The first week in May brought a new leader in France and new
prospects for same sex couples seeking marriage. But at the American
Psychiatric Association's annual meeting in Philadelphia, attended by 11,000
psychiatrists, it was the same old same old. Instead of listening to the public
outcry about overmedicated children, soldiers, elderly and everyday people
watching too many drug ads, the psychiatry group re-affirmed its resolve to
pathologize healthy people and even rolled out new groups to target.
This is the year the APA puts the finishing touches on DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, a compendium that determines what treatments insurers will cover, what disorders merit funding as "public health" threats and of course, Pharma marketing and profits. Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-5's authors have Pharma links.
No kidding. Present at this year's meeting were former APA president Alan F. Schatzberg, MD and Charles Nemeroff, MD, both investigated by Congress for murky Pharma income. Schatzberg and Nemeroff are co-editors of the APA-published Textbook of Psychopharmacology whose 2009 edition cites the work of Richard Borison, MD former psychiatry chief at the Augusta Veterans Affairs medical center who was sentenced to 15 years in prison for a $10 million clinical trial fraud. Also present was S. Charles Schulz, MD, who was investigated for financial links to AstraZeneca believed to alter his scientific conclusions.
Even though Assistant Secretary of Defense Jonathan Woodson sent a memo to all branches of the military in February about overprescription of antipsychotic medications like Seroquel and Risperdal for PTSD, military figures closely linked to that overprescription were listed in attendance at the APA meeting.
Elspeth Ritchie, MD, who told the Denver Post that AstraZeneca's Seroquel was "very useful for the treatment of anxiety and combat-related nightmares," though it was (and is) not approved for such treatment while she was medical director of the army's Strategic Communications Office in 2008, participated in many symposiums. Ritchie, who is now chief clinical officer for the District of Columbia's department of mental health, appeared in an AstraZeneca and Eli Lilly funded webcast for the Massachusetts General Hospital Psychiatry Academy in 2008 in which she lauds the use of "sophisticated" psychiatric medicines "on the battlefield." (see endnote)
Seroquel earned AstraZeneca nearly $6 billion in revenue last year, reports the Philadelphia Inquirer. "IMS Health, a healthcare information and services company, said that in the 12 months ending in February of this year, 14.1 million Seroquel prescriptions were written, more than any other antipsychotic," it reports.
Also participating in the military and PTSD content at the APA meeting was Matthew Friedman, MD, Executive Director of the VA's National Center for PTSD who reported, "I received an honorarium from AstraZeneca in the past year," in a 2009 government slide show called "Pharmacological Treatments of PTSD and Comorbid Disorder." Friedman also served as a Pfizer Visiting Professor at the Medical University of South Carolina College of Medicine last year yet is listed in the APA meeting guide as having no "significant relationships to disclose." APA officials have not responded to several requests for comment.
Of course disorders that Big Pharma has helped monetize like bipolar (which was termed "under diagnosed" and emerging in the elderly at the meeting) and "mood disorders" (once called "life") were well represented. But an alarming amount of attention also went to the apparent new Pharma profit center of alcoholism and drug addiction.