Legislation & Regulation

The BBC reports that the number of people in Scotland taking antidepressants has increased by 5% in the past year with most of the patients being women and those in the poorest parts of the country. “We are now looking at the flabbergasting statistic of more than one in seven people in Scotland being prescribed antidepressants this year,” Conservative health spokesman Jackson Carlaw said. “We urgently have to look at better alternatives than simply parking people on medication in the hope things don't get any worse, with no aspiration for complete recovery."

On Tuesday morning, the ACLU filed a lawsuit on behalf of three former detainees against the psychologists who collaborated with the Central Intelligence Agency (CIA) to oversee the torture program. According to the Intercept, psychologists James Mitchell and John “Bruce” Jessen and their employees collected over $85 million dollars for designing and implementing techniques, based off of the work of Martin Seligman, that combatted torture-resistance techniques by creating a state of “learned helplessness.” There is, however, no evidence that these techniques gleaned any useful intelligence.

Statistics from the UK reveal that prescriptions for painkillers and antidepressants continue to rise despite concerns over dependence and debilitating withdrawal effects. The British Medical Association (BMA) Board of Science has released a report that acknowledges changes to medical practice, research and policy necessary for addressing the dependence and withdrawal effects of benzodiazepines, opioids, and antidepressants.

One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.

The University of Minnesota recently announced that it is ending the controversial practice of recruiting study participants from patients involuntarily being held in their psychiatric unit. In a commentary for Minnesota’s Star Tribune, bioethicist and MIA contributor Carl Elliot reports that the university has still not apologized to the patient who spoke out against this practice. Instead, “the university has done its best to discredit him.”

Sheila Kaplan for the Boston Globe reports that Dr. Robert Califf, the Obama administration's nominee to lead the Food and Drug Administration (FDA), has removed his name from a series of scientific papers that he recently coauthored. The decision to remove his name, against publication ethics standards, has brought Califf under renewed criticism.

On his weekly HBO show, Last Week Tonight, host John Oliver argues that the tendency to discuss mental health in the wake of a mass shooting is "deeply misleading."

Even thought current mental health treatments are “suboptimal,” there is a lack of attention paid to the preventative effects of diet and nutrition. Recent studies suggests that nutritional changes can influence the risk for mental health issues and that nutritional supplements, called nutraceuticals, can be prescribed for existing conditions.

Medscape Psychiatry reports that the “man-made epidemic” of opioid abuse in the United States is the result of over-prescription and poor research.

With the explosion of genetic testing and the emerging field of pharmacogenetics, patients can now take a DNA test and receive psychiatric drug recommendations customized to fit their genetic makeup. In an editorial for the latest issue of the Journal of Nervous and Mental Disease, Columbia University Psychiatrist Robert Klitzman warns that clinicians need to be aware of the limitations of these genetic tests being marketed to them.

The antidepressant Paxil has been linked to birth defects. "An Ohio federal judge on Wednesday ruled that GlaxoSmithKline must face a product liability suit brought by a woman whose child was born with heart defects after she took the antidepressant Paxil during her pregnancy, ruling that she had successfully pled fraud."

The Psychiatric Advisor reports on new research from King’s College London that suggests that antipsychotics can cause serious harm to people with Parkinson’s.

NPR reports on how ketamine is being used off-label to treat depression.

After the 2009 suicide of a seven-year-old foster kid who had been on two “black box” medications intended for adults, Florida updated its policies to protect vulnerable children from over-prescription. Unfortunately, according to a report by Orlando Weekly, “foster children are still being put on psychotropic medications without caregivers following proper procedures.”

Psychologists for Social Responsibility (PsySR), one of the groups that led the push for changes to the American Psychological Association’s (APA) collusion in the CIA torture program (as detailed in the Hoffman report), is again calling on the APA for a change in policies.

Individuals diagnosed with psychotic disorders have an earlier onset of psychosis if they have previously been exposed to prescription stimulants, according to new research currently in press in the Journal of Psychiatric Research.

The University of Minnesota announced a change to its research ethics policies this month after coming under criticism “following the recruitment of a schizophrenia...

In an Op-ed for the Times Union, Madeleine Ringwald explains how the Helping Families in Mental Health Crisis Act “would severely disable protection and advocacy organizations from protecting the civil, legal and human rights of people in mental health services.” “Whether you examine it through a scientific, civil rights or bottom-line lens, Murphy's bill should appall you,” she writes. “Any legislation that bolsters institutionalization at the cost of community-based services seeks not to help those with mental health needs, but help society find ways to hide, suppress and silence them.”

In the Atlantic, Cari Romm describes “what it is like to earn a living as a research subject in clinical trials.” “Phase 1 trials are almost always where the money is,” she writes, but they are “also the least regulated” and “companies aren’t legally required to register a trial with Clinicaltrials.gov.” “It seems to me like if you were considering signing up for one of these things, you would at least want to know the data that’s out there about [safety],” said Carl Elliott, an author for MIA and expert on the ethics of human subject research.

Yesterday, the Journal of the American Medical Association (JAMA) released an editorial entitled “Confluence, Not Conflict of Interest: Name Change Necessary.” The authors argue that the phrase “conflict of interest is pejorative,” and a better term “would be confluence of interest, implying an alingnment of primary and secondary interests.”

Hundreds of people have been given remote control deep brain stimulation implants for psychiatric disorders such as depression, OCD and Tourette’s. Yet DBS specialists still have no clue about its mechanisms of action and research suggests its hefty health and safety risks far outweigh benefits.

Bloomberg reports that the FDA asked Pfizer in August “to modify safety warnings for its antidepressant Zoloft (sertraline) and acknowledge for the first time that some studies linked the mood-altering medication to heart defects in newborns.”

On Sunday, the front page of the UK’s Independent ran a story entitled, “Thousands of children are being medicated for ADHD – when the condition may not even exist.” Fiction novelist and author of the upcoming “Concentr8,” William Sutcliffe, writes, “The pharmaceutical/medical industry teaches us that whatever the problem, a pill is the answer.” “This notion is becoming so all-powerful, and so locked together with a pressurised, exam-centred, conformist educational system, that every parent who has a misbehaving or inattentive child may now find themselves pushed towards a diagnosis of ADHD.”

In Saturday’s New York Times, Sabrina Tavernise describes the close industry ties of Dr. Robert Califf, a cardiologist and researcher recently tapped by the Obama administration to head the FDA. In a conflict of interest statement published last year, Califf “declared financial support from more than 20 companies,” leading some public health advocates to “question whether his background could tilt him in the direction of an industry he would be in charge of supervising.” Tavernise points to a presentation Califf gave on “Disrupting Clinical Research: Transforming a System” in 2014 where he singled out regulation as a barrier to research and innovation. “I think it illuminates his thinking,” Daniel Carpenter, a Harvard professor who studies the FDA, said of the slide. “In a sense, he’s the ultimate industry insider.”

It is appropriate to hold a company or doctors who may be aiming to make money out of vulnerable people to a high standard when it comes to efficacy, but for those interested to advance the treatment of patients with any medical condition it is not appropriate to deny the likely existence of harms on the basis of a failure to reach a significance threshold that the very process of conducting an RCT will mean cannot be met, as investigators' attention is systematically diverted elsewhere.