Recent quotes:

Antidepressants don't work, or depression doesn't exist (as a meaningful category)

The real truth isn't found within the published paper but rather within a busy table on page 142 of the online appendix. It is here where the authors report what we want: the actual difference between drugs and placebo, before and after treatment, on the depression rating scales. Here we see that the Cohen's d standardized mean difference effect sizes range from a low of 0.19 to a high of 0.62 with amitriptyline. Thus, amitriptyline exceeds the clinically meaningful threshold of 0.50, with a traditional meta-analytic method. No other drug does so, with the closest second place being fluvoxamine, with a Cohen's d value of 0.44. Looking at all of the agents, 10 drugs have Cohen's d values less than 0.30, which is very small and clinically meaningless, whereas four have effect sizes from 0.30 to 0.34. Thus, 74% (14/19) of antidepressants clearly have little or no clinically important benefit in this analysis (for some reason, no data are provided in this table with two of the drugs). Four drugs have effect sizes of 0.37-0.44, and as noted, one agent exceeds the 0.50 threshold (amitriptyline). Perhaps a clearer conclusion than anything else is the well-proven fact that the tricyclic antidepressants are more effective than newer agents (there were no monoamine oxidase inhibitors in this meta-analysis).

Blame everything but the gift horse...

I was in an emotional free-fall, so I visited a psychiatrist. He said the antidepressant my general practitioner prescribed to help with my life-long struggle with anxiety wasn't what I needed, so he prescribed a new one. This seemed to only make things worse. Within a few days, I found myself thinking the unthinkable: I want to die.  I couldn’t imagine a life without my father and our hours-long conversations about, well, everything. The pain was debilitating, getting out of bed was an Olympian event, and life was utterly devoid of meaning. I stopped eating and shed 15 pounds in a month. I couldn’t see any reason to be alive.

Insel and "digital phenotype"

His company is working on using the technique to pre-screen for depression, post-traumatic stress disorder, schizophrenia and bipolar disorder. Their initial studies were able to link the digital features from participants' phones to how well they did on neural cognitive tests.

Nonprescription use of Ritalin linked to adverse side effects, UB study finds - University at Buffalo

“We saw changes in the brain chemistry in ways that are known to have an impact on the reward pathway, locomotor activity, and other behaviors, as well as effects on body weight,” Thanos says. “These changes in brain chemistry were associated with serious concerns such as risk-taking behaviors, disruptions in the sleep/wake cycle and problematic weight loss, as well as resulting in increased activity and anti-anxiety and antidepressive effects.” Further research indicated that female subjects were more sensitive to the behavioral effects of methylphenidate than the males. Thanos hopes that studying the effects of methylphenidate on those without ADHD may lead to a greater understanding of how the drug works on the brain and behavior, and can help researchers understand the impact of the drug on young people throughout development. “Understanding more about the effects of methylphenidate is also important as people with ADHD show greater risk to be diagnosed with a drug dependency problem,” Thanos says. “In addition, this study highlights the potential long-range risks college students take in using Ritalin for a quick study boost.”

Psychiatric drugs killing more users than heroin, cocaine: experts | Vancouver Sun

Kerr noted that the rise in BZD-related deaths — “It’s been an epidemic brewing for many, many years” — very closely mirrors a rise in opioid-related deaths that has been widely documented. He cited a fourfold increase in BZD-related deaths in the United States between 1999 and 2014, and also noted that there are 50 per cent more deaths each year in the U.S. due to psychiatric medicine than heroin.

Current head of AACAP -- Texas Psychiatrist Karen Wagner Under Scrutiny - AHRPAHRP

Dr. Wagner co-authored the notorious, ghostwritten Paxil pediatric study #329, whose lead author, Martin Keller, MD, was replaced last month as chairman of psychiatry at Brown University. The Glaxo-paid authors of study #329 helped the company promote the myth that Paxil was "safe and effective" for use in children as early as 1998: in a poster presentation, Dr. Wagner claimed "The results of this study demonstrate the safety ofparoxetine in the treatment of adolescent depression. Side effects were modest with paroxetine." [2]  But internal Glaxo emails show the data from pediatric Paxil trials were negative.

