SSRIs and Conflicts of Interest

An FDA reviewer last week concluded that antidepressant medicines trigger suicidal thoughts and even suicide in some young adults suffering from depression. This week, the Food and Drug Administration will hold an advisory committee meeting to air this issue.

This is a subject where opinions are highly predictable -- where you stand depends very much on where you sit. The psychiatry profession is among the most compromised in modern medicine. Its practitioners, having lost their ability to command reimbursement from the insurance companies for talk therapy, have become purveyors of pills, and have allowed the drug industry through consulting deals and other emoluments to make up for some of their lost revenue.

However, there are some psychiatrist-physicians who aren't on the take from the drug industry. And, when a high profile meeting like the one that will take place this week comes up, you'd think the FDA would reach out to find them. Alas, the FDA organizers of this meetings still haven't gotten the message. The agency placed three people with ties to the drug industry on the panel.

They include Andrew Leon, a professor of public health at Cornell's Weill Medical School who is a permanent member of the committee. Leon has received between $10,001 and $50,000 per year as a member of a data monitoring board for an undisclosed firm that sells antidepressants, according to the FDA waiver that will allow him to sit on the committee. According to independent research by the Center for Science in the Public Interest, Leon has also consulted for Cyberonics, makers of the Vegus Nerve Shock Therapy System which treats severe depression, and Cortex Pharmaceuticals, which make a class of compounds used for Alzheimer's and depression. In addition, Leon's research has been sponsored by Forest Laboratories, which make Celexa, a selective serotonin reuptake inhibitor (SSRI).

Another panelist will be Bruce Pollock, who works at the Rotman Research Institute in Toronto. He will not be allowed to vote in on the issue because he receives as much as $10,000 per year sitting on the advisory board and speakers bureau for an antidepressant maker. Pollock also advises and speaks on behalf of Forest Labs, which makes the best-selling antidepressants, Celexa and Lexapro; for GlaxoSmithKline, maker of the antidepressant Paxil; and for Pfizer, maker of Zoloft, a popular anti-depression drug.

A third waiver was issued to Jean Bronstein, a retired nurse who will be the consumer representative on the committee. She owns stock valued from $5,001 to $100,000 in two drug firms that make antidepressants. Dozens of affected "consumers" will be speaking during the public portion of the meeting. It will be ineresting to see how much support they receive from Bronstein.