Paxil (Seroxat): Time For Honesty

CL Psych has really been tearing up all the news on Paxil (Seroxat) and adding his own original analysis. Go read it here. Now for some highlights of his take on the BBC show on Paxil and the involvement of Martin Keller, a psychiatrist at Brown University, in one of the key Paxil studies in kids:

"According to Panorama (and documents I’ve obtained), the paper was written by a ghostwriter. Keller’s response to the ghostwriter after he saw the paper? 'You did a superb job with this. Thank you very much. It is excellent. Enclosed are some rather minor changes from me, Neal, and Mike.' And let’s remember that Keller apparently did not wish to bother with looking at numbers. It would also appear that he did not want to bother much with the words based upon those numbers."

And:

"It is relatively well-known that Keller makes much money from his consulting and research arrangements with drug companies. In fact, several years ago, it was documented that Keller pulled in over $500,000 in a single year through these lucrative deals. When looking at how he stuck his name on a study he did not write, endorsing conclusions that were clearly far from the actual study data, can one seriously believe that Keller operated as an independent researcher? Can you believe that this is an isolated incident?"

The remainder of his analysis is just as aggressive. Now, for my two cents: Keller's colleagues at Brown should investigate this situation and, where justified, should censure Keller. The American Psychiatric Association should do the same. And, while I not a big believer in Congressional investigations, if the Dems are going to have a look-see at the Zyprexa scandal, then they should also take a look at Paxil. And Prozac. And Risperdal. And Seroquel. And Cymbalta. And the ADD drugs. And....You get the idea.

It is high time patients and clinicians got complete and total transparency about how drugs are designed, studied, approved and marketed. Last time I checked, patients are the ones paying the freight of the American (and European) mental health systems in brain, mind, body, spirit, soul and pocketbook. What's going on with Paxil and Zyprexa are serious issues and they deserve serious answers.

The time for excuses, obfuscation, prestidigitation and intellectual chicanery is over. It is time for complete honesty. And, keep in mind, I am pro-psychiatry, but what's going on is simply indefensible and bad for the long-term health of both the medical profession and patients.