Professor Hickie – Wrong, Wrong, Wrong.Yesterday (13 February 2012), in response to issues I raised in my last blog, Professor Ian Hickie made three misleading claims in The Australian and on ABC Radio. (Previous blog available at http://speedupsitstill.com/professor-ian-hickie-visionary-mental-health-reformer-paid-pharmaceutical-industry-opinion-leader )
“The bias in this paper is very disturbing…It is this kind of complicity that damages any hopes of a positive partnership between medicine and [the pharmaceutical] industry.” – Lancet Editor tweet on recent Hickie research
The Therapeutic Goods Administration (TGA) has issued a new safety advisory for Strattera, the non-stimulant drug once touted as a safe alternative to ADHD stimulants. Strattera already carries warnings for serious adverse events including suicidal ideation and potential fatal liver damage. The TGA has now added a warning about ‘clinically significant increases in heart rate and blood pressure’. (The new warning is available at http://www.tga.gov.au/safety/alerts-medicine-atomoxetine-111102.htm)
The decision by Australian Government Mental Health Minister Mark Butler to suspend proposed cuts to the “Better Access” program from a maximum of 16 visits to counselling services to 10 per year appears to be a welcome and rare win for talking therapies over drug therapies.
The following article written by L. Alan Sroufe, Professor Emeritus of Psychology at the University of Minnesota’s Institute of Child Development was published in the New York Times on 28 January 2012 (original available at http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html?_r=1&emc=eta1 )
Ritalin Gone Wrong – New York Times, January 28, 2012 by L. Alan Sroufe
For the first time in North American criminal history, a murder has been attributed to an anti-depressant drug. In the finding, handed down on the 16th of September 2011, a Canadian Judge said that he was satisfied that a 16 year old boy, who stabbed his brother’s friend in the stomach, would not have committed the offence had he not been treated with the drug Prozac (a brand of Fluoxetine).[1. Mike McIntyre, ‘Judge agrees Prozac made teen a killer’, Winnipeg Free Press, 17 September 2011. Available http://www.winnipegfreepress.com/breakingnews/judge-agrees-prozac-made-teen-a-killer-130010278.html (accessed 8 December 2011)]
The Draft Australian ADHD Clinical Practice Points are out for public comment until 28 November 2011. (available at http://consultations.nhmrc.gov.au/open_public_consultations/a-d-h-d) Please make the effort to prepare a submission. Common-sense voices concerned about the welfare of children, and not the profit and convenience of adults, need to be heard right now. It is certain the ADHD industry will be very organised and use this opportunity to try and expand their already lucrative markets. They cannot be allowed to dominate this very important process. My detailed submission follows. Feel free to borrow at will.
“Currently there are some isolated measures designed to help doctors and pharmacists suspicious of doctor shoppers but clearly they are inadequate. What is needed is a comprehensive, easy to use, ‘real time’ system of sharing information before prescriptions are dispensed. The Commonwealth and State governments may need to co-operate and remove privacy restrictions so that pharmacists can share information about what abuse-able drugs have been dispensed to individuals presenting prescription in their pharmacies. This change and a modest investment by government in the software needed to allow the ‘real time’ sharing of information between pharmacists, will shut off the pipeline of abuse-able prescription drugs that is fuelling this misery.”
A decade in politics has taught me it is rare for prominent people to acknowledge mistakes and even rarer for them to do everything in their power to correct them. And taking responsibility for past errors is especially problematic for members of the American medical profession who work within a blame avoidance culture created by the ever-present threat of malpractice suits. Special praise is therefore due to Dr Allen Frances the psychiatrist who led the development of DSMIV for his efforts to ensure that the mistakes of DSMIV are not repeated in the development of DSM5.
The American Psychiatric Association (APA) has published its draft changes for the fifth edition of its internationally influential Diagnostic and Statistical Manual of Mental Disorders (DSM5), due for final release in May 2013. Along with other worrying changes the APA seems determined to further loosen its already absurdly broad diagnostic criteria for ADHD.