Unsurprisingly, a frequent occurrence.
WSJ.com - Financial Ties to Industry Cloud Major Depression Study For pregnant women considering whether to continue taking antidepressant drugs, a study in a February issue of the Journal of the American Medical Association, or JAMA, contained a sobering warning: Stopping the medication greatly increases the risk of relapsing into depression.The study authors -- most of them leading psychiatrists at Massachusetts General Hospital, the University of California Los Angeles and Emory University -- said their results challenged a common assumption that hormonal changes during pregnancy protected expectant mothers against depression. In their article, they predicted the findings would prompt some women to stay on their depression medication through pregnancy. That was good news for the makers of big-selling antidepressants, who have recently faced growing questions about the safety of their medications when used during pregnancy.
But the study, and resulting television and newspaper reports of the research, failed to note that most of the 13 authors are paid as consultants or lecturers by the makers of antidepressants. The lead author -- Lee S. Cohen, a Harvard Medical School professor and director of the perinatal and reproductive psychiatry research program at Massachusetts General Hospital -- is a longtime consultant to three antidepressant makers, a paid speaker for seven of them and has his research work funded by four drug makers. None of his financial ties were reported in the study. In total, the authors failed to disclose more than 60 different financial relationships with drug companies.
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The work of these academic researchers highlights the role of “opinion” or “thought” leaders coveted by drug companies because of their ability to influence not only the practice of doctors, but popular opinion as well. In the case of antidepressant use during pregnancies, the industry-paid opinion leaders have become dominant authorities in the field. They help establish clinical guidelines, sit on editorial boards of medical journals, advise government agencies evaluating antidepressants and teach courses on the subject to other doctors.
One hopes Michael Moore reads this article, and manages to work it into his movie-in-progress.
Headlines warned of the danger of stopping antidepressants during pregnancy, and many local television news stations broadcast, unedited, a “video news release” put out by JAMA reporting on the study. That release featured Dr. Cohen and one of his patients, Lisa Kirshenbaum of Cranston, R.I., who was a part of the study. Ms. Kirschebaum experienced a miscarriage when she went off her antidepressants, according to the video. When she became pregnant again, she took her medication and delivered a healthy baby, according to the release. The actual study, however, did not examine whether mothers delivered healthy or sick babies. It tracked only whether they suffered from depression.The study reported financial relationships with antidepressant makers for two of the 13 authors of the study, Emory's Drs. Stowe and Jeffrey Newport. But at least seven others have relationships that were not disclosed. Among the most significant of the missing disclosures are those of the second listed author -- Lori Altshuler, director of the Mood Disorders Research Program at UCLA. She is a speaker or consultant to at least five antidepressant makers. An assistant says she is on sabbatical and unavailable for comment. Two of her colleagues -- Vivien Burt and Victoria Hendrick -- were also authors who didn't report financial relationships they have with antidepressant makers. Dr. Burt, in an interview, said “we all regret not having” disclosed those relationships and are “all genuinely interested in doing the right thing at all times.” Attempts to contact Dr. Hendrick were unsuccessful. Dr. Cohen says JAMA has imposed an embargo on his letter until the journal publishes it, so he can't discuss the contents.
Dr. Viguera of Mass General was another author, and did not disclose her speaking relationship with GlaxoSmithKline. She said the study was designed in such a way that “I don't see how any kind of relationship we have with a pharmaceutical company plays a role in that. ...I don't believe there is a conflict of interest.”
Tags: corruption, /Pharmaceuticals
