Latest Drugwonks' Blog
CBS Reporter Takes Swipe at Drug Industry, Praises Politician in Blog Post
Armen Keteyian lamented 'Big Pharma's' 'control' over Americans.
By Ken Shepherd
Business & Media Institute
“What can be done to break Big Pharma’s growing control of our minds and bodies? I wish I knew,†a critic of the pharmaceutical industry wrote recently on a media blog. But the author of that post was an ostensibly unbiased investigative journalist: CBS correspondent Armen Keteyian.
Network blogs can be a valuable, unfiltered look at reporters’ biases, and Keteyian’s December 14 post to CBS’s “Primary Source†was no exception.
“No matter how you slice it Wednesday was not a great day for the FDA,†Keteyian began his blog post, recounting how the December 13 “Evening News†presented “back-to-back stories†on a new FDA warning label for antidepressants and congressional criticism of FDA’s handling of Ketek, an antibiotic that can result in liver damage to some patients.
While December 13 might not have been FDA’s finest hour for public relations, the CBS reporter failed to account for how his bias could color his perceptions.
Keteyian, a former sportscaster, peppered his blog post with more anti-industry commentary, insisting that “Big Pharma seems in control [of] much of Congress, or at least its legislative agenda†before praising Iowa Republican Charles Grassley as a “straight-talking†senator who has “stood up and called out†pharmaceutical companies.
As the Business & Media Institute documented on December 14, CBS presented a decidedly sensationalistic look at the FDA’s decision to require a “black box†warning on drugs like Paxil and Zoloft when prescribed to patients up to the age of 25. In that December 13 report, Keteyian’s colleague Sharyl Attkisson focused heavily on the grief of distraught widows of suicidal patients while finding no air time for expert medical testimony.
Of course, medical experts such as NBC News’s chief medical editor Dr. Nancy Snyderman have noted that many psychiatrists find medication a crucial part of treating depression for some patients, albeit one with risks that require careful monitoring.
That dose of reality is a bitter pill to swallow for Keteyian, who lamented in his blog post that “America is a drug dependant [sic] nation†that takes pills “for just about every illness known to man or woman.â€
What's the frequency ... Armen?
Armen Keteyian lamented 'Big Pharma's' 'control' over Americans.
By Ken Shepherd
Business & Media Institute
“What can be done to break Big Pharma’s growing control of our minds and bodies? I wish I knew,†a critic of the pharmaceutical industry wrote recently on a media blog. But the author of that post was an ostensibly unbiased investigative journalist: CBS correspondent Armen Keteyian.
Network blogs can be a valuable, unfiltered look at reporters’ biases, and Keteyian’s December 14 post to CBS’s “Primary Source†was no exception.
“No matter how you slice it Wednesday was not a great day for the FDA,†Keteyian began his blog post, recounting how the December 13 “Evening News†presented “back-to-back stories†on a new FDA warning label for antidepressants and congressional criticism of FDA’s handling of Ketek, an antibiotic that can result in liver damage to some patients.
While December 13 might not have been FDA’s finest hour for public relations, the CBS reporter failed to account for how his bias could color his perceptions.
Keteyian, a former sportscaster, peppered his blog post with more anti-industry commentary, insisting that “Big Pharma seems in control [of] much of Congress, or at least its legislative agenda†before praising Iowa Republican Charles Grassley as a “straight-talking†senator who has “stood up and called out†pharmaceutical companies.
As the Business & Media Institute documented on December 14, CBS presented a decidedly sensationalistic look at the FDA’s decision to require a “black box†warning on drugs like Paxil and Zoloft when prescribed to patients up to the age of 25. In that December 13 report, Keteyian’s colleague Sharyl Attkisson focused heavily on the grief of distraught widows of suicidal patients while finding no air time for expert medical testimony.
Of course, medical experts such as NBC News’s chief medical editor Dr. Nancy Snyderman have noted that many psychiatrists find medication a crucial part of treating depression for some patients, albeit one with risks that require careful monitoring.
That dose of reality is a bitter pill to swallow for Keteyian, who lamented in his blog post that “America is a drug dependant [sic] nation†that takes pills “for just about every illness known to man or woman.â€
What's the frequency ... Armen?
If you want to begin to understand why breast cancer rates declined so suddenly in 2003 -- and remember we are three years behind the reporting curve -- read Tara Parker-Pope's definitive article in the WSJ:
What Made Breast Cancer Decline in 2003?
The Wall Street Journal
USA, 12/15/2006 - After rising for two decades, the number of women diagnosed with breast cancer fell in 2003 by a stunning 7%.
