May 20

Psychiatrist Scolds the APA After Winning Distinguished Fellow Award / NYC Sues 44 Pharma Companies

Psychiatrist Scolds the APA After Winning Distinguished Fellow Award/ NYC Sues 44 Pharma Companies

Fri, 6 Aug 2004

After receiving a 50-year “distinguished fellow award” from the American Psychiatric Association in May, 2004, Alex Braiman, M.D. a practicing psychiatrist, wrote a letter acknowledging that the APA’s “advocacy of unsupported “biologic” diagnostic and treatment practices [ ] corrode its efficacy and leadership.”

Furthermore, Dr. Braiman wrote:
“It is ironic that we are witnessing serious challenges to the scientific integrity of studies supporting the FDA approval of the SSRI class of antidepressants at a time when an unsilent majority of us go along with the pretense that this is evidence-based psychiatry.”

Dr. Braiman is echoing Dr. Loren Mosher’s letter of resignation from the APA in 1998.

Dr. Mosher fought for truth in psychiatry until his untimely death. In his letter he criticized APA’s “neurobiological tunnel vision” and deplored the “marriage of convenience between APA, NAMI and the drug companies (who gleefully support both groups because of their shared pro-drug stance)”

The media needs to pay close attention and examine the arguments made by the much maligned, but cogent critics of psychiatry. As Drs. Mosher and Braiman acknowledged: psychiatry’s claims about “chemical imbalances” and its reliance on ineffective, even hazardous drugs are anything but science-based. Psychiatry’s practice guidelines were written by psychiatrists contracted by drug manufacturers who are now being sued for fraudulent marketing and concealment of evidence that their drugs harm children.

As Dr. Braiman acknowledges, the Big Lie has been perpetrated, not just by Big Pharma, but by leading opinion shapers in psychiatry–all of whom are paid by drug manufacturers.

The media has also disseminated “one trick” false information about both the number of people afflicted with untreated mental illness, and the safety and effectiveness of antidepressants and the rest of psychotropic drugs. Such information was presented as scientific findings, but was only draped in pseudo-scientific copy. The purpose of almost all medical news reports was to promote the sale of drugs.

The media owes the public overdue truth telling as well–inasmuch as most of the American public get their information about medicine and health from the media. An investigative reporter could cull together 5-10 year’s worth of “mental health news reports” and track their effect: the numbers of children prescribed psychotropic drugs has risen to astronomical highs–despite lack of evidence that the drugs are of any benefit to them. However, there is no doubt about who benefits from the skyrocketing psychotropic drug expenditure.

See, for example, the escalated psychotropic drug expenditures under Florida’s implementation of TMAP (the Texas Medicines Algorithm Program), the drug industry’s favorite mental health guidelines

Reuters reports that New York City has filed a lawsuit against 44 pharmaceutical companies for Medicaid fraud. Similar complaints have been filed by several U.S. states, including Ohio, Texas and Montana, which accused big drugmakers of defrauding their Medicaid programs by inflating drug prices.

Medicaid is the federal health insurance program for 44 million needy people in the United States. The city is seeking to recover its 25-percent share of Medicaid payments made on behalf of New York City residents, as well as triple damages from each company for the overcharges. See: Reuters. NYC sues 44 drug companies alleging Medicaid fraud. Thursday August 5, 2:57 pm ET

The investigation by NYS Attorney General, Eliot Spitzer, is not limited to financial fraud by drug companies–it focuses on fraudulent based practice. This suit will, undoubtedly, leave few dark and secure spaces for the psychiatric drug industry to hide in.

Contact: Vera Hassner Sharav
Tel: 212-595-8974
Psychiatric News August 6, 2004
Volume 39 Number 15 p. 39
C 2004 American Psychiatric Association
Letters to the Editor

One-Trick Training?
Alex Braiman, M.D.
Farmington, N.M.

After I received my 50-year distinguished fellow award at APA’s 2004 annual meeting in May, there was time for thought on the flight back to New Mexico and my practice. APA has become a polarized organization, perhaps a reflection of the larger society, but it has tilted too far toward the advocacy of unsupported “biologic” diagnostic and treatment practices that corrode its efficacy and leadership.

We have trained a generation of psychiatrists who are “one-trick ponies,” with no arrows in their quiver after pharmacy and “rational polypharmacy” fail their patients. Perhaps that is why we are so threatened now that New Mexico and Louisiana have granted prescription privileges to psychologists.

It is ironic that we are witnessing serious challenges to the scientific integrity of studies supporting the FDA approval of the SSRI class of antidepressants at a time when an unsilent majority of us go along with the pretense that this is evidence-based psychiatry. The editors of Lancet wrote in the April 4 issue that “selective reporting of favourable research should be unimaginable.”

It is too easy to fault the drug companies. There are too many of us whose integrity has been compromised by grant support or honoraria for the rest of us to be able to trust their advice. The late George Engel, M.D., whom many of us consider the primary advocate of the biopsychosocial approach, would consider current statements about neuro-bio-chemical-genetic causality of mental disorders regressive.

I consider myself fortunate to be able to continue to practice psychiatry now that I am retired from teaching and lucky that I received my award before the name of APA changes, perhaps to the American Bipolar Association.


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