Creators Of Psychiatric Treatment Guidelines Deeply Tied To Pharma

An article in today's Boston Globe details a new study in Psychotherapy and Psychosomatics (it's not online yet) wherein researchers went through the American Psychiatric Association's treatment guidelines for depression, bipolar disorder and schizophrenia and found that 18 of the 20 authors had ties to pharmaceutical companies. Medications for the three diagnoses are a $25 billion a year market for Big Pharma.

"'Most patients assume that when they're prescribed a drug, the decision is made on the basis of an objective review of the scientific evidence,' said the paper's lead author, Lisa Cosgrove of the University of Massachusetts at Boston. 'However, our study raises the question: Is that decision based in science, or is there a financial incentive behind it? This is an important question because the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence.'"

The APA insists that it works to screen out pharma bias from its guidelines--and maybe they do--but isn't it interesting how treatment guidelines almost always comprise a big arrow pointing directly to the goods and services of pharma companies. (You can view the guidelines here.)

"Dr. Roy Perlis, listed as a consultant on the bipolar guidelines, works in psychiatric genetics at Massachusetts General Hospital. In published papers - including one that examined financial conflicts of interest in clinical trials of psychiatric medications - he disclosed having received consultant or speaker's fees from five major drug companies: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmith Kline, and Pfizer.

"But Perlis noted that the guidelines for bipolar disorder make two main points, neither of which benefit drug companies: that lithium, which has long been available as an inexpensive generic drug, is still the 'gold-standard treatment' and 'that certain kinds of talk therapy are a very important part of treatment.'"

Lithium, in its various coated-pill forms, isn't exactly cheap and it sure isn't a benign treatment, but what's classic is this gem from Perlis:

"'My job is to find better treatments for my patients. These are awful illnesses. People really suffer,' he said. 'And the people who are most responsible for developing new treatments right now are the pharmaceutical companies. What is being lost in all this is that if I didn't work with them, I couldn't do my job as a scientist - the part of my job that says we have people who are suffering that need new treatments.'"

New treatments? Please. Almost every psych med currently being written about, researched and so on these days has been on the market for 10 to 20 years (and longer) and quite often researchers like Perlis are simply conducting research that repurposes the drugs for diagnoses other than their original targets or seeks to repeat already-published research for the billionth time because the pharma companies and their academic partners didn't like the results of earlier studies, especially the federally-funded ones (like STAR-D, CATIE and STEP-BD) which show that pharma's psych meds don't work well at all and are side effect machines in a capsule.

Anyway, feel free to be bothered or not bothered by these ridiculous conflicts.