" cellpadding=\"2\" border=\"0\" align=\"center\">\n<tr>\n<td align=\"center\" colspan=\"3\"><strong><font color=\"#200020\">Top Five Drugs by Sales, Q4 2012<\/font><\/strong>           <\/p>\n<hr size=\"1\" \/><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" align=\"center\"><strong><font color=\"#200020\">Drug Name<\/font><\/strong><\/td>\n<td valign=\"top\" align=\"center\"><strong><font color=\"#200020\">Sales<\/font><\/strong><br \/>           <sup><strong>[$000]<\/strong><\/sup><\/td>\n<td valign=\"top\" align=\"center\"><strong><font color=\"#200020\">% Change<\/font><\/strong><br \/>           <sup><strong>[previous quarter]<\/strong><\/sup><\/td>\n<\/tr>\n<tr>\n<td><strong><font color=\"#660033\">Abilify<\/font><\/strong><\/td>\n<td>$1,478,301<\/td>\n<td align=\"center\">5.20%<\/td>\n<\/tr>\n<tr>\n<td><strong><font color=\"#660033\">Nexium<\/font><\/strong><\/td>\n<td>$1,441,472<\/td>\n<td align=\"center\">1.45%<\/td>\n<\/tr>\n<tr>\n<td><strong><font color=\"#660033\">Crestor<\/font><\/strong><\/td>\n<td>$1,275,483<\/td>\n<td align=\"center\">2.41%<\/td>\n<\/tr>\n<tr>\n<td><strong><font color=\"#660033\">Cymbalta<\/font><\/strong><\/td>\n<td>$1,227,484<\/td>\n<td align=\"center\">5.97%<\/td>\n<\/tr>\n<tr>\n<td><strong><font color=\"#660033\">Humira<\/font><\/strong><\/td>\n<td>$1,206,377<\/td>\n<td align=\"center\">4.70%<\/td>\n<\/tr>\n<\/table>\n<\/blockquote>\n<div align=\"justify\">Why indeed! Why at a time when the criticism of overmedication with psychiatric drugs is even more widespread than discussed in this article are so many people prescribed and prescribing <strong><font color=\"#200020\">Abilify<\/font><\/strong>? or for that matter, <strong><font color=\"#200020\">Cymbalta<\/font><\/strong>? why are people taking them? at such high costs? It&#8217;s a bit hard to fathom. It&#8217;s little wonder that Dr. Healy [and a lot of the rest of us] feels so frustrated.<\/div>\n<p align=\"justify\">As I read the Alternet article, I got stuck on the opening line, &quot;<em>For  the last 33 years, David Healy, an Irish&nbsp;psychiatrist and  professor&#8230;<\/em>&quot; The calculator in my head felt a jolt since <strong><font color=\"#200020\">2013 &#8211; 33 = 1980<\/font><\/strong>. In <strong><font color=\"#200020\">1980<\/font><\/strong>, there was no Prozac&reg; or SSRI in existence. I thought it was probably just some fuzzy math but I looked up Dr. Healy and found the quote that started this post [&quot;<em>In <\/em><em><strong><font color=\"#200020\">1990<\/font><\/strong>, Healy became a Senior Lecturer in Psychological&#8230;<\/em>&quot;] which made more sense. <strong><font color=\"#200020\">1990<\/font><\/strong> was when he took his faculty position, some 3 years after Prozac&reg; was approved. That would make it &quot;<em>For  the last <u>2<\/u>3 years, David Healy, an Irish&nbsp;psychiatrist and  professor&#8230;<\/em>&quot; That would mean that Healy&#8217;s focus on the pharmaceutical industry started at the very beginning of his academic career and has persisted to the present. But being the follow-your-nose type, I pulled down his 2004 book, <strong><font color=\"#200020\">Let Them Eat Prozac<\/font><\/strong>, and ended up rereading <strong><font color=\"#200020\">Chapter I &#8211; Take One<\/font><\/strong> [which is available on the Internet <a href=\"http:\/\/books.google.com\/books?id=5w64WC_-jbMC&#038;lpg=PP1&#038;pg=PA40#v=onepage&#038;q&#038;f=false\" target=\"_blank\">here<\/a> as a Google Book preview]. If you haven&#8217;t read it, it is still more than worth the time. This is the terse PubMed version of the report Dr. Healy read back then [in <strong><font color=\"#200020\">1990<\/font><\/strong>] reinforcing his own experiences with his cases:         <\/p>\n<blockquote>\n<div align=\"center\"><a target=\"_blank\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=%28%28teicher[Author]%29%20AND%20fluoxetine[Title]%29%20AND%20%28%221990%2F01%2F01%22[Date%20-%20Publication]%20%3A%20%221991%2F01%2F01%22[Date%20-%20Publication]%29\">Emergence of intense suicidal preoccupation during fluoxetine treatment<\/a><br \/>                  <sup><strong>by Teicher MH, Glod C, and Cole JO<\/strong><\/sup><br \/>                  <strong><font color=\"#004400\">American Journal of Psychiatry<\/font><\/strong>. 1990 147[2]:207-210.<\/div>\n<p>                   <\/p>\n<div align=\"justify\"><sup><strong>Six  depressed patients free of recent serious suicidal ideation developed  intense, violent suicidal preoccupation after 2-7 weeks of <span class=\"highlight\">fluoxetine<\/span> treatment. This state persisted for as little as 3 days to as long as 3 months after discontinuation of <span class=\"highlight\">fluoxetine<\/span>. None of these patients had ever experienced a similar state during treatment with any other psychotropic drug.<\/strong><\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">That abstract doesn&#8217;t do justice to the paper which included six detailed case reports. In that <strong><font color=\"#200020\">Chapter<\/font><\/strong> <a href=\"http:\/\/books.google.com\/books?id=5w64WC_-jbMC&#038;lpg=PP1&#038;pg=PA40#v=onepage&#038;q&#038;f=false\" target=\"_blank\">Take One<\/a>, Healy summarizes Teicher&#8217;s cases and gives detailed case reports of his own from those early days.         <\/div>\n<p align=\"justify\">Around that time, I had <em>left-or-been-sent-away-or-both<\/em> from an academic position as a dinosaur and was in practice. In 1991, I read two documents pertinent to this topic. The first was a <strong><font color=\"#990000\">Time Magazine<\/font><\/strong> <a href=\"http:\/\/www.cs.cmu.edu\/~dst\/Fishman\/time-behar.html\" target=\"_blank\">article<\/a> that blamed the concern about suicidality and Prozac&reg; on Scientology [covered by Dr. Healy <a href=\"http:\/\/books.google.com\/books?id=5w64WC_-jbMC&#038;lpg=PP1&#038;pg=PA58#v=onepage&#038;q&#038;f=false\" target=\"_blank\">here<\/a>], and the exceedingly thick r\u00e9sum\u00e9 of our new Chairman of Psychiatry at Emory, <strong><font color=\"#200020\">Dr. Charlie Nemeroff<\/font><\/strong>. At the time, I knew nothing about Scientology, or Prozac&reg;, or Dr. Healy, or Dr. Nemeroff. I sure didn&#8217;t know that in that year, Dr. Nemeroff was testifying for Eli Lilly in an FDA hearing on this very topic that Prozac&reg; was absolutely safe [see <a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/04\/16\/an-anatomy-of-a-deceit-6-anticipated-and-forestalled\/\">an anatomy of a deceit 6&hellip;<\/a>]:      <\/p>\n<blockquote>\n<div align=\"center\"><a href=\"http:\/\/www.fda.gov\/ohrms\/dockets\/ac\/Prozac\u00ae\/2443T1.pdf#page=200\" target=\"_blank\"><u><strong><font color=\"#200020\">FDA Hearing<\/font><\/strong><\/u><\/a><\/div>\n<div align=\"center\">September 20, 1991<\/div>\n<div align=\"justify\"><sup><strong>       <\/p>\n<p>            <strong>I would suggest to you that  I have as little confidence in these anecdotal reports as I do in the  anecdotal report of Teicher, and that, in fact, there is no substitute  for controlled prospective double-blind clinical trials&hellip;<\/strong><\/p>\n<p>              In conclusion, there is simply no scientific evidence  whatsoever, no placebo-controlled double-blind study that has  established a cause-and-effect relationship between antidepressant  pharmacotherapy of any class and suicidal acts or ideation. As Drs. Potter and Fawcett have suggested, limiting the  availability of antidepressants could have a very profound adverse  effect in terms of increasing the morbidity and, in fact, mortality  associated with untreated depression.<\/p>\n<p>             <strong>Dr. Charles Nemeroff<\/strong>, <br \/>                    Professor and Chair, Department of Psychiatry, <br \/>                   Emory University, Atlanta Georgia <\/p>\n<p>      <\/strong><\/sup><\/div>\n<\/blockquote>\n<hr width=\"75%\" size=\"1\" \/>\n<p align=\"justify\">What is this post about with all of its old stories? It was so refreshing to me to read Dr. Healy&#8217;s case reports in <strong><font color=\"#200020\">Let Them Eat Prozac<\/font><\/strong>, Dr. Teicher&#8217;s case reports in the full text of <strong><font color=\"#200020\">Emergence of intense suicidal preoccupation during fluoxetine treatment<\/font><\/strong>, the case reports on the <a href=\"https:\/\/www.rxisk.org\/Default.aspx\">Rxisk<\/a> site, and the case reports on the <a target=\"_blank\" href=\"http:\/\/davidhealy.com\">blog<\/a>  Dr. Healy started. And it was so infuriating to read Dr. Nemeroff&#8217;s pronouncement &quot;<em>I would suggest to you that  I have as little confidence in these  anecdotal reports as I do in the  anecdotal report of Teicher, and that,  in fact, there is no substitute  for controlled prospective  double-blind clinical trials&hellip;<\/em>&quot; It was the spirit of that quote that lead me to leave my job at Emory so long ago, a job I really loved. Back then, I had no idea that the depersonified clinical trial would replace the case focus that brought me to psychiatry in the first place. I thought it was just what was happening in the department I was leaving. <\/p>\n<p align=\"justify\">I&#8217;m not opposed to clinical trials <em>per se<\/em>. What I oppose is that they became the <em>sine qua non<\/em> of truth rather than ancillary information. And I am beyond outraged that they became such a regular conduit for manipulation and obscuring the truth as time went on. It was through those very depersonified and deified clinical trials that psychiatry handed over the reins to the Managed Care bean counters, the Pharmaceutical Companies, and the Dr. Nemeroffs in academia.<\/p>\n<div align=\"justify\">In clinical medicine, every single patient is a case report, an antecdote, not one nth of a clinical trial&#8230;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Healy was born in Raheny, Dublin. He completed an MD in neuroscience and studied psychiatry during a clinical research fellowship at Cambridge University Clinical School. In 1990, Healy became a Senior Lecturer in Psychological Medicine at North Wales&#8230; David Healy &#8211; in Wikipedia Pharmagossip recently linked to a good article on Alternet that tell an [&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_forum_subforum_count":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-37029","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/37029","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=37029"}],"version-history":[{"count":27,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/37029\/revisions"}],"predecessor-version":[{"id":37108,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/37029\/revisions\/37108"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=37029"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=37029"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=37029"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}