PSYCHIATRY WHISTLEBLOWERHelke Ferrie December 9, 2013
World Famous Psychiatrist Calls for a Revolution in Psychiatric Medicine
“You should give the same care to starting a treatment as you would buying a car or a house or selecting your friends or a spouse.”~ Dr. Allen Frances
Of the many exciting developments that occurred in the healthcare field this year, one of the most noteworthy was the release of a whistleblower report by a world famous psychiatrist. Dr. Allen Frances, the chair of the DSM-IV diagnostic manual for psychiatry, and one of the world’s leading psychiatrists, experienced a terrible awakening when the revision process of this Diagnostic and Statistical Manual began, resulting in the DSM-5 published this year.
Frances’ awakening was triggered by his realization that, following his wife’s recent death, he himself had suddenly become a ‘mental patient’ because he was experiencing grief lasting more than two weeks – as psychiatrized grief is defined in the new DSM-5. He also realized that the increased marketing opportunities the new DSM offered, targeting children especially, are out of control.
Upon further reflection, Frances realized that psychiatry, and the medical science it pretends to be without verifiable evidence, as well as fundamental principles of ethics in doctor-patient relationships, was going to hell in a hand basket. Thus his whistleblower book was launched in May 2013, entitled: Saving Normal – An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. In the book, he shows how secrecy, confidentiality agreements, jealous protection of intellectual property rights among contributors, the lack of independent oversight, financial mismanagement in the DSM-5 production process, and lack of consideration for patient welfare have all combined to create a manual which is mostly absurd and dangerous.
“Psychiatry,” Frances observes, is “just a special case of the bloat and waste that characterizes all of U.S. medicine. Commercial interests have hijacked the medical enterprise, putting profit before patients, and creating a feeding frenzy of overdiagnosis, overtesting, and overtreatment.” This is so because psychiatry “is especially vulnerable to manipulation of the normal/disease boundary because it lacks biological tests and relies heavily on subjective judgments that can be easily influenced by marketing.”
A second book, published simultaneously with Frances’ personal condemnation of psychiatry, is Garry Greenberg’s The Book of Woe. Greenberg takes the reader through the whole process of the making of the DSM-5, having attended all the meetings; he also describes the personal journey of Allen Frances. He describes the pivotal meeting of the DSM experts when key data were massaged to give the appearance of professional consensus and which, Greenberg describes, resulted in “the crossing of the Frankfurt Line,” so-called after Yale philosopher of science, Harry Frankfurt, who in 1986 published an influential book entitled On Bullshit. When the DSM-5 crossed from verifiable fact to “bullshit,” the revolt among insiders and observers began.
This excess of professional misconduct is measurable financially too: Big Pharma may be greedy, but not unrealistic. So in 2011 it announced that no more funds would be allocated for the development of new psychiatric drugs. This resulted in hard times for the American Psychiatric Association: annual Pharma funding of the APA is down from $18 million to just $4 million. Disillusioned psychiatrists don’t attend annual meetings much either, decreasing annual revenues by another $1.6 million. Not surprisingly, advertising in psychiatric journals is down to $6 million annually from $10 million, and even membership dues were down by $500,000 last year.
Irving Kirsch showed in his 15-year analysis of all the trial data (including the secret ones) that antidepressants are basically dangerous placebos – i.e. they trigger the illusion of improvement in the short term, while simultaneously being potentially harmful to the point of causing diabetes, cancer, and suicide in the long term.
Frances goes further: “Disease mongering cannot occur in a vacuum – it requires that drug companies engage the active collaboration of the doctors who write the prescriptions, the patients who ask for them, the researchers who invent the new mental disorders, the consumer groups that advocate for more treatment, and the media and the internet that spread the word.” It is therefore not a coincidence that the forty-fold increase in childhood bipolar diagnoses began when the U.S. allowed direct-to-consumer-advertising (DTCA), the only country in the world to do so.
