July 12, 2002

Scientifically unsupportable treatments: Hormone replacement therapy and anti-depression drugs

FYI

July 11th New York Times Editorial said “The news keeps getting worse about the value of hormone replacement therapies for postmenopausal women,” indicating that “The promotional blitz over the years has made hormone replacement therapy sound like a virtual fountain of youth.” http://www.nytimes.com/2002/07/11/opinion/11THU1.html?pagewanted=print&position=top

From the readers’ response to the revelations, it is clear that the biggest losers will be the doctors who sold their professional integrity to the drug industry:

“you are letting doctors off the hook too easily” wrote Alice L. Givan. “They have prescribed drugs to healthy women without first scrutinizing the evidence (or lack thereof) of drug efficacy. They have fallen for pharmaceutical marketing when they have been trained to know better (first do no harm).” http://www.nytimes.com/2002/07/12/opinion/L12HORM.html

Another medical area that has been propelled by “promotional blitz” rather than science is psychiatry. Critics have long contended that psychiatric ailments are broadly diagnosed to fulfill the marketing needs of newly developed drugs – so it was with Prozac and the SSRI antidepressants. The latest revelation exposing fraudulent treatment claims was delivered this week by a major study that examined the data submitted to the FDA for 47 clinical trials of antidepressants between 1987-1999. The investigators found that the claims made by drug manufacturers and by psychopharmacologists is contradicted by the evidence. The evidence shows that antidepressant drugs offer little, if any, benefit greater than placebo.

The new study, “The Emperor’s New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration” by Irving Kirsch, Thomas J. Moore, et al, is accompanied by 9 articles of commentary published by Prevention and Treatment, July 15, 2002: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm

Momentum is building as evidenced by a recent slate of articles in The New York Times. On June 30, 2002, The Times acknowledged in a front page article that the antidepressant drugs are not as effective as the “Miracle Drugs” the public has been led to believe. In that article, Erica Goode contradicted the lavish promotional ads in The Times magazine, by reporting that there is, in truth, no credible evidence to support the claim by drug manufacturers and psychiatry, that depression results from a chemical deficiency in the brain, nor by any other physiological cause:

“. . . as much as scientists have learned about depression, they still do not know enough to be able to aim chemical treatments precisely….they theorized that depression must result from a deficiency of these chemicals.

Yet a multitude of studies failed to prove this.” The failure to produce evidence of any biological malfunctioning has led critics to question the justification of prescribing powerful psychotropic drugs to millions of people–including children–on the basis of scientifically unsupportable claims. [Erica Goode, “Antidepressants Lift Clouds, But Lose ‘Miracle Drug’ Label,” June 30, 2002, front page. http://www.nytimes.com/2002/06/30/national/30DEPR.html?pagewanted=print&position=top

The article listed some of the adverse side effects such as emotional flatness: “All it did was make me feel like I had no emotions . . . I felt like a zombie,” and “. . . sensations of electrical zapping in the brain.”

However, it failed to mention the most controversial, potentially life-threatening, adverse reaction experienced by some people who take anti-depressants who become violent or suicidal, causing harm to themselves or others. [See, Stuart Donovan, PhD, and Richard Madeley, FFPHM, “Deliberate self-harm and antidepressant drugs: Investigation of a possible link,” The British Journal of Psychiatry (2000), 177:551-556; and .]

On July 3, 2002, Maureen Dowd turned the spotlight on the psychopharmaceutical industry in her NYT column:

“Addicted to their billion-dollar sales, the companies have been sneakily repackaging old pills for new uses, hawking their not-so-magic elixirs for everything from shyness to smoking to work stress to supermom its to severe premenstrual blues to muscle tension to dating anxiety.” Some psychiatrists admitted in the Times article [June 30, 2002] that “. . . the impression often conveyed by commercials for the drugs is clear: Almost anyone could benefit from them.” . . . “The more anxious the companies feel about profits, the more generalized the generalized anxiety disorders get.” Dowd’s wry observation holds true for both the debunked hormone replacement treatment and the uncertain “ailments” arising from the human condition that are seleced from the multiple selection charts of the Diagnostic & Statitstical Manual. [See, Maureen Dowd, “Aloft on Bozoloft,” July 3, 2002. http://www.nytimes.com/2002/07/03/opinion/03DOWD.html?pagewanted=print&position=top

On July 7, 2002, Alessandra Stanley examined a different area of “psychotherapy” in a front page article (below) and found evidence of psychotherapists who double as financial advisers, claiming they “help clients better understand what kind of portfolio best suits their psyches.”

These hucksters pretend they have greater wisdom than others on how to cope with life’s adversities–or, for that matter, good fortune.

They have invented such “syndromes” as: “sudden wealth syndrome” claiming their help is needed to “cope emotionally and practically with windfall wealth…” and “the endowment effect” which they define as “the tendency of investors to endow stock they own with more value than it has . . .” One of the specialists cited in The Times article, claims he “could do psychological evaluations based on a lengthy questionnaire and a 10-minute phone consultation.” Another who claims to have “developed expertise in wealth issues” describes how one of his clients “was worth $800 million and ended up worth only $20 million.”

One wonders how much that gullible client is willing to pluck down for such invaluable advice? Too bad he hadn’t gone for advice to the old saw who would have told him “A fool and his gold are soon parted.”

[See, ALESSANDRA STANLEY, Portfolios Depressed, Traders Seek Therapy July 7, 2002 http://www.nytimes.com/2002/07/07/business/07SHRI.html?pagewanted=print&position=top