The reasons behind the steep drop -- which translates to about 14,000 women who didn't get breast cancer that year -- aren't entirely clear. Changes in medication use, including a sharp decline in women taking menopause hormones and increased use of calcium supplements and anti-inflammatory drugs, may all have played a role. A 3% drop in mammography screening among menopausal women in the same year could also help explain why fewer breast cancers were found. "
Yes Virginia, our crazed friends at Breast Cancer Action have done a wonderful job of scaring people away from getting mammographies...
Tara takes on the issue of whether the decline in estrogen use is the sole cause, a view most other articles have been pushing despite the fact that not all breast cancers express the same way:
"One possible explanation for the decline in 2003 is that it is tied, at least in part, to the July 2002 release of the Women's Health Initiative study of estrogen and progestin, which linked the hormones with heart attacks and breast cancer in older women. The WHI, which studied Wyeth's estrogen-progestin drug Pempro, scared millions of women into stopping menopause-hormone therapy almost overnight. Since the WHI announcement, menopause-hormone use has fallen by about 30%."
However...
"While the decline in hormone use between 2002 and 2003 was dramatic, it is unlikely that hormones explain the entire drop because the incidence of ER-negative cancers -- or those that weren't boosted by estrogen -- also declined. As a result, researchers are looking at other changes during the time period that could help explain the overall drop in breast cancer. "
And then there are those horrible COX-2 drugs that David Graham proudly help push off the market:
"Other medications may also have played a role. A separate WHI observational study of more than 80,000 women showed that those who used anti-inflammatory drugs for at least five years had a 20% lower risk of breast cancer. In the U.S., prescriptions for popular anti-inflammatory drugs called Cox II inhibitors more than doubled between 1999 and 2003, according to IMS Health, which tracks pharmaceutical sales data. "
And Graham's lawyer got ticked off because I questioned Graham's judgement?
"Another explanation may be the increased use of the drug raloxifene, which is sold by Eli Lilly & Co. as Evista and was approved for the treatment of osteoporosis in 1999."
In sum, Parker-Pope's multi-factorial analysis is excellent and embodies the gold standard of medical reporting.....
What Made Breast Cancer Decline in 2003?
The Wall Street Journal
USA, 12/15/2006 - After rising for two decades, the number of women diagnosed with breast cancer fell in 2003 by a stunning 7%.
The reasons behind the steep drop -- which translates to about 14,000 women who didn't get breast cancer that year -- aren't entirely clear. Changes in medication use, including a sharp decline in women taking menopause hormones and increased use of calcium supplements and anti-inflammatory drugs, may all have played a role. A 3% drop in mammography screening among menopausal women in the same year could also help explain why fewer breast cancers were found. "
Yes Virginia, our crazed friends at Breast Cancer Action have done a wonderful job of scaring people away from getting mammographies...
Tara takes on the issue of whether the decline in estrogen use is the sole cause, a view most other articles have been pushing despite the fact that not all breast cancers express the same way:
"One possible explanation for the decline in 2003 is that it is tied, at least in part, to the July 2002 release of the Women's Health Initiative study of estrogen and progestin, which linked the hormones with heart attacks and breast cancer in older women. The WHI, which studied Wyeth's estrogen-progestin drug Pempro, scared millions of women into stopping menopause-hormone therapy almost overnight. Since the WHI announcement, menopause-hormone use has fallen by about 30%."
However...
"While the decline in hormone use between 2002 and 2003 was dramatic, it is unlikely that hormones explain the entire drop because the incidence of ER-negative cancers -- or those that weren't boosted by estrogen -- also declined. As a result, researchers are looking at other changes during the time period that could help explain the overall drop in breast cancer. "
And then there are those horrible COX-2 drugs that David Graham proudly help push off the market:
"Other medications may also have played a role. A separate WHI observational study of more than 80,000 women showed that those who used anti-inflammatory drugs for at least five years had a 20% lower risk of breast cancer. In the U.S., prescriptions for popular anti-inflammatory drugs called Cox II inhibitors more than doubled between 1999 and 2003, according to IMS Health, which tracks pharmaceutical sales data. "
And Graham's lawyer got ticked off because I questioned Graham's judgement?
"Another explanation may be the increased use of the drug raloxifene, which is sold by Eli Lilly & Co. as Evista and was approved for the treatment of osteoporosis in 1999."
In sum, Parker-Pope's multi-factorial analysis is excellent and embodies the gold standard of medical reporting.....
From the WSJ....The Food and Drug Administration won't call for major changes to the safety labeling for the Sanofi-Aventis SA antibiotic Ketek, but a public meeting today is expected to highlight debate over the agency's handling of the drug.