The Scary Statistics
How does crossing the Frankfurt Line affect patients? Frances states “We [Americans] have become a society of pill poppers.” Let’s look at the numbers:
• One in five adults uses at least one psychiatric drug;
• 11 % of adults took an antidepressant in 2010;
• 4% of our children are on stimulants, 4% of teenagers are on antidepressants (Frances explains that a child’s date of birth predicts an ADHD diagnosis. “Boys born in January are at a 70% higher risk than those born in December because January 1 is the cutoff for grade assignment. The youngest, least developmentally mature kids are much more likely to get the ADHD diagnosis.”);
• By age 21, 80% of young adults meet the mental disorder criteria of the DSM-5;
• 25% of nursing home residents are given anti-psychotics;
• 7% of the U.S. population is clinically addicted to psychiatric drugs;
• In Canada, between 2005 and 2009, use of psychostimulants went up by 36% and SSRIs by 44%, primarily due to advertising on U.S. television
• 80% of family doctors prescribe all psychiatric drugs (most are not qualified to do so)
• In the U.S., 75% of patients who were prescribed these drugs had no concrete symptoms that required them;
• 56% of all psychiatric experts in the DSM process have financial ties to drug companies;
• 25% of people are currently labeled mentally disordered, and half a million people care for them;
• An annual advertising budget of $2.4 billion is spent on Abilify and Seroquel – the fifth and sixth highest revenue producers of all drugs in all of medicine combined;
• Dr. Frances’ Drug Company Hall of Shame reports that between 2004 and 2012 Pfizer, Purdue, Bristol-Myers Squibb, Astra Zeneca, Forest, Novartis, Johnson & Johnson, Abbott, and GlaxoSmithKline paid out a total of $15 billion in criminal and civil fines, just for psychiatric drug harm. Here is a list of the drugs that were proven harmful in these cases (drugs that, in my opinion, should never be taken): Risperdal, Paxil, Wellbutrin, Avinda, Depakote, Trilepal, Lexopro, Celexa, Levothroid, Seroquel, Geodon, Lyrica, Bextra, Zyuvox, Zyprexa, Abilify, Serzone, Neurontin. NOTE: almost all these drugs are also known to trigger suicide (see psychiatrist Dr. David Healy’s http://www.Risk.org March 12, 2013 for details).
Whistleblower Psychiatrist Calls for Overhaul of Corrupt Practices
What so appalled Frances that he repeats it several times throughout his book is that “None of the past sixty years of drug company research has ever once come up with a new product that exceeded the efficacy of the earlier drugs that were discovered by accident.”
Frances is now committed to spending the rest of his life stopping the practice of drugging children who have been labeled with diagnoses of ADHD and bipolar syndromes. Far from merely ranting about the shocking derailment of psychiatry as a profession, Frances’ book has clear advice for the public, governments and doctors which he elucidates with excellent patient case histories. His prescription for reform includes: – no more direct-to-consumer-advertising;
– no Big Pharma-sponsored medical continuing education, paid opinion leader talks, Pharma contact with medical students;
– no corporate money for any medical organizations;
– no more sales representatives in any doctor’s office;
– no more free samples of these toxic and addictive drugs;
– no off-label marketing;
– no corporate funding of FDA (and Health Canada), and even bigger fines for illegal marketing. He also wants shorter drug patent protection (currently at 20 years) and a prohibition against financial aid to consumer groups. He is dead set against disease awareness campaigns and corporate financial contributions to political campaigns. Finally, a stop should be put to Big Pharma’s employees infiltrating the government’s regulatory system.
For doctors, Frances advises never prescribing a psychiatric drug on a first visit, but to opt instead for watchful waiting and non-drug interventions such as books, psychotherapy, self-help programs, etc. If a drug is attempted, all previous drugs should be stopped first. He is supported by British psychiatrist David Healy who, in his analysis of Big Pharma’s control over doctors, advises that all medical schools should have compulsory courses on pharmaceutical marketing behaviour.
Toronto Doctor Refused To Be Silenced by Big Pharma
During my eighteen years of reporting on medical politics, I’ve so far encountered two serious incidents which completely changed the medical landscape and succeeded in blocking the return to previous states of the status quo:
– The second has been described.
– The first was the Olivieri Case in the 1990s: University of Toronto’s blood disease expert, Dr. Nancy Olivieri, refused to back down when Apotex ordered her to be silent after one of their drugs, for which she was conducting world-wide trials, began to cause deadly liver failure or extreme crippling and untreatable arthritis in almost half of the patients. Apotex took the view that this finding happily proved that the other half of patients must be assumed to have received some benefit. However, risk-benefit Russian Roulette thinking is unacceptable in medical ethics and violates the Hippocratic Oath, the foundation of the doctor-patient relationship, i.e. “First do no harm.”
