“Promulgating therapeutic recommendations”

The following letter, written by Dr Philip Cowen and Dr Chris Thompson, was published in the BMJ in October 1994 [this, as it happens, being mid-way through the ‘Defeat Depression Campaign’]. The letter was in response to an ‘Education and Debate’ article titled “Prescribing selective serotonin reuptake inhibitors as strategy for prevention of suicide”. This article was by N Freemantle, A House, F Song, J M Mason, and T A Sheldon [It can be accessed read here]

This letter from Dr Philip Cowen and Dr Chris Thompson closes with a warning :“. . . those who study the health economics of the prescribing of antidepressant drugs need to have some knowledge of psychopharmacology. If they do not they will promulgate therapeutic recommendations that are at best clinically naive and at worst . . .  a potential hazard.”

Philip Cowen’s declarations of interest [over the course of his career] can be read here [at least some of them]. The list is however extensive. It would be fair to categorise Professor Cowen as a ‘paid opinion leader’

Dr Chris Thompson was a member of the small “Consensus panel” that formed the basis of the ‘Defeat Depression Campaign’. He also chaired this pharma-sponsored “Satellite symposium” on antidepressant ‘discontinuation syndrome‘.

In  October 2018, the Editor of BMJ shared this personal view:

I would go further. Evidence has repeatedly demonstrated that paid opinion leaders promulgate therapeutic recommendations that regularly turn out to be hazardous to patients. Full stop.