On 29 September Stephen Black wrote:
> Back on April 16th, I posted a longish note on the claim of Dr. David 
> Healy (see his "_Let Them Eat Prozac_ " book, for example) that SSRI 
> anti-depressants increase the risk of suicide, and whether his 
> subsequent hiring/firing at the University of Toronto was due to 
> pressure from Big Pharma against his appointment. I pointed out that 
> there was another version of this story--that Healy's job offer was 
> rescinded not because of undue influence, but because the faculty 
> belatedly discovered that Healy's opinions were not backed by good 
> science.

On 18 September there was an article/interview with David Healy in the
London Times (�Bitter pills: A doctor takes on the happy drugs� by Simon
Crompton):
http://www.timesonline.co.uk/article/0,,8122-1265973,00.html
(I don�t think this is accessible without subscription outside the UK. If
anyone would like to see the full article, let me know and I�ll email it.)

One passage in particular may be of interest for several issues it raises:

�Healy decided to investigate for himself how SSRIs affect the quality of
life of normal people. In 1999 he took a group of ten female and nine male
volunteers � psychiatrists, nurses and ad- ministrative staff � and asked
them to take anti-depressive pills for four weeks. For two weeks they were
on the SSRI Sertraline, and for two weeks they were on Reboxetine � a
different class of drug called a selective noradrenaline reuptake
inhibitor. What Healy discovered was alarming.

While many of these normal people were happy with one of the two drugs,
nearly two thirds of the group also felt significantly depressed or
disturbed on one of the treatments. In other words, there was a 50-50
chance of a GP putting their patients on an unsuitable pill...

Reporting on such findings made Healy a contentious figure among
colleagues unwilling to challenge the orthodox view, as well as with drug
companies. He didn�t realise exactly how contentious until 2000 when he
was offered a professorship by the University of Toronto � and then had
the offer withdrawn within a week of making a speech in Canada airing his
concerns about SSRIs. Healy says �it is widely believed� this was not
unconnected with the fact that the university �s mental health centre had
recently received a $1.5 million (�840,000) donation from the
manufacturers of Prozac � although the university still denies this.�

1. As Stephen has noted in his earlier posting, the study undertaken by
Healy would not pass muster for any reputable journal, which is presumably
why Healy�s report on it was published in an obscure journal whose name
eludes me.
2. If the journalist�s reporting is accurate, Healy�s saying that �it is
widely believed� that the rescinding of the offer at the University of
Toronto related to their recently a grant from a pharmaceutical company
receiving would seem to be disingenuous, since what is �widely believed�
may well be inaccurate, and Healy is well aware that other reasons,
equally plausible if not more so, have been given by the University.

Here is the position of the University, as expressed in a letter to Healy
by David S. Goldbloom, MD, FRCPC Physician-in-Chief Centre for Addiction
and Mental Health Professor of Psychiatry University of Toronto (co-signed
by Dr. Paul Garfinkel, President and Chief Executive Officer, CAMH, Dean
David Naylor, Faculty of Medicine, University of Toronto, and Dr. Donald
Wasylenki, Professor and Chair, Department of Psychiatry). After
regretting Healy�s failure to respond to communications from the
University over some four months, the letter continues:

�However, through your media appearances and through the statements of
others, I have learned that you do wish to have more information about the
reasons for rescinding the job offer. So although you have failed to
respond to repeated offers of direct communication with me made to you in
December 2000, I am advising of the following for your information.
The Search Committee, which I co-chaired, decided to offer you the
position of Clinical Director with knowledge that you had particular views
about fluoxetine that you expressed in the literature and through popular
media. We knew that as a scholar of the history of psychiatry, you had a
particular perspective on the evolution of drug therapy in psychiatry.
Members of the Search Committee expressed reservations about your
suitability specifically for the position of Clinical Director but overall
we decided to offer you the position.
Your presentation on November 30th raised further questions within our
staff and faculty regarding your suitability for this particular position.
No one disputed your academic freedom to say whatever you want in our or
any other University or in our academic health sciences centre. However,
the extremity of the views that you espoused caused an extraordinary stir
among the people who would be your junior and senior colleagues within
CAMH and the University Department of Psychiatry. I am referring to your
seemingly casual statements of thousands of people killing themselves on
and because of fluoxetine, of antipsychotics essentially causing more harm
than good, and of increasing hospitalization in the modem era. These
people felt your remarks were scientifically irresponsible, incompatible
with published scientific evidence and hence incompatible with the mantle
of responsibility of leadership of a clinical and academic program. There
was a clear message from these colleagues that your statements had little
balance. We began to feel that it would be difficult for you to lead a
program where you would not have the respect of those within it who would
work with you, those to whom you would report or those with whom you would
collaborate.�

For letter in full, see
http://www.pharmapolitics.com/davidgoldbloom.html
For other documents relating to the affair, see
http://www.pharmapolitics.com/

3. In the Times article the journalist notes:
�As a psychiatrist, he�s a great believer in the use of drugs, even SSRIs,
in the treatment of depression and mental illness. The point is that
everyone should be clear and explicit about the limitations of all drugs,
and they should be carefully targeted at the right people.� With which
latter sentiments I reckon all people in the field would agree. Much of
the problem, I suspect, is down to grossly overworked GPs prescribing the
drugs too liberally.

Re Healy�s book *Let Them Eat Prozac*, there is a detailed critical review
by Donald F. Klein, M.D., Professor of Psychiatry, Department of 
Psychiatry at the College of Physicians and Surgeons of Columbia
University, Director of Psychiatric Research and of the Department of
Therapeutics, New York State Psychiatric Institute, New York, NY, USA. See
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
http://www.butterfliesandwheels.com/articleprint.php?num=57
http://www.butterfliesandwheels.com/articleprint.php?num=58
 

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