When Psychiatry is Debated, it Becomes an 'Attack'.

Mommy, make them stop!

I laughed hard upon reading a recent article published in The Lancet Psychiatry [27 May 2014
doi:10.1016/S2215-0366(14)70232-9]

You see, there's a bunch of psychiatrists who are taking umbrage to those that oppose unwarranted use of antidepressants. The psychiatrist argument smacks of total hypocrisy and lacks any scientific data, preferring instead to quote hearsay whilst using the defence of antidiagnosis and antitreatment groups attacking their belief system [because that's all it is, a belief.]

What's remarkable about this article is pretty much summed up in its final paragraph. My thoughts on this later.

Here we have 5 professionals putting their name to an article, namely, David J Nutt, Guy M Goodwin, Dinesh Bhugra, Seena Fazel and Stephen Lawrie.

They claim they are being targeted by an anti-psychiatry movement when, in fact, they are being asked to debate the issue of antidepressants publicly.

This latest stunt from David J Nutt et al just highlights how psychiatry, when backed into a corner, does everything to avoid going head to head in a public forum with people that disagree with them.

Rather than enter into a public debate they choose to deflect their cowardice by playing the victim.

"Psychiatry is used to being attacked by external parties with antidiagnosis and antitreatment agendas."

"Most of these people are depressed and more than 70% are not taking an antidepressant at the time of death. Blanket condemnation of antidepressants by lobby groups and colleagues risks increasing that proportion"

"Antipsychiatry groups usually claim that depressed patients should be treated with exercise and psychotherapy instead of drugs. However, little controlled evidence exists to support the use of psychotherapy as an alternative to antidepressants in major depression."

"...the anti-psychiatry movement, although now long in the tooth, has revived itself with the recent conspiracy theory that the pharmaceutical industry, in league with psychiatrists, actively plots to create diseases and manufacture drugs no better than placebo."

Nutt et al are so far of the mark here. There are many individuals, myself included, who are not part of groups - choosing instead to go it alone, to speak out against something because it's the right thing to do.

What I find worrying about this article is the bare-faced cheek of it's authors who dismiss claims that the pharmaceutical industry is in league with psychiatrists and then, because the Lancet abide by transparency, reveal the authors ties to the industry.

{Insert canned laughter here}

DJN has received grants and personal fees from Lundbeck and GSK; and personal fees from Lilly, BMS, Otsuka, Servier, and Pfizer. GMG has received grants and personal fees from Servier and Lundbeck; personal fees from Teva, Otsuka, Takeda, Eli Lilly, Merck, GSK, and AstraZeneca; and grants from P1vital. SL has received research funding from Abbvie, Roche, and Pfizer in connection with genetic, brain imaging, and therapeutic studies of people with schizophrenia. He has also been paid by Janssen and Roche to speak at or chair educational meetings about schizophrenia, as well as to contribute to advisory boards about new antipsychotic treatments. The other authors declare no competing interests.

It's laughable.

It's akin to the following hamster claiming that he doesn't know where the carrots are.

And we, the gullible public, are expected to believe Nutt et al because [boo hoo] they are being targeted by antipsychiatry groups.

If Nutt had anything about him, he'd step up to the plate and publicly debate what he thinks he knows about antidepressants and their safety - instead he, with his colleagues, run to the Headmaster because they cannot answer their critics in a public place - ergo they are being bullied, targeted by academics who have different opinions.

"Mommy, make them stop."

A few weeks ago Professor Peter Gøtzsche, Nordic Cochrane Centre, Dr Joanna Moncrieff, University College London and Dr James Davies, University of Roehampton challenged Nutt et all to an open debate. All three are part of The Council for Evidence Based Psychiatry [CEP] - the clue to what they seek is in the title of their organisation - "Evidence Based Psychiatry".

One way to put a stop to this is to stop the pissing match. Go public, sit on a panel - Gøtzsche et al on one side of the table, Nutt et al on the other side.

What we are currently witnessing is fight-hype, we see this, normally in Boxing. Two fighters talk the talk before beating one another in the ring. Difference being, they get in the ring to iron out their problems.

The CEP have challenged Psychiatry but Psychiatry is making excuses, they want to keep their heavy-weight belt and fear they will lose it if they accept the challenge.

We have the CEP in one corner here and Nutt et al in another. The CEP are ready to exchange blows but Nutt et al want protection from the referee. "The CEP are anti-me Mr Referee, do I have to fight them?"

In 2004 Nutt held 300 shares in GlaxoSmithKline and was also a paid consultant for them. It's a pity Nutt didn't add this in his article in the Lancet.

The Lancet Psychiatry article, Attacks on antidepressants: signs of deep-seated stigma?, can be read here [registration needed]

Bob Fiddaman