1. He sends a letter like this one to Roger Meyer of Best Practice which is a private for profit company that receives no federal grant money. But that's beside the point since the crime is now simply conducting and publishing research on any observation of any post market benefit of any drug for mental illness in peer reviewed publications such as JAMA. Which is what Fred Goodwin and Roger Meyer did along with authors from Kaiser Permanente and Group Health of Puget Sound.
(Suicide Risk in Bipolar Disorder During Treatment With Lithium and Divalproex
JAMA. 2003;290:1467-1473.)
The subject of Grassley's investigation is the following: " A Population-based sample of 20 638 health plan members aged 14 years or older who had at least 1 outpatient diagnosis of bipolar disorder and at least 1 filled prescription for lithium, divalproex, or carbamazepine between January 1, 1994, and December 31, 2001. Follow-up for each individual began with first qualifying prescription and ended with death, disenrollment from the health plan, or end of the study period."
The results?
In both health plans, unadjusted rates were greater during treatment with divalproex than during treatment with lithium for emergency department suicide attempt (31.3 vs 10.8 per 1000 person-years; P<.001), suicide attempt resulting in hospitalization (10.5 vs 4.2 per 1000 person-years; P<.001), and suicide death (1.7 vs 0.7 per 1000 person-years; P = .04). After adjustment for age, sex, health plan, year of diagnosis, comorbid medical and psychiatric conditions, and concomitant use of other psychotropic drugs, risk of suicide death was 2.7 times higher (95% confidence interval [CI], 1.1-6.3; P = .03) during treatment with divalproex than during treatment with lithium. Corresponding hazard ratios for nonfatal attempts were 1.7 (95% CI, 1.2-2.3; P = .002) for attempts resulting in hospitalization and 1.8 (95% CI, 1.4-2.2; P<.001) for attempts diagnosed in the emergency department.
Conclusion Among patients treated for bipolar disorder, risk of suicide attempt and suicide death is lower during treatment with lithium than during treatment with divalproex.
See how dangerous this is. No wonder Pharmalot rushed to blog on the Grassley "probe"
Worst Practice? Senate Probes NPR Host’s Firm
Of course, engaging in such activities in identifying risks is ok and individuals with such information should contact Grassley's office or the Church of Scientology or both. (Something tells me that either way the one will get the info to the other.
2. How did Phamalot find out. Turns out that Grassley, well before Roger Meyer even responded to the Grassley "probe" send what his missive to to the media in advance of sending the letter to Roger Meyer as well as bloggers such as pharmalot whose blog is an oasis for the anti-psycho-pharm crowd. Pharmalot then trumpets that Best Practice is being investigated by Grassley. Did Pharmalot contact Roger Meyer or Fred Goodwin or read the JAMA article in question. Of course not. Is such behavior defamatory. To my mind it is. When I have gone over the top -- and I have - I have at least apologized or issued a retraction. We will see what happens to Pharmalot in the days ahead. Even bloggers should abide by a code of moral decency.3. But don't hold your breath. The pharmalot blog along with others will generate more mainstream media headlines and articles. And a press release from Grassley that is already to go.
Will this have a chilling effect on the publication of off-label effects of medications. Of course it will. Will that harm patients and undermine innovation. Of course. Along with the assault on any tie between industry and academia.
The hijacking of science for fear and profit continues apace.
