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Tuesday, February 18, 2014

Elementary, My Dear Dawson

Dr Dawson, I presume, is either getting his rocks off or away licking his wounds somewhere as he comes under fire from a number of patient advocates.

George Dawson, MD, a psychiatrist from the United States has, it appears, bitten off more than he can chew by responding to a blog post written by Peter Gøtzsche, who is a critic of antidepressant use and the pharmaceutical industry. I highlighted an interview with Gøtzsche a few weeks ago. [See Pharmafia: An Interview With Peter Gøtzsche]

Dawson took umbrage to most, if not all of the things Gøtzsche had written in his blog post, Psychiatry Gone Astray. The Gøtzsche post appeared on Dr David Healy's website and he has now, unwittingly, become a target of Dr Dawson.

It's Elementary school time folks and Dawson is shouting over everyone else because, well, isn't that what psychiatrists do when one questions the science behind their profession?

Dawson's critique of Gøtzsche's blog post was, as expected, one-sided. Dawson is very much in the pro-antidepressant use camp. His critique highlights his leaning toward drugging patients who suffer with a chemical imbalance, this is the same imbalance that has been poo-poohed many times by leading experts. Even pharmaceutical companies, who came up with the term originally, now have to admit defeat. Patient information leaflets now add the word "May" or "It is thought" in front of this speculation, an example being, "It is thought your depression is caused by a chemical imbalance".

Lets just look at the two blog posts of Gøtzsche and Dawson

Gøtzsche takes popular psychiatry beliefs and adds them to the myth pile, his first...

Myth 1: Your disease is caused by a chemical imbalance in the brain

Dawson responds with...

"This is a red herring that is frequently marched out in the media and often connected with a conspiracy theory that psychiatrists are tools of pharmaceutical companies who probably originated this idea."  He adds... "the alleged myth fails at the clinical level."

Dawson offers no concrete proof, just beliefs, which is, in essence, what psychiatry is all about.

Myth 2: It’s no problem to stop treatment with antidepressants.

Dawson responds...

"Another red herring.  I have trained psychiatrists, internists, family physicians and medical students and taught them psychopharmacology.  A general principle of psychopharmacology is no abrupt changes in therapy and most drug prescribing information suggests that.  I routinely address this issue as part of informed consent and advise people that there may be difficulty discontinuing antidepressants and describe the potential symptoms."  He adds, "It is quite easy to criticize if you are never faced with the prospect of discontinuing therapy."

Dawson kind of contradicts himself here. On one hand he claims that Gøtzsche's statement is a red herring then continues with  "there may be difficulty discontinuing antidepressants." So, not such a red herring after all then.

Dawson continues to critique all 10 of Gøtzsche's myth list. You can put them up side by side if you open the two links in different tabs in your browser. Gøtzsche versus Dawson.

Both Gøtzsche and Dawson have their supporters, this becomes evident when one looks at the comment section of each post. They make interesting reading and highlight Dawson's defence of his belief that antidepressants do not cause severe withdrawal.

A commentator, Altostrata, writes:

"As for antidepressants not being addictive -- this is a semantic argument."

Dawson responds...

"The idea that antidepressants and addictive medications is an irrational belief that I doubt I will be able to talk out of. I would recommend you abandon at least that part of it because it leaves you with a serious credibility problem..." 

So, according to Dawson, anyone who believes antidepressants are addictive are "irrational".

This statement in itself pretty much sums up the field of psychiatry. Here we have someone who believes in something because they have experienced it first hand. Because their belief doesn't fit in with the blinkered views of psychiatry, they are labelled "irrational".

Further afield, Irish blogger, The Truthman, has wrote about Dawson here. It's a great post as Truthman actually gets down to the nitty gritty of it all. He talks as a former patient and user of Seroxat [known as Paxil in the US]

Truthman writes in an open letter fashion to Dawson...

It is clear to me that your audacity and arrogance towards criticism of the profession goes beyond mere rebuttal, and disturbingly into the realm of utter derision. You have a total disregard for the views and the opinions of those you treat. Your psychiatric paradigm, and the ideology it contains, seems sacrosanct to you, this is dangerous, it is also gravely unwise.
The reason people like you are so dangerous is: you hold power and authority over extremely vulnerable people. Decisions you make about how a vulnerable patient is treated can literally mean the difference between life and death. Your hostility towards valid criticism (and the expression of that opposition) even from within your own profession, seems to matter more to you than compassion and proper care of the mentally (emotionally) ill. This is profoundly unsettling.
For me, at least, Truthman hits the nail on the head with one single paragraph...

I was prescribed Seroxat by a psychiatrist, the psychiatrist told me I had a chemical imbalance, my doctor told me that anti-depressants are like insulin to Diabetics, and that I would be on them for life. I was on them for 4 years, I couldn't come off them because if I did then I would hit a severe withdrawal. That may not be the classical definition of addiction but it was total dependence, the withdrawals were also horrific. Depression is not merely a cluster of symptoms, you are not the authority on it, depression sufferers are. Your profession is not the authority on mental and emotional despair and anguish, those that suffer its depths are!

Amen to that.

Dawson continues to defend his stance on antidepressant use and psychiatry... one wouldn't expect anything less.

Dawson, to my knowledge, hasn't yet been asked for his opinion on antidepressant use in pregnancy. I'd love to hear his blinkered views on this.

Meantime, this is for Dawson and his supporters.

It leaves me wondering [but not for long] if those featured in the video below all had a chemical imbalance and were all mentally disturbed in the way that psychiatry says they were. All I ask Dr Dawson is this... Is it just a coincidence?

Bob Fiddaman

Author of The evidence, however is clear, the Seroxat scandal