R. Mosher, M.D.
How Drug Company Money Has Corrupted Psychiatry
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 levelsprivate 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.