1999-Loren Mosher MD: I Want No Part of It Anymore

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[sSRI-Research] 1999-Loren Mosher MD: Are Psychiatrists

Betraying Their Patients?

 

 

 

September/October 1999

 

http://moshersoteria.com/psycho.htm

 

 

" I Want No Part of It Anymore "

Loren R. Mosher, M.D.

Dr. Mosher is the director of Soteria Associates, San Diego, and a

Clinical Professor of Psychiatry, School of Medicine, University of

California at San Diego, California.

 

The trouble began in the late 1970s when I conducted a controversial

study: I opened a program -- Soteria House -- where newly diagnosed

schizophrenic patients lived medication-free with a young,

nonprofessional staff trained to listen to and understand them and

provide companionship. The idea was that schizophrenia can often be

overcome with the help of meaningful relationships, rather than with

drugs, and that such treatment would eventually lead to unquestionably

healthier lives.

 

The experiment worked better than expected. Over the initial six

weeks, patients recovered as quickly as those treated with medication

in hospitals.

 

The results of the study were published in scores of psychiatric

journals, nursing journals and books, but the project lost its funding

and the facility was closed. Amid the storm of controversy that

followed, control of the research project was taken out of my hands. I

also faced an investigation into my behavior as chief of the National

Institute of Mental Health's Center for Studies of Schizophrenia and

was excluded from prestigious academic events. By 1980, I was removed

from my post altogether. All of this occurred because of my strong

stand against the overuse of medication and disregard for drug-free,

psychological interventions to treat psychological disorders.

 

I soon found a less politically sensitive position at the Uniformed

Services University of the Health Sciences in Maryland. Eight years

later, I re-entered the political arena as the head of the public

mental health system in Montgomery County, Md., but not without a

fight from friends of the drug industry. The Maryland Psychiatric

Society asked that a state pharmacy committee review my credentials

and prescribing practices to make sure that Montgomery County patients

would receive proper----read: drug----treatments. In addition, a

pro-drug family advocacy organization arranged for more than 250

furious letters to be sent to the elected county executive who had

hired me. Fortunately, my employers were not drugindustry-dominated,

so I kept my position.

 

Why does the world of psychiatry find me so threatening? Because drug

companies pour millions of dollars into the pockets of psychiatrists

around the country, making them reluctant to recognize that drugs may

not always be in the best interest of their patients. They are too

busy enjoying drug company perks: consultant gigs, research grants,

fine wine and fancy meals

 

Pharmaceutical companies pay through the nose to get their message

across to psychiatrists across the country. They finance symposia at

the two predominant annual psychiatric conventions, offer yummy treats

and music to conventioneers, and pay $1,000-$2,000 per speaker to hock

their wares. It is estimated that, in total, drug companies spend an

average of $10,000 per physician, per year, on education.

 

And, of course, the doctors-for-hire tell only half the story. How

widely is it known, for example, that Prozac and its successor

antidepressants cause sexual dysfunction in as many as 70% of people

taking them?

 

What's even scarier is the greed that is directing a good deal of drug

testing today. It is estimated that drug manufacturers have, on

average, 12 years to recoup costs and make profits on a given

medication before a generic form can be made. So pressure to test new

drugs mounts. In the field of psychiatric drug testing, organizations

make a profit of as much as $40,000 for every patient who successfully

completes a trial. And university psychiatry departments, private

research clinics and some individual doctors live on this money.

 

The good news is that the press is catching on. The New York News,

Milwaukee Journal Sentinel and New York Post have recently run

articles or series on how pharmaceutical companies use cash incentives

to encourage doctors to prescribe their drugs.

 

This spring, the New York Post revealed that Columbia University has

been cashing in. Its Office of Clinical Trials generates about $10

million a year testing new medications--much of which is granted to

the Columbia Psychiatric Institute for implementing these tests. The

director of the institute was being paid $140,000 a year by various

drug companies to tour the country promoting their drugs. He also

received payments of nearly $12,000 from a drug manufacturer to head

up a study on panic disorders. How could he rate these drugs fairly

when-his livelihood was dependent on the success of the drug

manufacturer? The director resigned in the aftermath of the article's

publication.

 

At, least one drug company, WyethAyerst Research, has spoken out

against offering cash bonuses and other incentives to researchers. But

company representatives admit it's difficult to stay competitive when

other groups so eagerly violate ethical concerns.

 

The APA Connection

The American Psychiatric Association representing the majority of

psychiatrists in America, with about 40,000 members--is also unduly

influenced by pharmaceutical dollars. The Association:

 

a.. receives substantial rent from drug companies for huge symposia

spaces at national conventions.

b.. derives an enormous percentage of its income from drug

companies--30% of its total budget is from drug company advertising in

its many publications.

c.. accepts a large number of unrestricted educational grants from

drug companies.

This relationship is dangerous because researchers and psychiatrists

then feel indebted to the drug companies, remain biased in favor of

drug cures, downplay side effects and seldom try other types of

interventions. And they know they have the unspoken blessing of the

APA to do so.

 

Collectively, these practices aggressively promote reliance on

prescription drug use -- so much so that many people think drugs

should be forced on those who refuse to take them. The APA supports

the National Alliance for the Mentally Ill, which believes that

mentally ill patients should be coerced to take medication. I am

appalled by this level of social control. Mentally ill people should

be given a choice to have their illness treated in alternative ways.

 

Over the last decade, I have written a number of letters bringing my

concerns to the APA's attention but have received no response. The

association claims that what it's doing is in the " best interest of

patients, " but its strong ties to the drug industry suggest otherwise.

 

Recently, it was dues-paying time for the APA, and I sat there looking

at the form. I thought about the unholy alliance between the

association and the drug industry. I thought about how consumers are

being affected by this alliance, about the overuse of medication,

about side effects and about alternative treatments. I thought about

how irresponsibly some of my colleagues are acting toward the general

public and the mentally ill. And I realized, I want no part of it anymore.

 

 

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