September 25, 2007

Suicide Rates As A Public Relations Tool

That's the headline on this op-ed in the Boston Globe yesterday. Penned by Alison Bass, a former medical writer for the paper, it's like I could've written it myself. She rips apart the recent Gibbons paper in the Asmerican Journal of Psychiatry which had all manner of illogic in it and which I and others have ripped apart endlessly. Bass asks why some docs insist on pressing the SSRI-Rx-drop-causes-suicide hypothesis the way some folks believe in virgin birth.

"Who stands to benefit from the latest alarm about an apparent upturn in youth suicide rates? The sharp drop in the sale of SSRIs since 2004 has put a big dent in their manufacturers' bottom line. These companies have an enormous stake in reversing the current FDA warnings. That might explain why Pfizer (the maker of Zoloft) contributed $30,000 to cover the cost of collecting data for the American Journal of Psychiatry study, which was also funded by the National Institute of Mental Health. It's also worth noting that the two lead authors of the paper have disclosed financial conflicts of interest: Columbia professor of psychiatry Dr. John Mann has been a paid consultant to at least two SSRI makers, Pfizer and GlaxoSmithKline (the maker of Paxil), and Robert Gibbons has served as an expert witness for Wyeth Pharmaceuticals (the maker of Effexor, another SSRI)."

A couple of errors in Bass' copy, however. Effexor is not an SSRI. It's an SNRI, or serotonin-norepinephrine reuptake inhibitor. She also claims that 2005 suicide data is not available yet. In fact, the figures recently became available, as I noted recently, and while they are preliminary, such numbers don't undergo much revision when they become final--and they sure serve to bolster the argument of those who, like me, believe that anti-depressant prescription rates are not tightly linked to suicide rates. The evidence is simply more mixed than some in the psych world would have you believe.

But I sure agree with the thrust of Bass' op-ed. As I've stated before, the Gibbons paper's flaws much be addressed promptly by the AJP. Unless the journal happens to believe in virgin birth. (Via The Trouble With Spikol.)

Posted by Philip Dawdy at September 25, 2007 12:01 AM
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