[NVIC] Doctor Experts Ties to Drug Industry

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" If a medication is strong enough to have a beneficial effect, it's powerful

enough to have a toxic effect as well, and we should care about how these

drugs are prescribed, " said Drummond Rennie, deputy editor of the Journal of

the American Medical Association.

BL Fisher Note:

More and more people are becoming educated about health care choices and are

turning away from toxic drugs and vaccines prescribed by doctors with close

ties to drug companies. They are also turning away from the psychiatrists,

pediatricians, and other doctors who prescribe toxic drugs and vaccines that

are harming too many children and adults. The unholly alliance between

doctors and drug companies is being revealed for what it has become: an

ignorant, arrogant and dangerous exploitation of the public health for power

and profit.

http://www.chicagotribune.com/news/nationworld/chi-0604200194apr20,1,3690657

..story?coll=chi-newsnationworld-hed

Chicago Tribune

Posted on Thu, Apr. 20, 2006

Report: Guide's authors, drug companies kept in touch

By Judith Graham

Chicago Tribune

Most of the experts who prepared the world's leading medical guide to mental

illness had undisclosed financial relationships with drug companies that

presented potential conflicts of interest, according to a new report

published Thursday in the journal Psychotherapy and Psychosomatics.

The study is the first to document extensive monetary connections between

drug companies, psychiatrists and other scientists responsible for the

American Psychiatric Association's Diagnostic and Statistical Manual of

Mental Disorders.

The DSM, as it's commonly called, defines all the mental illnesses

recognized by psychiatry and outlines the criteria used to determine whether

a person has one of these conditions. Medical professionals refer to it as

the " bible of mental health " in the U.S. The current version, the DSM-IV,

was published in 1994 and modified in 2000.

The manual is of enormous importance to pharmaceutical firms, as the Food

and Drug Administration will not approve a drug to treat a mental illness

unless the condition is in the DSM. Drug companies then can market approved

medications to physicians and consumers.

" This is one of the most important medical documents we have in this

country, yet the public doesn't have relevant information about the experts

involved in developing and revising it, " said Sheldon Krimsky, a Tufts

University professor and co-author of the new paper.

His study found that 56 percent of 170 panel members responsible for

overseeing the DSM-IV had some type of financial tie to the drug

industry--including getting research grants from drug companies (42

percent), serving as consultants (22 percent) and participating in speakers

bureaus (16 percent). These relationships weren't revealed publicly.

The risk is that financial relationships might directly or indirectly bias

panel members to make decisions favorable to the drug industry.

Relationships formed after the DSM-IV's publication also can be problematic

in that panel members could appear to be " cashing in " on their influence,

Krimsky noted.

The enormous growth in prescriptions for psychiatric drugs also raises

concerns about the potential impact on consumers.

Dr. Darrel Regier, director of research at the American Psychiatric

Association, said disclosure of potential conflicts of interest " wasn't the

standard in the field " at the time the latest edition came out. " For the

next revision, " due in 2011, " we will have full disclosure, " he said.

Of particular concern, Krimsky suggested, is his study's finding that 100

percent of the experts on DSM-IV panels overseeing mood disorders and

schizophrenia/psychotic disorders were financially involved with the drug

industry. These are the largest categories of psychiatric drugs in the

world--2004 sales of $20.3 billion and $14.4 billion respectively.

" The more lucrative the drug market, the higher the percentage of experts

with financial ties--that has to raise serious questions about these panels'

objectivity, " said Rothman, professor of social medicine at Columbia

University's College of Physicians and Surgeons.

" We have not had an opportunity to review the study, but it is important to

note that the physicians and other health-care professionals who sat on

expert medical advisory panels have impeccable integrity, " said Ken ,

senior vice president for Pharmaceutical Research and Manufacturers of

America.

Others think drug industry practices are challenging the integrity of

science. " The very vocabulary of psychiatry is now defined at all levels by

the pharmaceutical industry, " said Dr. Irwin Savodnik, an assistant clinical

professor of psychiatry at the University of California, Los Angeles.

According to his calculations, the original 1952 DSM manual contained 107

mental health disorders. By the fourth edition in 1994, the number had more

than tripled to 365.

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