On 26 April Stephen Black wrote [snip]: > According to Dr. James C. Coyne, a professor in the Department of > Psychiatry of the University of Pennsylvania, Dr Healy also published > an experiment on the topic. The "experiment" consisted in giving anti- > depressants to 20 of his non-depressed colleagues (his subordinates) > and asking them how they felt. As an appropriate experiment, this one > wouldn't pass high school biology. It is as far as one can imagine > from a serious investigation of the topic which would require a > double-blind, placebo-controlled, randomized study of individuals > suffering from depression. If this experiment is what Dr. Healy > believes to be acceptable evidence (and he cited it as an expert > witness in a court case), there is certainly cause for concern. > Tellingly, Dr. Coyne notes that the study was published in the > journal _Primary Care Psychiatry_, which is so obscure that it fails > to be indexed in the vast database of the National Library of > Medicine (PubMed).
I recall well the news report of the experiment when the results were announced by Healy, and found it depressing that the science correspondents in the broadsheets in the UK treated his claims so uncritically. There�s an interesting review by Donald F. Klein of Healy�s book *The Creation of Pharmacology* on the Human Nature Review website: http://human-nature.com/nibbs/02/healy.html Allen Esterson Former lecturer, Science Department Southwark College, London [EMAIL PROTECTED] http://www.human-nature.com/esterson/index.html http://www.butterfliesandwheels.com/articleprint.php?num=10 -------------------------------- Mon, 26 Apr 2004 10:14:45 -0500 Author: "Stephen Black" <[EMAIL PROTECTED]> Subject: Re: Suicide / Antidepressant > On 25 Apr 2004, Bill Scott wrote: > > >> Paul-- > > > You are correct, but I would be happy to find more, such as David > > Healy, who refuse to push the party line. > > David Healy is famous to Canadian academics but probably less so to > others. So I'd like to recycle a note I wrote to our university > faculty list relating to his case. As you will see, my position > differs sharply from the received wisdom among Canadian academics. I > said something like this: > > Dear Colleagues: > > Here's a controversial diversion from marking exams. I was surprised > to find that we don't have a copy of David Healy's book "Let Them Eat > Prozac" in the library, and I'm planning to rectify that oversight [I > did, and we do now, but it was out, so I still haven't read it!]. > But in looking for a book review that I recalled about it, I came > across some interesting material which provides a rather different > view of the affair. > > Although I had not been paying much attention, I understand the > currently-accepted version of the story is that Dr. Healy, a renowned > expert in psychopharmacology, was offered a prestigious position at > the University of Toronto. That offer was abruptly rescinded after > Dr. Healy gave a talk in which he criticized the use of Prozac-like > drugs (SSRIs) taken for depression, which he claimed led to an > increase in suicide. The implication was that the the pharmaceutical > industry applied pressure on the U of T to cancel his appointment, > and the U of T caved. The Canadian Association of University Teachers > (CAUT) considered this a challenge to academic freedom and supported > him in a lawsuit against the U of T. This was settled to Dr. Healy's > satisfaction with his appointment as a visiting professor to the U of > T. The current academic view is that the conclusion of this affair > represents the triumph of a fearless academic against the oppressive > might of Big Pharma. > > But there's another side to the story. From what I gather, much of > what Dr. Healy cites in support of his contention that Prozac-type > drugs cause suicide is anecdotal. This is the kind of evidence that > impresses laypeople but is absolutely worthless in determining cause > and effect. Determining cause and effect is particularly difficult in > this case, because many of the people for whom Prozac is prescribed > are given the drug _because_ they are suicidal. > > According to Dr. James C. Coyne, a professor in the Department of > Psychiatry of the University of Pennsylvania, Dr Healy also published > an experiment on the topic. The "experiment" consisted in giving anti- > depressants to 20 of his non-depressed colleagues (his subordinates) > and asking them how they felt. As an appropriate experiment, this one > wouldn't pass high school biology. It is as far as one can imagine > from a serious investigation of the topic which would require a > double-blind, placebo-controlled, randomized study of individuals > suffering from depression. If this experiment is what Dr. Healy > believes to be acceptable evidence (and he cited it as an expert > witness in a court case), there is certainly cause for concern. > Tellingly, Dr. Coyne notes that the study was published in the > journal _Primary Care Psychiatry_, which is so obscure that it fails > to be indexed in the vast database of the National Library of > Medicine (PubMed). > > Dr. Coyne raises another interesting issue. Using a website where > primary documents relating to the case are available, he cites a > letter from Dr. David Goldbloom of the Department of Psychiatry of > the University of Toronto, explaining to Dr. Healy why the job offer > was rescinded. In that letter Dr. Goldbloom says that Dr. Healy's > view on Prozac-type drugs was already well-known when the original > offer was made, that the offer was made despite "reservations about > your suitability", and that these concerns intensified after Dr. > Healy's disastrous speech which presented opinions which were > "scientifically irresponsible". I found it particularly interesting > that Dr. Goldbloom also alluded to a conflict of interest on the part > of Dr. Healy in recommending a competitor to Prozac with support from > the maker of that competitor drug. Dr. Coyne notes that Dr. Healy > never replied to that charge. > > Overall, I'm no apologist for pills. But based on this information, > it sounds as though the case may be less about academic freedom and > more about a bad decision to hire someone unsuitable, made worse by > trying to get out of it. Ironically, it seems to me that there are > better reasons to attack the use of Prozac-type drugs than the > uncertain claim that they promote suicide. For one, they cause > sexual dysfunction as a side-effect, a finding which the drug > companies have done their best to hide. Moreover, despite the claim > that these drugs have a specific pharmacological effect at the > synapse to relieve depression, they perform little better than > placebo in randomized double-blind experiments. A view current in > prominent and respected journals which has received little publicity > is that, overall, Prozac-type drugs may be no more than high-priced > sugar pills! > > Some sources: > > Spurgeon, D. (2002). Psychiatrist settles dispute with Toronto > University. British Medical Journal, 324, 1177 [go to > http://bmj.bmjjournals.com/ and search the archives with this title] > > Coyne, J. (2001). The rescinded offer to Healy: More complex a matter > than it first looks? British Medical Journal rapid response > http://bmj.bmjjournals.com/cgi/eletters/323/7313/591/a > > Coyne, J. (2001). Is Healy's work scientific or ethical? British > Medical Journal rapid response > http://bmj.bmjjournals.com/cgi/eletters/322/7300/1446/b > > > Primary resources, David Healy affair. http://www.pharmapolitics.com/ > > Click on "Dr. Goldbloom writes to Dr. Healy". The conflict of > interest accusation appears in the last part of the letter, in the > paragraph beginning "At the time of rescinding your job offer..." > > Lapierrer, Y. (2003). Suicidality with selective serotonin reuptake > inhibitors: Valid claim? Review of Psychiatry and Neuroscience, 28, > 340-7. > > While I take no sides in the debate over the possible tendency to > suicide of SSRIs, I found the above just-published review in a > journal of the Canadian Medical Assocation interesting. It's > available on-line at: > http://www.cma.ca/cma/staticContent/HTML/N0/l2/jpn/vol-28/issue- > 5/pdf/pg340.pdf. > > Lapierre concludes: "The evidence currently available does not > suppport the hypothesis that antidepressants or, more specifically, > SSRIs cause increased suicidality in patients with depression". > > Kirsch, I., & Sapirstein, G. (1998). Listening to Prozac but hearing > placebo: a meta-analysis of antidepressant medication. Prevention & > Treatment, 1, posted on-line June 26. Available at > http://www.journals.apa.org/prevention/volume1/pre0010002a.html > > The above provides an introduction to the claim that Prozac is no > better than a placebo. See also: > > New study finds little difference between effects of antidepressants > and placebo. Press release of the American Psychological Association, > > July 5, 2002. http://www.apa.org/releases/antidepressants.html > > New note: The British Medical Journal has published a book review of > Healy's book _Let Them Eat Prozac_ at an incredibly long url. It's > better to go to http://bmj.bmjjournals.com/, click on "Search > archives", and then search on the key words "Healy" and "eat". > > The reviewer, Joe Collier, calls this a "curate's egg" of a book, > which I understand means "good and bad" or "good in parts". He also > says "the text is autobiographical, overlong, over-indulgent, > somewhat uncritical, and often indiscreet. Healy's aim seems to be > one of self-advancement...". He also says "But the book is not all > bad". > > > Stephen > > ___________________________________________________ > Stephen L. Black, Ph.D. tel: (819) 822-9600 ext 2470 > Department of Psychology fax: (819) 822-9661 > Bishop's University e-mail: [EMAIL PROTECTED] > Lennoxville, QC J1M 1Z7 > Canada > > Dept web page at http://www.ubishops.ca/ccc/div/soc/psy > TIPS discussion list for psychology teachers at > http://faculty.frostburg.edu/psyc/southerly/tips/index.htm > _______________________________________________ --- You are currently subscribed to tips as: [EMAIL PROTECTED] To unsubscribe send a blank email to [EMAIL PROTECTED]
