Request, and Questions, to Oxford researchers Dr Andrea Cipriani ARCPsych and Dr John Geddes FRCPsych

(Sent by email 18.00 today)

Dear Dr Cipriani and Dr Geddes

I intended to email you with some questions about your 21st February ‘network meta-analysis’ paper, but as you have published personal (ad hominem) abuse in your 5th April Lancet Psychiatry Comment I will start with my request.

You wrote: ‘some coverage in the media and social platforms was inaccurate—in particular, there was an undue focus on the binary and polarising question of clinical significance. People can always manipulate information to fuel controversy and this appears to occur frequently in the stigmatised area of mental health.’

This clearly implies that many practitioners, and many others concerned about harms from antidepressants, were primarily motivated to mischievously ‘fuel controversy’. You do not cite any evidence for this claim, and without wholly adequate evidence it is therefore ad hominem (to the person) abuse. Please provide such evidence, or withdraw the claim and apologise, with adequate publicity.

As someone who believes he is among the targets of this personal abuse, I reject the implication that my valid criticisms fuel stigma: the opposite is true, in my view. I am not merely a psychiatrist but someone who has been a patient, in the NHS, with depression.

My questions:

1. Dr Carmine Pariante commented on the 21st February paper as the Royal College of Psychiatrists spokesperson, not as an academic. I have complained about his statement and that has now been escalated to the GMC. When did you provide the 21/2 paper to him (or the College)?

2. Did you provide previous versions? If so, when?

3. Did you communicate with Dr Pariante about the paper, or provide any additional information about it, before or on the day of publication? Please give an account.

4. Your use of ‘antidepressants might work’ in the title of your 5th April comment appears to be a striking retreat from your statement to the BBC:  ‘This study is the final answer to a long-standing controversy about whether anti-depressants work for depression. We found the most commonly prescribed anti-depressants work for moderate to severe depression…’

Do you accept that it was you yourselves who made the ‘question of clinical significance’ into a ‘binary’ one?

I fail to see how the answer to the last question can be anything other than ‘yes’, but will consider any evidence or reasoning you provide. Please note that as ‘the final answer’ did not appear in the Lancet, I consider it legitimate to ask you outside of its correspondence function.

I submit the questions to you as practitioners, not academics: academic freedom is not relevant. If I do not receive a full and adequate response, to the request and the questions, in seven days (18.00 Monday 16th) it is likely that I will submit complaints to the NHS Trusts where you do your clinical work and research.

On the issue of communication with Dr Pariante, you are respectively an associate and fellow of the College and I will consider a parallel complaint there.

yours sincerely

Dr Neil MacFarlane

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About Dr Neil MacFarlane MRCPsych

Independent Psychiatrist providing culturally informed mental health opinion, advice, and a few new facts. Based near London, UK. Main qualifications: BA MBBS MA MRCPsych.

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