Prescribed Harm Manifesto: learning disability and autism now included
(Only No 3 is new: the previous No 3 in the October 2018 version has been added to No 5 here)
1. The Royal College of Psychiatrists (RCPsych) and other Medical Royal Colleges will acknowledge that work by Charles Medawar, Dr Richard Smith, Dr David Healy FRCPsych, Dr Bernard Carroll MD, and others, led to the major series of civil fines and criminal convictions of pharmaceutical companies in the United States. Much of this work was brought to the general public’s attention through the BBC Panorama Secrets of Seroxat programmes (2002-7).
2. Many of those fines and convictions concerned marketing. The RCPsych will actively promote adequate scrutiny and awareness of pharmaceutical industry (Pharma) marketing, in the past, present and future. The RCPsych Dean Dr Kate Lovett FRCPsych has stated that general marketing and even ‘Western materialistic culture’ often has negative impacts on mental health, but to be credible the psychiatric establishment must take substantial responsibility for its collusion with the over- and mismarketing of psychiatric drugs. That collusion has often involved over- and mis-diagnosis.
3. The STOMP campaign, ‘Stopping over medication of people with a learning disability, autism or both‘, will only be effective if the causes of overmedication are properly addressed. In 2013 Johnson and Johnson, the patent developers of risperidone, who still own the brand Risperdal, was fined 2.2 billion dollars for part-criminal overmarketing of the drug to the elderly, and to people with learning disability and/or autism. That overmarketing is likely to have influenced UK practice (see 13 and 17, below), but the Public Health England website fails to note it.
4. The RCPsych will seek full compulsory disclosure of all pharmaceutical company payments to mental health professionals (MHPs), including speaking and meeting attendance payments (with date, location, and details of the meeting), research funding, and expert witness work. This should be available together on an easily searchable database, and not merely for three years, as on the very limited current ABPI speaking and meeting attendance register.
5. The RCPsych will seek to bring UK pharmaceutical regulation back into the Department of Health. The RCPsych will oppose the employment of people in regulatory bodies, who were previously employed by a pharmaceutical company with any record of wrongdoing in any country. Exceptions would be those who have clearly shown to the public that they opposed and reversed wrongdoing while working for such a company.
6. Ex-GlaxoSmithKline (GSK) CEO ‘Sir’ Andrew Witty has not shown that. The RCPsych will ask Dr Ben Goldacre MRCPsych to withdraw, or provide credible evidence for, his statement in 2012, made shortly after GSK’s 3 billion dollar fine and criminal conviction mostly in relation to paroxetine and bupropion, that Mr Witty was ‘a good guy’.
7. The RCPsych president Dr Wendy Burn FRCPSych will apologise to Dr Peter Gordon MRCPsych, harmed by GSK’s paroxetine, for her discourteous and unprofessional shunning of his enquiries and submissions. (Added 2nd July: Dr Gordon has since resigned his membership of the RCPsych, and revealed that he was ‘gaslighted’ by its Scottish leadership. This was reported in the Scottish and London press. See the many links to Dr Gordon’s blog in the penultimate paragraph of my September 2018 piece on Dr David Baldwin).
8. Specialist NHS clinics for people with Prescribed Harm and related problems will be set up. The RCPsych will seek out Pharma-sceptic psychiatrists, some of whom may have left NHS employment or retired early, and other mental health professionals, for this work.
9. The RCPsych will ask former president Dr Dinesh Bhugra FRCPsych, Dr David Nutt FRCPsych, Dr Guy Goodwin FRCPsych and Dr Stephen Lawrie FRCPsych, to withdraw and apologise for their 2014 Lancet article which smeared, without citing any evidence, people with Prescribed Harm as ‘conspiracy theorists’ and/or motivated by financial gain to manufacture ‘bizarre’ symptoms.
10. Dr Edward Bullmore FRCPsych, the most senior psychiatrist in Cambridge (UK), who is part of the RCPsych’s ‘Gatsby Commission’, will withdraw and apologise for his ‘neurophobia’ smear against critics of psychiatry-Pharma’s exaggeration of evidence for ‘chemical imbalance’, widely used for marketing purposes. He will also undertake to fully disclose, at all future events, that he is a vice-president of GSK.
11. Given his senior position within the pharmaceutical industry, the RCPsych will ask Dr Bullmore to what extent the industry has used tactics similar to that of the tobacco industry against critics and litigants. Recent concerns about the use of non-disclosure agreements (NDAs) by Harvey Weinstein and others have highlighted how civil legal proceedings can suppress relevant information, against the public interest.
12. The RCPsych will ask Dr Bullmore about Pharma marketeers’ use of the term ‘Drug Whore’ to describe ‘Key Opinion Leaders’ (KOLs), as revealed by Gwen Olsen in 2005. It may be necessary for Dr David Baldwin FRCPsych to clarify his recent statement about language critical of his own position as a KOL.
13. The RCPsych will remove Dr Jeffrey Lieberman MD from the Gatsby Commission. Dr Lieberman’s response to the concerns about Pharma in the 2000s was very limited. In 2013 he claimed that the pharmaceutical industry had reformed, but as one of the most senior doctors in the United States he must take substantial responsibility for the subsequent prescription opioid epidemic in the United States, which clearly showed that it had not. He continues to avoid answering questions about the ethics of his experiments giving stimulants to people with schizophrenia in order to deliberately provoke psychotic symptoms.
14. The RCPsych will remove Dr Simon Wessely FRCPsych from the Gatsby Commission. Dr Wessely downplayed the potential for conflicts of interest between Pharma and psychiatry as early as 2003, describing it as a ‘non-problem. In 2015 he claimed on national radio that he had ‘never worked for pharma‘, but despite his past record of being funded to speak at conferences, he has declined to make a public correction. As a very prominent psychiatrist internationally, Dr Wessely must take some responsibility for the opioid epidemic in the United States.
15. The withdrawn and redacted 2007 BBC Panorama programme on ADHD medication featured the same journalist (Shelley Jofre) who investigated Secrets of Seroxat. The RCPsych will support a request to the BBC to make the programme’s full interviews with psychologists and other experts available (with appropriate redaction of material – if any – discussing individual patients).
16. A historical review of Benzodiazepines, antipsychotics, and all other psychiatric medications will be undertaken, and the RCPsych will look to engage both amateur and professional historians.
17. The RCPSych spokesperson Dr Carmine Pariante MRCPsych, who has not repeated his claim that the 21st February Cipriani et al Lancet meta-analysis ‘finally puts to bed the controversy on antidepressants’, will make a full retraction which the RCPsych will promote to the media.
18. The RCPsych will critically review the continued influence of corrupt academic psychiatrists such as Dr Charles Nemeroff MD, on psychiatric research and practice. The worst excesses resulting from Pharma-psychiatry enmeshment appear to have been in the United States, where direct-to-patient advertising and lack of corporate regulation have led to both overmedication and higher prescription charges.
19. Many people who have suffered prescribed harm are very suspicious of the pharmaceutical industry. However, substantial improvements in regulation and behaviour of the industry and of psychiatry in the UK may lead to increased patient confidence for products developed and tested here rather than in the US (or even the post-Brexit EU). In turn, this may result in a relative growth of employment in the UK-based industry.
20. The RCPsych will consult with Pharma-sceptic psychiatrists, other mental health professionals, and current and former patients to determine what further steps should be taken.