"The drug companies are so entrenched in the education of medical students and the continuing education of doctors," he says, "it is no stretch for me to claim that we now have a "medical-pharmaceutical complex."
"In it," he notes, "doctors' education and information is so controlled by the drug industry, doctors don't even know how limited their information is."
According to Dr. Cohen, "New generations of doctors are taught that they know everything important about medications, when in fact they don't."
According to world renowned SSRI expert, Dr. David Healy, author of, Let Them Eat Prozac, The Antidepressant Era, and The Creation of Psychopharmacology, medical conventions of groups like the American Psychiatric Association have become promotional and marketing "circuses," with drug companies sponsoring limousine service, luxury hotel accommodations, meals, all registration and committee meetings, social events, publications, special lectures, and product samples.
In regard to the group's meeting in 2002, the Washington Post reported: "In the days leading up to the American Psychiatric Association's meeting in Philadelphia, pharmaceutical companies mailed attendees hundreds of free phone cards, as well as invitations to museums, jazz concerts and fancy dinners."
"And in several dozen symposiums during the weeklong meeting," the Post said, "companies paid the APA about $50,000 per session to control which scientists and papers were presented and to help shape the presentations."
Bought and paid for doctors speak to the media to tout the benefits of the drugs and downplay the results of the negative studies and conduct seminars for other doctors funded by drug companies to promote the off-label use of their employer's drugs.
These doctors sit on the boards of foundations and professional bodies and decide which drugs will be approved for medication formulary lists in Clinical Practice Guidelines and thus, which drugs will be covered by government health care programs and insurance companies.
In a review of North American and European Clinical Practice Guideline for a variety of treatment areas, including depression, Choudhry et al (2002) found that nearly 60% of the Guideline authors had relationships with the drug companies whose drugs were considered in the guidelines and in the majority of cases, no conflict of interest disclosures were made in the guidelines to indicate the possible bias of the authors.
Clinical research has also become privatized and funded by the drug companies. According to John Abramson, a clinical instructor at Harvard Medical School and the author of "Overdosed America," three-quarters of the clinical studies published in the three most respected medical journals, the New England Journal of Medicine, the Journal of the American Medical Association, and the Lancet are now commercially funded.
"As a result," he says, "our medical knowledge grows not in the direction that best improves our health but toward corporate profits, the way that plants grow toward sunlight."
And drug companies do much more than buy advertising in these medical journals. According to the editor of the Lancet, drug makers also pay millions of dollars for reprints of articles favorable to their product for sales representatives to hand out to doctors.
In the case of Celexa, a decision to bar the use of the drug with pregnant women would drastically lower Forest's profits. In May 2005, researchers from the University of Pittsburgh, estimated in the Journal of American Medical Association, that in any given year at least 80,000 pregnant women in US are prescribed SSRIs.
At a February 9, 2006 news conference, Dr Sandra Kweder, of the FDA, told reporters that women of reproductive age are the "biggest users of antidepressant drugs."
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