Medical Nobel laureates and the world’s leading journals lined up to support Dr. Olivieri and insisted that patient deaths or harm are not merely collateral damage to be managed for profit. The feathers are still flying in this battle which is far from over, but having begun will certainly not be lost.
On November 14th, 2013, the inaugural Olivieri Lectureship on Medical Ethics took place at University of Toronto, and will continue annually in different university venues. The speaker was University of Minnesota’s Dr. Carl Elliott, author of White Coat Black Hat. In the book, Dr. Elliott reports on what most often happens in clinical trials, namely serious harm to trial participants, along with data fraud, and almost always in secret. The very design of a trial is often already doctored to preordain the desired results useful to subsequent marketing. The trial data are massaged to ensure FDA approvals and to guarantee a successful marketing campaign. Meanwhile, the full data remain Big Pharma’s proprietary property and only become public when the harm done to large numbers of patients can no longer be denied.
Currently, Dr. David Healy, supported by the prestigious Cochrane Collaboration of medical researchers, is spearheading a petition in the European Parliament designed to stop Big Pharma from undermining the EU’s planned laws to force Big Pharma to make all data on all drug trials publicly available.
Dr. Elliott focused on how Big Pharma, in collusion with universities and medical opinion leaders (i.e. professors whose careers depend on recruiting trial participants and conducting Big Pharma trials), usually successfully covers up even the worst suicide cases occurring during these trials. Even recruiting homeless people, often already victims of excessive psychiatric attention, is not discouraged by ethics committees and the FDA. Elliott described one case of a condemned building in Florida, once a motel, where clinical trials on illegal Mexican immigrants were conducted without any oversight whatsoever. And if the results are still too terrible, despite all efforts of whitewashing pesky research outcomes, Big Pharma just relocates their drug trials into third world countries.
The good news is that all of this is becoming public. I have no privileged source of information – all that I report on comes from publicly available information sources. That ought to be encouraging to even the most pessimistic reader!
About 10 years ago it was still possible for me to be totally up to date on nasty revelations in medicine. But now I am pleasantly defeated! The world’s leading medical journals publish such a torrent of truth-saying research on the fraud and harm contaminating all of medical research and practice, that I am no longer able to keep up fully.
True, the battle rages back and forth along the Frankfurt Line mentioned above, but once the “barnyard smell that pervades psychiatry,” as described by Greenberg, becomes generally noticed (as it inevitably must and not only in psychiatry), then medical arrogance and patients’ childish expectations do hit the wall of reality.
What really must be done now is the education of patients. Frances devotes a whole chapter to patient education, providing instructions that are true for all medical encounters. Like parents, doctors absolutely do not know best, but helpful information does arise from honest dialogue and the willingness to not expect a quick fix.
• A. Frances MD, Saving Normal, Morrow, 2013
• G. Greenberg, The Book of Woe – The DSM-5 and the Unmaking of Psychiatry, Blue Rider Press, 2013
• The Olivieri Case, Canadian Association of University Teachers, Toronto University Press, 2000
• D. Healy, Pharmageddon, University of California, 2011. Visit https://www.rxisk.org
• R. Whitaker, Anatomy of an Epidemic, Broadway, 2010. Visit www.madinamerica.com
• I. Kirsch, The Emperor’s New Drugs – Exploding the Antidepressant Myth, Bodley Head, 2009
• C. Elliott, White Coat Black Hat, Beacon 2010
• P. Breggin MD, Psychiatric Drug Withdrawal, Springer, 2013. Visit http://www.icspp.org
• A. Hoffer MD, Adventures in Psychiatry – The Scientific Memoirs, Kos 2005. Canadian Schizophrenia Foundation 416-733-2117.
• P. Holford, How to quit without feeling like SxxT, Piatkus, 2008
• J. Glenmullen MD, The Antidepressant Solution, Free Press 2009
• H. Ferrie, Creative Outrage, KOS Publishing 2013 available for free from http://www.helkeferrie.com