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Psychiatry

Tufts University study shows more than half of psychiatric DSM-IV authors have financial links to Big Pharma

Wednesday, May 31, 2006 by: Jessica Fraser
Tags: psychiatry, psychiatric drugs, pharmacuetical corruption


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Hollywood star Tom Cruise made national headlines when he launched a verbal assault on the field of psychiatry while appearing on the Today Show with host Matt Lauer in June 2005. Cruise called the field "pseudoscience" and criticized Adderall and Ritalin, the prescription drugs prescribed for ADHD and hyperactivity in children, and also called actress Brooke Shields' decision to medically treat depression "misinformed."

The world joined in the battle that ensued after the show: Cruise vs. Shields, Anti-psychiatry vs. Pro-psychiatry. In all the media flux and talking heads that put in their two cents, the central issue was lost: Is psychiatry a genuine field made up of doctors who are helping the mentally ill with safe drugs, or is it truly a "pseudoscience" that exists only to sell dangerous prescription drugs to unsuspecting patients -- all in the name of making money for the pharmaceutical industry?

That question may have been answered, thanks to the results of a University of Massachusetts and Tufts University study that was released in April 2006. According to an April 22 Reuters article, the study found that 56 percent of 170 psychiatric "experts" who helped work on the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- considered the "bible" of the psychiatric field -- had financial links to drug makers at some point from 1989 to 1994, when the most recent edition of the DSM was released.

Those "financial links" included ownership of drug company stock, travel expenses, research funding, consulting fees and payment for gifts. In addition, Reuters reports that all the "experts" who developed parts of the DSM that define schizophrenia, mood disorders and psychotic disorders had these financial links.

"The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders," the study said.

Essentially, Big Pharma's seemingly bottomless pocketbook somehow contributed to 56 percent of the "experts" who worked on the American Psychiatric Association's (APA) widely used reference for defining mental illness.

The director of the APA's research division, Dr. Darrel Regier, countered the study's results by claiming the study was "an attempt to develop probably some guilt by association with the pharmaceutical industry." Regier said he didn't believe the DSM contributors' financial links to drug companies had influenced the manual, and told Reuters that if the "experts" who wrote the manual were not involved with the pharmaceutical industry, "that would mean they were really out of step with the major advances in the treatment of mental illness."

Apparently Dr. Regier had forgotten the five class-action conspiracy lawsuits brought against the APA and Ritalin maker Novartis in September 2000. The lawsuits, which were filed in federal courts in New Jersey, Florida, Texas, Puerto Rico and California, charged that Novartis Pharmaceuticals Corporation and the APA had illegally conspired to boost sales of Ritalin by too broadly defining ADD and ADHD. Those suits were all dropped by February 2002, after the plaintiffs were unable to produce enough evidence.

The powers that define a "proven" drug often have financial links with companies that stand to profit most

Richard Harding, MD, then-president of the APA, said after the final lawsuit was dropped: "The medical profession never stands taller than when it refuses to allow a court to modify or ban a proven medical intervention for a proven medical disorder."

Proven? One might wonder how the very agency that defines a disorder can truly call it -- and its drug treatment -- "proven," especially when those making the definitions have financial links with the company that stands to make the most money from treating those so-called "proven medical disorders."

The issue at hand is bias. How can researchers and "experts" be completely honest in their recommendations when their pockets are being lined by Big Pharma -- the primary recipient of profits made from treating the very disorders they are called on to define? Moreover, how does this relationship between the psychiatric industry and Big Pharma affect the safety of the drugs that are being prescribed as treatment?

Here's where the FDA comes into play. The Food and Drug Administration -- scorned lately by some media outlets for its lax drug approval processes -- made a decision in October 2005 that seemingly only serves to further bolster the bank accounts of psychiatric drug makers. In a nutshell, an FDA panel voted to shorten the length of drug trials for psychiatric drugs. These drugs can now be tested for as little as two weeks before the FDA deems them "safe" for much longer use. The reason behind this decision? Members of the Psychopharmacologic Drugs Advisory Committee (PDAC) -- which handed down the unanimous decision to keep testing time short -- said requiring longer trials would slow down the drug development process and timely approval for drugs to treat mental illnesses.

Oh, what a tangled web Big Pharma weaves! It's really a vicious cycle: The APA defines mental disorders in a manual used across the board by the psychiatric industry, all the while accepting money and gifts from the pharmaceutical companies that stand to make massive profits from the treatment of those disorders; the psychiatrists relying on the DSM diagnose people with mental illnesses and disorders left and right and prescribe "treatments," which are often drugs; and to make the process smoother and the money flow faster, the FDA shortens the duration of the drug trials for the very "treatments" recommended for the mental disorders defined by the APA. Big Pharma happily watches its profits grow and APA "experts" watch their profits grow -- but who gets the short end of the deal? As usual, the patient does.

A 10-year-old child can be diagnosed with ADHD and pushed by his school, his parents and his doctors into getting medical "treatment." Thanks to the APA, the FDA and Big Pharma, he can then be put on the newest, most advanced psychiatric drug on the market -- tested for a grand total of two weeks -- before it's in this child's medicine cabinet and working its chemical wonders to calm him down.

The medical profession says Big Pharma's role in psychiatry should be the norm, since monetary links have no possible influence

Perhaps the most disturbing element of this entire issue is that the APA asserts it has done nothing wrong. According the Dr. Regier's logic, Big Pharma's involvement in the decision-making processes in the psychiatric industry should be the norm -- not the erroneous exception. Of course, this relationship is supported by the APA under the guise that monetary links with drug companies couldn't possibly influence the decision makers who write the DSM.

However, the study's authors openly disagree with such faulty logic: "Transparency is especially important when there are multiple and continuous financial relationships between panel members and the pharmaceutical industry, because of the greater likelihood that the drug industry may be exerting an undue influence."

The problem is clear: In order for psychiatry to conduct honest research and create safe and effective treatments for genuine mental illnesses -- through drugs or other therapies -- its decision makers cannot have any financial links to the pharmaceutical industry. The solution is equally clear: The APA and the field of psychiatry must cut any and all ties with Big Pharma before it can lose its "pseudoscience" label, and the FDA must have a stricter, longer and more thorough drug safety trial process for approving psychiatric drugs.

Though celebrity weigh-ins on big issues should generally be taken with a big grain of salt, Tom Cruise may have hit the nail on the head with his Today Show denouncement of psychiatry. In addition to denying the existence of the "chemical imbalances" so frequently cited by drug companies to push their psychiatric medications, Cruise even went so far as to say that taking vitamins and exercising would help reverse depression. A NewsTarget article posted last April also reveals that in addition to taking supplements and increasing exercise, eating nutritious, healing foods can treat depression and mental disorders better than prescription drugs -- and without the high price and risky side effects.

If you find yourself or a family member in need of help with a mental disorder, consider two things: First, the advice and treatment recommendations you get from a psychiatrist may not be the best advice, as psychiatrists get much of their information from the DSM, written by the APA. Second, consider the alternatives -- mental disorders and illnesses can be treated safely and effectively using natural, safe alternatives to potentially dangerous prescription drugs.


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