Lessons learned from placebo groups in antidepressant trials

The analysis of ‘nocebo effects’, e.g. adverse effects in placebo groups of antidepressant trials also confirms the impact of expectations: nocebo symptoms reflected the typical side-effect patterns expected in the drug group, with higher symptoms rates in the placebo groups of tricyclic antidepressant trials compared with placebo groups of trials testing selective serotonin reuptake inhibitors.

University Officials Defend Handling of Researcher's Misconduct

In all, 89 of the 103 subjects enrolled in the study — 86 percent — did not meet the eligibility criteria to participate, records show. They were too young, had previously used psychotropic medication, or did not meet other guidelines to participate.

Prevalence | ADHD | NCBDDD | CDC

Percent of Youth Aged 4-17 Ever Diagnosed with Attention-Deficit/Hyperactivity Disorder by State: National Survey of Children's Health

A.D.H.D. Study Suggests Medication May Reduce Crime - The New York Times

“The study adds a lot,” said Dr. Gabrielle Carlson, director of child and adolescent psychiatry at Stony Brook University medical school, who was not involved in the study. “Cutting the crime rate, that’s not trivial. Maybe it will get some help for people in jail. It gives people who were on the fence maybe a little more confidence in this treatment.”

Cash interests taint drug advice | Nature

Only one author declared a conflict of interest, but further checks by the CSPI revealed that four other authors had failed to disclose research funding from relevant drug companies. The problem could be even worse in guidelines that don't contain conflict-of-interest declarations, warns Merrill Goozner, director of the CSPI's Integrity in Science project. “It is usually the journals and supplements that rely heavily on industry advertising that are least likely to have good disclosure policies.”

Drug Companies & Doctors: A Story of Corruption | by Marcia Angell | The New York Review of Books

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of TheNew England Journal of Medicine.

Doctor quits Brigham to speak for pay - The Boston Globe

’’There are physicians earning so much money [from drug makers] that they would give up their jobs,’’ said Dr. Steven Nissen, head of cardiovascular medicine at the Cleveland Clinic Foundation. “It’s a shocking story. Normally you’d give up the [pharmaceutical company] honoraria.’’

Antidepressants and bladder medicines linked to dementia in landmark study -- ScienceDaily

"We studied patients with a new dementia diagnosis and looked at what anticholinergic medication they were prescribed between four and 20 years prior to being diagnosed. "We found that people who had been diagnosed with dementia were up to 30 per cent more likely to have been prescribed specific classes of anticholinergic medications. And the association with dementia increases with greater exposure to these types of medication. "What we don't know for sure is whether the medication is the cause. It could be that these medications are being prescribed for very early symptoms indicating the onset of dementia.

The Selling of Attention Deficit Disorder - The New York Times

In an interview last month, Dr. Dodson said he makes a new diagnosis in about 300 patients a year and, because he disagrees with studies showing that many A.D.H.D. children are not impaired as adults, always recommends their taking stimulants for the rest of their lives. He said that concern about abuse and side effects is “incredibly overblown,” and that his longtime work for drug companies does not influence his opinions. He said he received about $2,000 for the 2002 talk for Shire. He earned $45,500 in speaking fees from pharmaceutical companies in 2010 to 2011, according to ProPublica, which tracks such payments. “If people want help, my job is to make sure they get it,” Dr. Dodson said. Regarding people concerned about prescribing physicians being paid by drug companies, he added: “They like a good conspiracy theory. I don’t let it slow me down.”

