Saturday, March 07, 2015

"There are serious critics of psychiatric diagnosis and ... treatment ..."

Allen Frances, who I have mentioned in a previous post, has been attacked by Paula Caplan (see her article) for being very well paid by Johnson and Johnson (J&J) for producing guidelines which promoted the use of its drug, risperidone, as "first choice" in schizophrenia. Frances, in reply, argues that this is what he believed at the time, but admits it was unwise to have done this with drug industry funding. It suited both doctors and patients to believe that the atypical antipsychotics, like risperidone, were an advance in treatment (see my OpenMind column).

There has also been illegal over-marketing of risperidone. J&J pleaded guilty to a misdemeanor criminal charge of improperly marketing risperidone as a treatment for elderly dementia patients (see NYT article). It has also settled in cases where it has been accused of other "off-label" marketing, particularly in children, and of overstating the safety and effectiveness of the medication (eg. see report on Texas case).

Even some of the most biomedical of psychiatrists have expressed concern about unethical practice in psychiatry (eg. see my book review). The corruption of modern psychiatry does influence the academic debate about diagnosis and treatment (eg. see previous post).

4 comments:

Chrys Muirhead said...

I think that Dr Allen Frances's personal attack on Paula Caplan is nasty and leaves a bad taste in the mouth. It shows his true colours, his arrogance and disrespect of women. I can understand his annoyance at being exposed but there is no excuse for his derogatory behaviour.

Duncan Double said...

I agree. His argumentum ad hominem can't hide the fact that he was extremely well paid for helping overmarket risperidone. Even if he believed risperidone should have been first line treatment for schizophrenia, this is now generally seen as wrong. I guess the money must compensate for being manipulated by the drug company.

Asia said...

Very interesting entry. I'll check back here

Allan Seltzer said...

The end stage of psychiatry is biochemical reductionism...http://blackdogtimes.com/2015/03/18/the-molecular-hydraulics-of-mental-disorder/