A blot, a stain, or perhaps something worse?

In my dictionary I find this definition of ‘blot’:

On learning that GSK will resume paying doctors to promote its drugs after a “policy U turn”, Fiona Godlee, Editor in Chief of the BMJ stated  :

Yet ten years have passed since this article was published in the BMJ:

This may explain why the current Editor in Chief now unreservedly states:

I have campaigned for Sunshine legislation for over a decade now. I have also repeatedly sought support for such from the medical Royal Colleges and the General Medical Council.

On the 22nd February 2018 we woke up to News headlines like this:

This was a coordinated clarion call based upon the publication in the Lancet of this meta-analysis of short-term antidepressant prescribing for major depressive disorder:

A Fellow of the Royal College of Psychiatrists was widely quoted:

Expert reactions  were promoted by the Science Media Centre:

In these reports there was neither mention of the potential for over-medicalisation nor of the lack of evidence on which to base long term prescribing of antidepressants:

Given wide support for Realistic Medicine which advocates “fully informed prescribing” I was surprised to find imbalance in the Science Media Centre’s reporting of “where science meets the headlines”:

Across the UK, the number of people being prescribed antidepressants continue to rise. It would appear that many of those people prescribed antidepressants end up taking them indefinitely.

There is a dearth of evidence to support long term antidepressant prescribing. The widely quoted Geddes study extends to three years only and failed to consider whether “recurrent symptoms” might be due to physiological withdrawal from medication.

The increase in prescribing has been demonstrated across all age groups:

The scale of prescribing has naturally brought forth evidence by experience. All experience is integral to science: whether that experience is positive, negative or somewhere in-between. In both Scotland and Wales shared experience has led to petitions:

These petitions are still under consideration and the evidence gathered so far has encouraged open discussion of a range of important issues:

The following letter was published in the Times on 25 February 2018 and has been subject of a formal complaint (I was one of the signatories to this complaint):

Since that time one of the signatories, Professor David Baldwin, has resigned from the Public Health England review into prescribed drug dependence and withdrawal:

Professor David Baldwin has stated that he resigned because of a “campaign” of “abuse” against him:

The term “Pharma Whore” is not one that I would ever use.

However, I am steadfast in my view that science is not science if financial gains are not made completely open. I fully realise that many other potential biases exist. I simply argue that we should start with all competing financial interests.

At an ‘accredited’ Royal College of Psychiatrists in Scotland Winter Meeting held on the 29th January 2016, Dr Mark Taylor, a key opinion leader, and Fellow of the College commented:

“you are either abstinent or promiscuous when it comes to industry. Well you can see which side I am on”. Audience laughter followed.

Paul Rees, CEO for the Royal College of Psychiatrists (8 June 2018):

The Previous CEO of the Royal College of Psychiatrists offered this reassurance in December 2016:

Professor David Baldwin, in an on-line CV stated that he has:

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Meantime a number of members of the Royal College of Psychiatrists, who have a significant on-line presence continue to robustly assert:

The BMJ has published a number of articles on this which would indicate that this is far from a “myth” [this is a front cover from the BMJ]:

The following review was published at the beginning of this month:

Whilst the silence from my College has been deafening, a wide range of national newspapers have reported this systematic review on actual experience of antidepressants:

I am an admirer of the work of Patrick Geddes, biologist, sociologist, geographer and philanthropist . He advocated that “by living we learn”. This philosophy does not take anything away from evidence based medicine. However, my view is that evidence based medicine will remain uninformed without it:

I am naturally polite, respectful and try my best to use language with care. I was thus left distressed to receive this communication:

As a campaigner for openness I have shared this letter and suggested that we need to be kind with one another even if our views may differ:

Summary:

At the beginning of this post I quoted the Editor in Chief of the BMJ who was concerned that paid opinion leaders were a “blot” on medicine’s integrity. It is an interesting paradox that that the College I have been a member of for over 25 years appears to consider me to be a ‘blot’ for campaigning for transparency.

The dictionary definition of “blot” uses the word “stain”. In 2012 I had a paper published on Iatrogenic Stigma which considered the word stain:

Those who have experienced harm do not wish to diminish, in any way, the experience of those who have benefited from prescribing. No experience should be stonewalled, disbelieved and then shamed.

The following words have been used publicly by Members and Fellows of the Royal College of Psychiatrists in relation to those who have shared experience of prescribed harm. I find myself asking if this is a “blot”, a “stain” or something worse:

Post-script:

I will continue to urge all the Royal Colleges to support the introduction of Sunshine legislation in the UK.

 

 

 

 

4 Replies to “A blot, a stain, or perhaps something worse?”

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