The Psychopharmacology Committee [Chaired by Paid Opinion Leaders]

Professor David Baldwin took chairmanship of the Royal College of Psychiatrists Psychopharmacology Committee when Professor Allan Young had completed his tenure as chair.

Based on available evidence, and this is limited, it seems that Professor David Baldwin has worked for the pharmaceutical industry through most of his career as a psychiatrist, academic, and educator.

On the 8th October 1998, paroxetine was licensed in the UK for “Social anxiety disorder”. I was commenced on it for anxiety just weeks later. Nearly twenty years on and I am still taking it. I was never told that I might be taking it life-long. Had I been told of this I would not have consented to take it. Professor David Baldwin was the lead co-ordinator of the European trial on paroxetine for “Social anxiety disorder”.

After several months on paroxetine I stopped taking it. I thought nothing of this until 36 hours after stopping it, when I felt nauseated, began to sweat profusely, and heard a constant buzzing in my head. I found that I could no longer think clearly nor concentrate. In short, I felt dreadful.  Wondering if it was paroxetine (given the temporal relationship to my symptoms with the stopping of my only medication) (I was thinking as a doctor) I restarted paroxetine . . . and within a few hours my ‘symptoms’ went away.

From that time on, I tried gradually to reduce my paroxetine. I failed. I found that cutting tablets into small pieces could never be exact. Whilst discontinuing from paroxetine, I felt like I had flu, woke up frequently during the night, and became irritable and bleak in outlook.

My GP then kindly helped by prescribing liquid paroxetine, and with the aid of a micro-pipette,  I reduced it as slowly as I possibly could. At this time (though I was not aware of it then) the Guardian had reported an “inquiry thrown into doubt over members’ links with manufacturers”:

In my gradual discontinuation of paroxetine I was aware that my mood had become lower than I had ever experienced.  In early 2004, a little more than a week following finally discontinuing paroxetine, I had my only severe depression. I ended up in a psychiatric hospital but took my discharge. I then tried to hang myself with my belt.  I  am here to tell you some of this story because the steel curtain rail broke. The suffering that my wee children and my wife must have gone through is beyond what a loving daddy should ever wish to to consider.

In December 2016  the Royal College of Psychiatrists offered reassurance that relationships with Pharma were “all in the past” and that all is now “puritanical”.

Concerned about what seemed to me as casual reassurance I shared with the then President of the Royal College of Psychiatrists, Prof Sir Simon Wessely, evidence that demonstrated that these reassuring public statements had been made without justification.

Following my communications with my College (mostly unanswered) changes were made to the governance of competing financial interests of College members. The new system put in place is unsearchable, bureaucratic, and provides neither dates nor details.

I want to make absolutely clear that I consider key opinion leaders to be honourable people. However we need to acknowledge evidence that has demonstrated that paid opinion leaders promote prescribing of worse treatments for patients. It seems to me that my profession remains in denial about this.

In late February 2018, Professor David Baldwin, along with the President of the Royal College of Psychiatrists, Professor Wendy Burn, had this letter published in the Times:

This robust public statement was to be part of a formal complaint made to the Royal College of Psychiatrists.

1 in 5 of us are now taking antidepressants, and many of us indefinitely. Many of us find that we cannot stop taking our medication. If we have symptoms on stopping, these are  generally considered as symptoms of “relapse”.

Geddes study of 2003  does not provide “compelling evidence” for “maintenance treatment” [the authors conclude as much in their discussion].

Declaration of interest: I was one of those who signed a formal complaint to the Royal College of Psychiatrists.