The agency's newest views about Ketek became public in documents posted in advance of a gathering today and tomorrow of an advisory committee that is expected to weigh safety concerns tied to the drug, along with evidence for its efficacy.
From the WSJ
The Food and Drug Administration's plan to expand warnings about a link between antidepressants and suicidal thoughts and behavior to include young adults is sparking strong push-back from psychiatrists. That, in turn, raises questions about how wide an effect the change would have on prescribing patterns.
Yesterday, the agency proposed to add adults younger than 25 years old to the at-risk groups mentioned in the strong "black box" warning on the labels of antidepressant drugs. Currently, the warning says the medicines "increased the risk" of suicidal tendencies in children and adolescents in studies. But the FDA said its analysis shows the pattern reversed itself for people older than 30, and particularly for those over 65, for whom the drugs were associated with a protective effect against suicidal behavior, a point the agency also plans to add in the black box.
The FDA also reiterated the need for doctors to carefully monitor patients taking antidepressants for the emergence of, or increase in, any suicidal tendencies.
An FDA advisory committee, meeting yesterday, endorsed the agency's latest proposal by a 6-2 vote. But it also encouraged the FDA to add language to the black box about the importance of treating depression in hopes that the addition of new warnings won't cause doctors to limit the antidepressant prescriptions.
The FDA played it straight with the data and the advisory panel reflected clinical concerns as opposed to the shrieks of the crazies....
Shame on on the shameless Shankar Vedantam of the Washington Post who continues to continue space and legitimacy to the Sciento-illogical soundings of Alliance for Allen Life Form Protection....They still pump out the sewage that there is no biological basis for mental illness, the same crap Tom Cruise dumped on Matt Lauer. It reduced TomKat to a laughing stock. It gets the Alliance more coverage from Shankar...Is there any editorial oversight at the Washington Post?
The agency's newest views about Ketek became public in documents posted in advance of a gathering today and tomorrow of an advisory committee that is expected to weigh safety concerns tied to the drug, along with evidence for its efficacy.
From the WSJ
The Food and Drug Administration's plan to expand warnings about a link between antidepressants and suicidal thoughts and behavior to include young adults is sparking strong push-back from psychiatrists. That, in turn, raises questions about how wide an effect the change would have on prescribing patterns.
Yesterday, the agency proposed to add adults younger than 25 years old to the at-risk groups mentioned in the strong "black box" warning on the labels of antidepressant drugs. Currently, the warning says the medicines "increased the risk" of suicidal tendencies in children and adolescents in studies. But the FDA said its analysis shows the pattern reversed itself for people older than 30, and particularly for those over 65, for whom the drugs were associated with a protective effect against suicidal behavior, a point the agency also plans to add in the black box.
The FDA also reiterated the need for doctors to carefully monitor patients taking antidepressants for the emergence of, or increase in, any suicidal tendencies.
An FDA advisory committee, meeting yesterday, endorsed the agency's latest proposal by a 6-2 vote. But it also encouraged the FDA to add language to the black box about the importance of treating depression in hopes that the addition of new warnings won't cause doctors to limit the antidepressant prescriptions.
The FDA played it straight with the data and the advisory panel reflected clinical concerns as opposed to the shrieks of the crazies....
Shame on on the shameless Shankar Vedantam of the Washington Post who continues to continue space and legitimacy to the Sciento-illogical soundings of Alliance for Allen Life Form Protection....They still pump out the sewage that there is no biological basis for mental illness, the same crap Tom Cruise dumped on Matt Lauer. It reduced TomKat to a laughing stock. It gets the Alliance more coverage from Shankar...Is there any editorial oversight at the Washington Post?
That's the acronym for the new agency to replace the FDA.
It stands for the Taco Purity and Direct to Consumer Advertising and Post Market Drug Safety Administration.
The basic functions of the agency will to ensure that the essential public health questions of the day...accuracy of TV drug ads, the conduct of decade long post market drug studies and taco integrity are funded -- not by user fees so as to avoid an corruption by industry -- but by the taxpayer. I mean, with the rise of internet and email and blogs, the agency will need at least 100,000 staffers to police every single communication and post alone. And think of the new inspectors it will need to insure the safety of the taco discovery and development process.....
Drugwonks wants to thank Senators Schumer, Clinton, Kohl, Grassley and Congressmen Waxman and Markey for focusing the public's attention on this urgent issues.
It stands for the Taco Purity and Direct to Consumer Advertising and Post Market Drug Safety Administration.
