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Diseases Grow at Psychiatry Meeting-Thanks to Big Pharma

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The first week in May brought a new leader in France and new prospects for same sex couples seeking marriage. But at the American Psychiatric Association's annual meeting in Philadelphia, attended by 11,000 psychiatrists, it was the same old same old. Instead of listening to the public outcry about overmedicated children, soldiers, elderly and everyday people watching too many drug ads, the psychiatry group re-affirmed its resolve to pathologize healthy people and even rolled out new groups to target.

This is the year the APA puts the finishing touches on DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, a compendium that determines what treatments insurers will cover, what disorders merit funding as "public health" threats and of course, Pharma marketing and profits. Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-5's authors have Pharma links.

Volkowz

No kidding. Present at this year's meeting were former APA president Alan F. Schatzberg, MD and Charles Nemeroff, MD, both investigated by Congress for murky Pharma income. Schatzberg and Nemeroff are co-editors of the APA-published Textbook of Psychopharmacology whose 2009 edition cites the work of Richard Borison, MD former psychiatry chief at the Augusta Veterans Affairs medical center who was sentenced to 15 years in prison for a $10 million clinical trial fraud. Also present was S. Charles Schulz, MD, who was investigated for financial links to AstraZeneca believed to alter his scientific conclusions.

Even though Assistant Secretary of Defense Jonathan Woodson sent a memo to all branches of the military in February about overprescription of antipsychotic medications like Seroquel and Risperdal for PTSD, military figures closely linked to that overprescription were also listed in attendance at the APA meeting.

Elspeth Ritchie, MD, told the Denver Post that AstraZeneca's Seroquel was "very useful for the treatment of anxiety and combat-related nightmares," though it was (and is) not approved for such treatment while she was medical director of the army's Strategic Communications Office in 2008, participated in many symposiums. Ritchie, who is now chief clinical officer for the District of Columbia's department of mental health, appeared in an AstraZeneca and Eli Lilly funded webcast for the Massachusetts General Hospital Psychiatry Academy in 2008 in which she lauds the use of "sophisticated" psychiatric medicines "on the battlefield."

Seroquel earned AstraZeneca nearly $6 billion in revenue last year, reports the Philadelphia Inquirer. "IMS Health, a healthcare information and services company, said that in the 12 months ending in February of this year, 14.1 million Seroquel prescriptions were written, more than any other antipsychotic," it reports.

Also participating in the military and PTSD content at the APA meeting was Matthew Friedman, MD, Executive Director of the VA's National Center for PTSD who reported, "I received an honorarium from AstraZeneca in the past year," in a 2009 government slide show called "Pharmacological Treatments of PTSD and Comorbid Disorder." Friedman also served as a Pfizer Visiting Professor at the Medical University of South Carolina College of Medicine last year yet is listed in the APA meeting guide as having no "significant relationships to disclose." APA officials have not responded to several requests for comment.

Of course disorders that Big Pharma has helped monetize like bipolar (which was termed "under diagnosed" and emerging in the elderly at the meeting) and "mood disorders" (once called "life") were well represented. But an alarming amount of attention also went to the apparent new Pharma profit center of alcoholism and drug addiction.

Addiction specialists have known for more than 70 years that the only "treatment" for drug addiction and alcoholism (after patients are detoxed) are anonymous, self-help programs that are also free. In fact medicine is as powerless to understand or treat drug addiction and alcoholism as alcoholics and drug addicts are over their addiction.

Still the National Institutes of Health, in conjunction with Big Pharma, continues to spend millions, some say billions, developing "animal models" of addiction and vaccines to "cure" them. Nora D. Volkow, MD director of the National Institute on Drug Abuse, says she seeks a vaccine to treat those at risk of alcoholism and drug addiction on the basis of "biological and environmental factors," before they get sick. (See: treating those "at risk" for psychosis or depression or bipolar disorder on the basis of their family histories with no symptoms evidence.)

It is pretty fair to say Volkow is not an alcoholic or drug addict. Any of them could tell her they don't seek "help" until they're out of options-and even then not from a doctor but from each other. In fact, if Pharma, the National Institute on Drug Abuse and the American Psychiatric Association think they can treat a disease caused by drugs with a drug, that's pretty insane. In fact, one of the treatments suggested for alcoholism at the meeting was quetiapine, also known as Seroquel.

"The Returning Veteran: PTSD and Traumatic Brain Injury," Massachusetts General Hospital Psychiatry Academy, May 28, 2008

Martha Rosenberg is a columnist and cartoonist, who writes about public health Read more stories by Martha Rosenberg.

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