Research Center Tied to Drug Company - The New York Times

A June 2002 e-mail message to Dr. Biederman from Dr. Gahan Pandina, a Johnson & Johnson executive, included a brief abstract of a study of Risperdal in children with disruptive behavior disorder. The message said the study was intended to be presented at the 2002 annual meeting of the American Academy of Child and Adolescent Psychiatry. “We have generated a review abstract,” Dr. Pandina wrote, “but I must review this longer abstract before passing this along.” One problem with the study, Dr. Pandina wrote, is that the children given placebos and those given Risperdal both improved significantly. “So, if you could,” Dr. Pandina added, “please give some thought to how to handle this issue if it occurs.” The draft abstract that Dr. Pandina put in the e-mail message, however, stated that only the children given Risperdal improved, while those given placebos did not. Dr. Pandina asked Dr. Biederman to sign a form listing himself as the author so the company could present the study to the conference, according to the message. “I will review this morning,” responded Dr. Biederman, according to the documents. “I will be happy to sign the forms if you could kindly send them to me.” The documents do not make clear whether he approved the final summary of the brief abstract in similar form or asked to read the longer report on the study.

Research Center Tied to Drug Company - The New York Times

A February 2002 e-mail message from Georges Gharabawi, a Johnson & Johnson executive, said Dr. Biederman approached the company “multiple times to propose the creation” of the center. “The rationale of this center,” the message stated, “is to generate and disseminate data supporting the use of risperidone in” children and adolescents.

Research Center Tied to Drug Company - The New York Times

In a November 1999 e-mail message, John Bruins, a Johnson & Johnson marketing executive, begs his supervisors to approve a $3,000 check to Dr. Biederman as payment for a lecture he gave at the University of Connecticut. “Dr. Biederman is not someone to jerk around,” Mr. Bruins wrote. “He is a very proud national figure in child psych and has a very short fuse.”

Research Center Tied to Drug Company - The New York Times

But e-mail messages and internal documents from Johnson & Johnson made public in a court filing reveal that Dr. Biederman pushed the company to finance a research center at Massachusetts General Hospital, in Boston, with a goal to “move forward the commercial goals of J.& J.” The documents also show that the company prepared a draft summary of a study that Dr. Biederman, of Harvard, was said to have written.

Pharma’s broken business model — Part 2: Scraping the barrel in drug discovery – Endpoints News

Ac­cord­ing to the Human Pro­tein Atlas, there are 19,613 pro­teins en­coded by the human genome.  Of these, 14,545 (74%) have no known link or re­la­tion­ship with dis­ease, which rules them out as po­ten­tial new drug tar­gets be­cause they fail to meet cri­te­rion 1 above.  Per­haps these pro­teins are non-es­sen­tial, as any de­fi­cien­cies can be com­pen­sated by other pro­teins or path­ways; or per­haps they are es­sen­tial, how­ever any de­fi­cien­cies are lethal be­fore birth so they never have the chance to cause any dis­ease.  In any case, we have no rea­son to be­lieve that tar­get­ing these pro­teins will do any­thing for any known human dis­ease. Now of the 5,068 pro­teins that have any link to dis­ease, 3,131 (16% of all human pro­teins) are con­sid­ered to be “un­drug­gable”, ei­ther be­cause they have no ob­vi­ous pocket ca­pa­ble of bind­ing small mol­e­cule drugs, or be­cause they are in­tra­cel­lu­lar and thus in­ac­ces­si­ble to large pro­teins that can­not pen­e­trate the cell mem­brane.  We must rule out these pro­teins as po­ten­tial new drug tar­gets be­cause we cur­rently have no way to tar­get them, so they fail to meet cri­te­rion 2 above.

Psychotic and Manic-like Symptoms During Stimulant Treatment of Attention Deficit Hyperactivity Disorder | American Journal of Psychiatry

Combining across stimulant medications, during double-blind, placebo-controlled trials, placebo was not associated with any toxicosis events in 3,990 subjects with a combined duration of treatment of over 425 years. For therapeutic doses of active medication, there were 13 reports of toxicosis in 5,717 subjects with a combined treatment duration of over 800 years. In open-label trials, stimulants were associated with 45 reports of toxicosis in 15,999 subjects with a combined treatment duration of almost 9,400 years. Although there are methodological problems in summing across stimulant medications and across studies that may have different sensitivities for identifying psychotic-like and manic-like symptoms, these numbers suggest as a preliminary estimate that toxicosis will occur in approximately 0.25% of children treated with stimulants, or about 1 in 400—a proportion suggesting an infrequent but not rare effect of therapeutic dosing.