The basic functions of the agency will to ensure that the essential public health questions of the day...accuracy of TV drug ads, the conduct of decade long post market drug studies and taco integrity are funded -- not by user fees so as to avoid an corruption by industry -- but by the taxpayer. I mean, with the rise of internet and email and blogs, the agency will need at least 100,000 staffers to police every single communication and post alone. And think of the new inspectors it will need to insure the safety of the taco discovery and development process.....
Drugwonks wants to thank Senators Schumer, Clinton, Kohl, Grassley and Congressmen Waxman and Markey for focusing the public's attention on this urgent issues.
The GAO report on DTC is so chock-full of half-truths that it is breathtaking to behold.
Consider this subhead (page 14 of the report), "Research Suggests DTC Advertising Increases Drug Spending and Utilization." Now to the casual observer (read here "politician" or "many journalists") that means the same thing as "DTC Advertising Increases the Cost of Drugs."
Not so.
It's a GAO solipsism.
A more accurate statement would be that DTC advertising drives patients to their doctors who, in turn, reach a diagnosis and then appropriately prescribe. That DTC helps patients and their physicians diagnose an existing medical condition earlier than might otherwise occur is a tremendously positive and potent public health service.
Is that statement in the GAO report? Nope.
Also, if more people are being appropriately prescribed more medicines -- then , indeed, we will as a nation be spending more on pharmaceuticals. But the GAO report makes this sound like a nepharious scheme. And don't be surprised if this theme is taken up by the usual suspects.
What's interesting is that the GAO doesn't report that, if you look at the "list" price of all the on-patent drugs within a given therapeutic category (which almost nobody pays) and then look at their individual advertising spends, what you will not find is a causal relationship. Oops.
And it's very disturbing that the GAO report didn't even consider FDA's research on DTC and physician prescribing patterns. What the FDA found was that physicians are NOT inappropriately prescribing medicines just because their patients ask for them.
But why worry about facts when you've got rhetoric on your side.
Consider this subhead (page 14 of the report), "Research Suggests DTC Advertising Increases Drug Spending and Utilization." Now to the casual observer (read here "politician" or "many journalists") that means the same thing as "DTC Advertising Increases the Cost of Drugs."
Not so.
It's a GAO solipsism.
A more accurate statement would be that DTC advertising drives patients to their doctors who, in turn, reach a diagnosis and then appropriately prescribe. That DTC helps patients and their physicians diagnose an existing medical condition earlier than might otherwise occur is a tremendously positive and potent public health service.
Is that statement in the GAO report? Nope.
Also, if more people are being appropriately prescribed more medicines -- then , indeed, we will as a nation be spending more on pharmaceuticals. But the GAO report makes this sound like a nepharious scheme. And don't be surprised if this theme is taken up by the usual suspects.
What's interesting is that the GAO doesn't report that, if you look at the "list" price of all the on-patent drugs within a given therapeutic category (which almost nobody pays) and then look at their individual advertising spends, what you will not find is a causal relationship. Oops.
And it's very disturbing that the GAO report didn't even consider FDA's research on DTC and physician prescribing patterns. What the FDA found was that physicians are NOT inappropriately prescribing medicines just because their patients ask for them.
But why worry about facts when you've got rhetoric on your side.
The Government Accountability Office’s new report on DTC states the obvious -- the FDA lacks an effective way to screen, review and track pharmaceutical advertising.
Considering that more than 10,000 ads and Web sites are brought to the agency's attention each year, that DDMAC has but six reviewers, and that the PhRMA DTC guidelines recommend that ALL advertising be submitted for review – makes us underwhelmed by the GAO’s prescience and wisdom.
Once again drugwonks says, “show me the money.â€
In a draft of a letter to be sent today to the White House, Senator Herb Kohl, D-Wis., asks President Bush to give the FDA more money to review and regulate direct-to-consumer ads. Kohl, along with Republican Sens. Bill Frist of Tennessee and Charles Grassley of Iowa, requested the GAO report.
''If we are serious about protecting the health of consumers in our country, then we need an FDA capable of reviewing ads and taking swift action when necessary. This report tells us that were nowhere close to that goal,'' said Kohl, who will become chairman of the Senate panel with jurisdiction over the FDA budget.
Hello PDUFA!
Letter Imperfect
On the same topic, the GAO report comments that the FDA is sending out fewer DTC-related NOVs.
Indeed, Waxman Redux.
But the truth is that you can’t count letters and say that enforcement is better or worse. It may just as well be the case that pharmaceutical companies are being more compliant (in a regulatory sense) – as could easily be predicted since the FDA has been more precise in detailing (you should excuse the expression) what “in compliance†means. Not precise enough – but better than before.
