Pharma Attacks Black Boxes as Antidepressant Sales Fall

http://en.epochtimes.com/n2/health/pharma-attacks-black-boxes-4636.html

In April, Dr. Catherine DeAngelis, editor of the Journal of the American Medical Association (JAMA), wrote that pharma’s influence on medicine “is so blatant now you’d have to be deaf, blind and dumb not to see it,” adding, “We should all get together and say, ‘Enough!’”

But an article in the Sept. 3 JAMA finds her not taking her own medicine.

Ever since 2004 when the FDA mandated black boxes on selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac and Paxil that warned of suicidal behavior in children and teens—causing sales to drop 25 percent—pharma has been on the warpath.

In a research letter in JAMA titled Suicide Trends Among Youths Aged 10 to 19 Years in the United States, 1995–2005, Jeffrey A. Bridge, Ph.D. of Nationwide Children’s Hospital in Columbus, Ohio, Joel B. Greenhouse, Ph.D., of Carnegie Mellon University in Pittsburgh, Pa., and three other authors continue pharma’s campaign against black boxes.

The warnings they say have actually increased suicide by scaring doctors and parents away from perfectly good drugs—kind of like how the withdrawal of diet-drug Phen-Fen is causing our national obesity.

Nor is Bridge, who spoke at a Lilly-sponsored conference on youth suicide in Switzerland in May, a stranger to JAMA’s pages with his pro-antidepressant message.

A study he headed in last April’s JAMA (Clinical Response and Risk for Reported Suicidal Ideation and Suicide Attempts in Pediatric Antidepressant Treatment) found “a much lower overall risk” of suicide than the FDA reports when “the potential benefit of these medications” was added.

In fact, the drugs should be “a first-line treatment option” says Bridge for the childhood scourges of major depressive disorder (MDD) and obsessive-compulsive disorder (OCD)—which somehow didn’t exist before pharma had moneymaking drugs to treat them.

Do you know where your children are?

Joel Greenhouse also has a pro-antidepressant trail. He lent statistical support for a Lilly-funded article in the Aug. 18, 2004, JAMA (Fluoxetine, Cognitive-Behavioral Therapy, and Their Combination for Adolescents With Depression), which vindicated Lilly’s beleaguered Prozac for depressed adolescents when used in conjunction with cognitive-behavioral therapy.

And in April 2006, Greenhouse coauthored a study posted on ClinicalTrials.gov (Do Antidepressants Cause Suicidality in Children?) that while agreeing “an association between antidepressant use and an increased risk of suicidality” exists, concluded “that the evidence … is weak,” when analyzed with Bayesian hierarchical models.

Got that?

But in reporting the Bridge/Greenhouse research, news organizations were as vigilant in their vetting as JAMA—especially The Wall Street Journal. It quotes Kelly Posner, Ph.D., a Columbia University researcher “who says she doesn’t have any financial ties to drug companies”—she would know, right?—in an article about the JAMA research, corroborating that the suicide rise was seen “as soon as these warnings started,” and, “If you look at the whole evidence puzzle, it points in one direction—antidepressants save lives.”

Unfortunately, Posner’s “evidence puzzle,” according to a June 2007 paper in the Journal of the American Academy of Child & Adolescent Psychiatry (Texas Children’s Medication Algorithm Project), is a little fuzzier, with financial ties to 14 drug companies.

“Dr. Posner has received research support from GSK, Forest, Eisai, Z Pharmaceuticals, Johnson & Johnson, Abbott Laboratories, Wyeth-Ayerst Research, Organon USA, BMS, Sanofi-Aventis, Cephalon, Novartis, Shire Pharmaceuticals, and UCB Pharma,” says the paper.

Who can say “conflict of interest”?
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