"Dr. Nemeroff came up to me in the course of the meeting in what was a very scary meeting between him and me and told me that my career would be destroyed if I kept on showing results like the ones that I'd just shown, that I had no right to bring out hazards of the pills like these." - David Healy
Actual script from 'Dr. David Healy' CBC News and Current Affairs
Broadcast on Tue 12 Jun 2001
DARROW MACINTYRE: A quiet, small town in North Wales. It seems an unlikely place to find a man like David Healy, university professor and psychiatrist, renowned in medical circles from New York to Paris to London as one of Europe's eminent scientist. This time last year, Healy was about to leave Wales. Lured to Toronto by this university teaching hospital, the Centre for Addiction and Mental Health and the promise of his own research clinic there. Then one day last November, something strange happened. After almost two years of courting Dr. Healy and finally offering him the big job, senior staff at the centre abruptly decided to dump him. They say they found out just in a nick of time that Healy held certain unscientific views about a number of psychiatric drugs, views they say could harm patient care. But many in the academic community think their decision had less to do with science and more to do with money. What this is really about, they say, is the role drug companies play in influencing scientific debate. When it comes to anti-depressants there are few people who know more than Dr. Healy. Especially about a group of drugs called S.S.R.I. or Selective Seratonin Re-uptake Inhibitors. The best known of these is Prozac, the most widely prescribed anti-depressant in the world. But for a decade now, research has suggested that drugs like Prozac may actually cause some people to have suicidal urges. Nobody really knows how often, but Healy thinks often enough to be concerned.
DAVID HEALY: Let's say in the case of Prozac that it causes the problem, it will cause people to commit suicide at a rate of one in 1,000 people who actually go on the drug. To most people here a figure like that, that sounds like a fairly low figure. It sounds like a reasonable trade-off almost. But if 50 million people go on the drug, then that becomes 50,000 suicides which is maybe higher than there has been, but it becomes an awfully big figure. It's what the FDA call the public health multiplier which is a small hazard distributed among millions of people becomes a big problem.
MACINTYRE: Recently David Healy conducted studies aimed at trying to figure out just who is at risk and who isn't. Are you opposed to the use of S.S.R.I.'s?
HEALY: Absolutely not. No. My Ph.D. thesis was on the seratonin re-uptake system and I've been, I was one of the people when the S.S.R.I.'s came out first who would have been much quicker than most of the rest of my colleagues to use this new group of drugs. I continue to put a very large number of people that I see on the drugs. And I believe as the research that we've done indicates that if you're really going to use the drugs properly and I'm in the business of using these drugs to treat people, is you're really going to find out who does well on these drugs, what you find out at the same time is who does poorly.
MACINTYRE: Dr. Healy's not the first one to document this problem. Doctors at Harvard University raised concerns about S.S.R.I.'s and suicide years ago. Harvard lecturer and psychiatrist Joseph Glen Mullen wrote about it in his book "Prozac Backlash". He says more doctors should listen to Healy.
JOSEPH GLEN MULLEN: Dr. Healy for many, many years has been widely regarded as one of the leading psychiatrist in Europe and really in the world. His research is outstanding. And he's one of the few people who has continued to do research on the suicidality issue in particular and been a strong proponent of patients needing to get this kind of information.
MACINTYRE: Last summer, the centre made it official. They wanted Healy as the top scientist in their mood and anxiety disorders clinic. They offered him the director's job and he accepted.
HEALY: I felt very good about it. And I also brought over my family and certainly they all seemed reasonably open to the move as well. So we all began to get fairly excited.
MACINTYRE: At the time the centre had no problem with Healy's research. But someone else did.
CHARLES NEMEROFF: Hello. My name is Charles Nemeroff.
MACINTYRE: Chair of the Department of Psychiatry at Atlanta's prestigious Emory University, Dr. Charles Nemeroff is a highly respected and influential scientist. And a paid consultant to a dozen drug companies. A leading psychiatric magazine recently profiled him under the headline Boss of Bosses. Is the brash and controversial Charles Nemeroff, the most powerful man in psychiatry. Inside the authors wrote, Nemeroff is among the most coveted advisors to the pharmaceutical industry. And he fully expects to lead the corporate strategies of those he advises. Those who do not heed his advice are often the recipients of his wrath. Last summer at Cambridge University in England, Healy had a brush with the boss of bosses.
HEALY: Dr. Nemeroff came up to me in the course of the meeting in what was a very scary meeting between him and me and told me that my career would be destroyed if I kept on showing results like the ones that I'd just shown, that I had no right to bring out hazards of the pills like these.
MACINTYRE: In a written statement, a doctor who witnessed the confrontation told us, when it became clear that David Healy would not back down from his points of view, Nemeroff said that what Healy was publishing might harm the drug industry, specifically Eli Lilly. He, Charles Nemeroff, said that these people were ruthless and would go to great lengths to make life hard for academics who published articles associating suicide with Prozac.
HEALY: It was a fairly short encounter. It lasted about two or three minutes but a very scary one.
MACINTYRE: James Turk is with the Canadian Association of University Teachers. He says to a drug company concerned about profits, researchers like Healy could be seen as dangerous.
JAMES TURK: I mean he's one of the world's leading scholars on anti-depressants. He's done clinical trials for some of the drug companies. But what he isn't is not in the drug companies' pockets. And Healy's argument is that S.S.R.I.'s are suitable for some patients but in fact can be very harmful for others. And the impression I get is that the drug companies want 100 percent of the market whereas if you do that research and Healy's right, that there are 40 percent or 50 percent of the people who currently get S.S.R.I.'s for whom it's not appropriate, then the market is cut in half.
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