"I can read you like a book. And not a very good book. Certainly not 'Bravo Two Zero' by Andy McNab. Which actually improves with every read." ~ Alan Partridge
Many of us have read today's news articles published in several "mainstream" media outlets. Backslapping has ensued amongst those responsible for this apparent "U-turn". Today's media exposé isn't really an exposé, not when adverse effects, which include suicidality and suicide have intentionally been omitted in today's articles and in the Royal College of Psychiatrists (RCPsych) new "position paper."
Stop the backslaps. This is no volte-face, as you will see.
For years the stance of the Royal College of Psychiatrists (RCPsych) has been that what I call brain pellets and they call "antidepressants" are safe, effective and cause only minimal problems when patients try to stop taking them. RCPsych's stance has been documented for many years on their website, in their strategically placed media articles and on social networking sites.
Today RCPsych published a 29-page document on its website with emphasis regarding people who have, and still are, struggling with brain-pellet withdrawal. How long this document will remain on RCPsych's website is anyone's guess given RCPsych has a habit of removing evidence of withdrawal problems from its website (1)
The 29-page document, a "Position statement on antidepressants and depression", is a buck-passing exercise. Nothing more, nothing less. The diligent media (Guardian, The Times, The Mirror, Daily Mail) are doing what they often do best: providing RCPsych and the field of psychiatry with a free mouthpiece for positive PR.
The position paper gives RCPsych an opportunity to harp on about depression and how serious it is and gently--almost as a sidenote--slip in, "Oh, by the way, some people may struggle coming off the drugs we prescribe."
Why So Cynical?
Back in 2011, the British drug regulator, the MHRA, unleashed the SSRI Learning Module. This 'module' was aimed at prescribing physicians who, according to the MHRA, needed to learn more about antidepressant withdrawal problems, particularly from the SSRI class of drugs such as Zoloft, Prozac, Seroxat, etc.
The move back then is identical to what we see today: A gesture to try and stifle patients' voices, promote the drugs as a safe and effective treatment for depression, and appease, in some small way, advocates who have for many years accurately pointed out the truth. Previous denials by RCPsych and MHRA regarding this public health crisis made possible the prescribed harm and deaths of countless people. But these facts weren't really mentioned in today's media outlets.
As I typically do after any MHRA announcement, I reviewed their module and found some glaring omissions. Lot's of talk, but no real action. RCPsych's paper is similar. To learn more about the MHRA's SSRI Learning Module read here, here and here.
Next, read the emails I sent the MHRA regarding their claim that experts are on hand to help people struggling withdrawal problems.
So here we are 8 years later and we awake to another announcement, this one from the prescribers and RCPsych. The announcement is littered with contradictions. Moreover, the serious prescribing problems are barely addressed and played down all the while supposed benefits are emphasized. The old message still comes through loud and clear despite its newfound, quietly sly delivery: That is, "The product benefits outweigh the risks."
I've often struggled with the benefits vs risks claim because I've never actually seen a list of these so-called benefits yet I have seen an ever-increasing list of risks.
For years we have been told the benefits outweigh the risks but when we question these benefits and ask what they are, exactly, there is no meaningful answer. The empty replies often parroted include "Depression is a serious illness." and "These drugs save lives." Interesting to note that data proving such claims never seems to be provided by RCPsych and prescribers who otherwise like to stress the importance of scientific data. RCPsych's press release and today's news articles also seem to omit the fact that SSRIs are often prescribed off-label for reasons unrelated to "depression." Such discussions and concerns regarding people who were prescribed these drugs NOT for depression is glaringly absent despite that these people also suffer from withdrawal and drug-induced akathisia (which can create anxiety and depression as an adverse drug effect). Those who died avoidable SSRI-induced akathisia deaths are also apparently invisible ghosts.
Yes, they really did state such meaningless nonsense. If Prozac (and presumably other SSRIs) help rectify a chemical imbalance then, that's the one and only benefit according to the British drug regulator. The fact that the chemical imbalance theory/marketing spin has been debunked and no longer touted by RCPsych didn't seem to matter to the MHRA, who, incidentally, are fully funded by drug companies.
