How Drug Company Money Has Corrupted Psychiatryby Loren R. Mosher, M.D.
The American Psychiatric Association (APA) is the nationwide organization to which most psychiatrists belong. In some ways it is a trade union. A large proportion of its income is from drug company advertising in its journals and newspaper. It also receives "unrestricted educational grants" and convention revenue from drug companies. Drug company sponsored symposia and exhibitions dominate the two major annual psychiatric conventions. Of course, the symposia speakers are paid handsomely for their half-day appearances. In my opinion, the APA is so dependent on pharmaceutical company support that it can not afford to criticize the overuse and misuse of psychotropic drugs. Perhaps more importantly, the APA is unwilling to mandate education of psychiatrists about the the seriousness of the short and long-term toxicities and withdrawal reactions from the drugs.
The drug companies pay speakers ($1000-2000 per appearance) who give psychiatric grand rounds and/or evening speeches (dinner provided by the company) to local psychiatric societies. Speakers come from lists of psychiatrists who will basically endorse their products. Doctors training to be psychiatrists are specially targeted for these speakers.
The drug companies give contracts to university based and private psychiatric research companies to conduct drug trials that are required for U.S. Food & Drug Administration (FDA) approval of the drugs they sell. The company provides the protocol and the researcher may receive as much as $40,000 per patient that completes the study. This allows the drug company considerable influence on the way the drug studies are conducted. All of these drug manufacturer activities have increased in scope and intensity since the introduction of newly patented drugs, beginning with Prozac in 1989. They must reap the profits before patents run out.
Research protocols used in studies of psychiatric drugs required for the approval of the FDA are supposed to be reviewed by Institutional Review Boards (IRB's) to be sure they do not pose undue risks to the study subjects. Members of these boards have been found to be highly paid consultants to drug companies whose protocols they review. That is, they have obvious conflicts of interests and are not objective, unbiased reviewers of the psychiatric drug studies over which they pass judgment. The latest "novel" anti-psychotic drug that has been approved by our federal drug regulatory agency (FDA) is Zeldox, which the FDA allowed to be introduced to the US market despite Zeldox's dangers.
In my view American psychiatry has become drug dependent (that is, devoted to pill pushing) at all levels - private practitioners, public system psychiatrists, university faculty and organizationally. What should be the most humanistic medical specialty has become mechanistic, reductionistic, tunnel-visioned and dehumanizing. Modern psychiatry has forgotten the Hippocratic principle: Above all, do no harm.
THE AUTHOR, Loren R. Mosher, holds a B.A. from Stanford University and an M.D., with honors, from Harvard Medical School, where he subsequently received his psychiatric training. He is now Clinical Professor of Psychiatry, School of Medicine, University of California, San Diego, and Director of Soteria Associates, 2616 Angell Avenue, San Diego, Calif. 92122, (858) 550-0312, Fax (858) 558-0854. See www.mosher-soteria.com.
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