Pharmaceutical Advertising Down But Not Out - News - News Releases - 2013

The pharmaceutical industry has pulled back on marketing to physicians and consumers, yet some enduring patterns persist. According to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health, advertising peaked in 2004, with industry promotion to physicians declining nearly 25 percent by 2010, to $27.7 billion or 9 percent of sales.  Similar declines were seen in direct-to-consumer advertising, which remains concentrated among a small number of products. The number of products promoted to providers peaked at over 3,000 in 2004, and declined by approximately 20 percent by 2010. Despite these changes, there was little change in the split of marketing between primary care physicians and specialists, and the proportion of all promotion taking place in physicians’ offices also remains unchanged. Free samples and physician detailing accounted for over 70 percent of promotional expenditures in 2010, with the remainder comprised by consumer advertising as well as physician marketing through journal ads, e-promotion and sponsored conferences and meetings. The results are featured in the February 2013 issue of the open-access journal PLOS ONE.

OCD after three weeks on ADHD drugs – henry copeland – Medium

One boy spent 36 hours playing with legos. Another had a similar experience with video games. Another child spent seven straight hours raking leaves, “after which he still felt compelled to rake individual leaves as they fell.”

Research Misconduct Identified by the US Food and Drug Administration: Out of Sight, Out of Mind, Out of the Peer-Reviewed Literature | Medical Journals and Publishing | JAMA Internal Medicine | JAMA Network

Fifty-seven published clinical trials were identified for which an FDA inspection of a trial site had found significant evidence of 1 or more of the following problems: falsification or submission of false information, 22 trials (39%); problems with adverse events reporting, 14 trials (25%); protocol violations, 42 trials (74%); inadequate or inaccurate recordkeeping, 35 trials (61%); failure to protect the safety of patients and/or issues with oversight or informed consent, 30 trials (53%); and violations not otherwise categorized, 20 trials (35%). Only 3 of the 78 publications (4%) that resulted from trials in which the FDA found significant violations mentioned the objectionable conditions or practices found during the inspection. No corrections, retractions, expressions of concern, or other comments acknowledging the key issues identified by the inspection were subsequently published.

Big Pharma Is America’s New Mafia

While $90 million went to drug-company sponsored meals in 2013, according to the Open Payments database, at least $1.4 Billion went to research. If we can believe that doctors can be bought with a slice of pizza pie, then we cannot underrate the influence of research monies. And by the way, that $1.4 billion is probably a fraction of what is spent on researchers. Obamacare allows a four-year delay in the reporting of research grants for reasons that really don’t make any sense. An explanation from Medscape does little to satisfy: “The thinking is that if there were public transparency, it might stifle companies from getting involved in very early research…. And that’s again to specifically protect that research space.”

Research Center Tied to Drug Company - The New York Times

tors. In a November 1999 e-mail message, John Bruins, a Johnson & Johnson marketing executive, begs his supervisors to approve a $3,000 check to Dr. Biederman as payment for a lecture he gave at the University of Connecticut. “Dr. Biederman is not someone to jerk around,” Mr. Bruins wrote. “He is a very proud national figure in child psych and has a very short fuse.” Mr. Bruins wrote that Dr. Biederman was furious after Johnson & Johnson rejected a request that Dr. Biederman had made for a $280,000 research grant. “I have never seen someone so angry,” Mr. Bruins wrote. “Since that time, our business became non-existant (sic) within his area of control.” Mr. Bruins concluded that unless Dr. Biederman received a check soon, “I am truly afraid of the consequences.”