RCPsych released their position statement on products marketed as antidepressants because they have come under fire on Twitter from many drug safety advocates too numerous to individually mention here. RCPsych President, Wendy Burn, has claimed she never knew how bad the withdrawal problem is until she joined Twitter. Most would agree that the implications of this admission are staggering. For more than 30 years brain pellets have been on the market, and Burn and her colleagues have been prescribing them to elderly patients and children, two groups who are most at-risk for experiencing adverse effects to any drugs, not just SSRIs. What astounds me most about today's news is the messages Burn has been receiving on Twitter, some of which are from drug safety advocates thanking her. Yes, thanking her! Let's all send thanks to the drug companies, whilst we're at it. For years they denied withdrawal problems when, like Burn, were forced to change warnings about brain pellet withdrawal. How can you thank someone who has been forced to admit the truth by those damaged by the very same drugs Burn has continuously defended? The mind boggles.
RCPsych's position paper calls for more education for prescribers. RCPsych should start with its own president who has previously maintained that for years she has never seen withdrawal. I don't think Burn's admission is rare among prescribers. People have difficulty seeing what they don't want to see. People have difficulty recognizing and identifying what they believe seldom exists and/or doesn't exist at all. Lastly, like the drug companies, prescribers who don't want to know the honest answers to relevant questions--questions that will likely reduce prescribing, reduce product sales and increase public knowledge of product risks--choose not to ask certain questions.
Some might call this blog cynical but I've been writing about the withdrawal problem for more than 13 years and have witnessed endless ignorance, collusion and denial by drug companies, regulators and prescribers. RCPsych's publicly announced U-turn today will likely create little if any meaningful change. The only thing it does accomplish is to show RCPsych with egg on its face, an egg that will quickly be wiped clean as RCPsych continues to claim 1) They didn't previously know about serious withdrawal problems and 2) The benefits of "antidepressants" still outweigh the risks.
Evidence of RCPych's tactical position was seen just hours after the media announced their apparent U-turn. Dr Adrian James, a Forensic Psychiatrist with Devon Partnership NHS Trust and Registrar Royal College of Psychiatrists, was a guest on BBC Radio 4 show. He was there to discuss today's headlines. Here's what he said.
"...withdrawal was mild and self-limiting and not the real story, the real story was not enough people are getting antidepressant drugs."
As I said, the position paper just allows them to promote the use of brain pellets. The only upshot of James' torrid PR today presented by BBC radio is that the public is increasingly starting to see right through this shameless drug promotion and call it out for what it is.
I'd be more impressed if RCPsych were to hassle drug companies for the raw data regarding brain pellets, without which they can never give fully informed consent. Never.
Let us not forget those who have died as a result of medical "professionals" instructing patients to stop SSRIs cold turkey, or lowered brain pellet dosages too quickly or, wrongly increased SSRI dosages in response to symptoms that were actually SSRI-induced akathisia. Many of these men, women and children were prescribed brain pellets by average GP's who took their advice from RCPsych. Don't expect to see any remorse or apologies for the dead and/or for those who currently live lives with permanently prescribed harms. Do expect more of the same from the RCPsych fundamentalists.
There are too many captains at RCPsych, all of whom are blindly steering their ship into an iceberg. We, the patients, are the passengers. Some of us have already perished thanks to the stance of RCPsych. My heart, today, goes out to all those who have died as a result of the incompetence and ignorance of the Royal College. It goes out further to the families of those who will lose loved ones in the future due to RCPsych's tactical games. Trust me, there will be more deaths. And RCPsych knows it.
I held talks with the MHRA back in 2008. Recommendations were made by the MHRA. They promised to consult with the British National Formulary (BNF) and NICE. Nothing came of it (3)
Plus ça change, plus c'est la même chose.
Bob Fiddaman
(1) RCP Remove Damning Antidepressant Document From Website
(2) Prozac - Benefits Vs Risks - MHRA Correspondence
(3) Guidance on the Management of Withdrawal from Seroxat (Paroxetine) and Other SSRIs