GAO also reports that the FDA is taking longer to send out letters. This issue is more complicated, but the bottom line is that sending out poorly lawyered letters more swiftly is a fool’s errand.
Unfortunately, there are a lot of fools out there. Fools on the Hill.
Considering that more than 10,000 ads and Web sites are brought to the agency's attention each year, that DDMAC has but six reviewers, and that the PhRMA DTC guidelines recommend that ALL advertising be submitted for review – makes us underwhelmed by the GAO’s prescience and wisdom.
Once again drugwonks says, “show me the money.â€
In a draft of a letter to be sent today to the White House, Senator Herb Kohl, D-Wis., asks President Bush to give the FDA more money to review and regulate direct-to-consumer ads. Kohl, along with Republican Sens. Bill Frist of Tennessee and Charles Grassley of Iowa, requested the GAO report.
''If we are serious about protecting the health of consumers in our country, then we need an FDA capable of reviewing ads and taking swift action when necessary. This report tells us that were nowhere close to that goal,'' said Kohl, who will become chairman of the Senate panel with jurisdiction over the FDA budget.
Hello PDUFA!
Letter Imperfect
On the same topic, the GAO report comments that the FDA is sending out fewer DTC-related NOVs.
Indeed, Waxman Redux.
But the truth is that you can’t count letters and say that enforcement is better or worse. It may just as well be the case that pharmaceutical companies are being more compliant (in a regulatory sense) – as could easily be predicted since the FDA has been more precise in detailing (you should excuse the expression) what “in compliance†means. Not precise enough – but better than before.
GAO also reports that the FDA is taking longer to send out letters. This issue is more complicated, but the bottom line is that sending out poorly lawyered letters more swiftly is a fool’s errand.
Unfortunately, there are a lot of fools out there. Fools on the Hill.
Excellent article in Scientific American.......
Special Report: 10 Promising Treatments for World's Biggest Health Threats
Cutting-edge pharmaceuticals now being tested could revolutionize the fight against cancer, Alzheimer's, HIV, diabetes, nicotine addiction and other devastating diseases
By Charles Q. Choi
Treatments for diabetes, smoking, Alzheimer's disease and lung cancer are just a few of the potentially lifesaving cures Scientific American has chosen to highlight in this year's roundup of drugs you've never heard of, despite their potentially huge impact on global health.
These 10 treatments, all of which could significantly impact global health and wellness, are currently running the last gauntlet a pharmaceutical must run before it becomes available to the public--the clinical trial. During this trial researchers test the drug on humans, carefully observing its side effects as well as its overall effectiveness.
All of the following substances have already passed phase I safety trials and are proceeding into phase II or III efficacy and toxicity trials. (One caveat: any therapy in development runs a risk of failure, even after passing phase III.)
A number of these trials represent completely novel classes of therapy, such as employing fragments of RNA that interfere with problem genes or developing vaccines meant to quell drug addiction.
Some of this year's candidates target the usual rogues' gallery of killers, such as malaria, lung cancer and HIV.
Many of the disorders targeted by the following treatments are becoming increasingly widespread. These disorders include diabetes, which the Centers for Disease Control and Prevention projects will someday afflict one in three children born today; Alzheimer's, which has become more common as life expectancy has increased; and the dengue viruses, which are causing larger and more frequent epidemics, especially in the tropics.
One of this year's drugs even has the potential to serve as a safer replacement for the painkiller Vioxx.
The link to the entire article and the list of all the drugs in development (until price controls or IOM like FDA reform proposal kill them off) here
http://www.sciam.com/print_version.cfm?articleID=7271FB84-E7F2-99DF-38227214BDE0DE78
Special Report: 10 Promising Treatments for World's Biggest Health Threats
Cutting-edge pharmaceuticals now being tested could revolutionize the fight against cancer, Alzheimer's, HIV, diabetes, nicotine addiction and other devastating diseases
By Charles Q. Choi
Treatments for diabetes, smoking, Alzheimer's disease and lung cancer are just a few of the potentially lifesaving cures Scientific American has chosen to highlight in this year's roundup of drugs you've never heard of, despite their potentially huge impact on global health.
These 10 treatments, all of which could significantly impact global health and wellness, are currently running the last gauntlet a pharmaceutical must run before it becomes available to the public--the clinical trial. During this trial researchers test the drug on humans, carefully observing its side effects as well as its overall effectiveness.
All of the following substances have already passed phase I safety trials and are proceeding into phase II or III efficacy and toxicity trials. (One caveat: any therapy in development runs a risk of failure, even after passing phase III.)
A number of these trials represent completely novel classes of therapy, such as employing fragments of RNA that interfere with problem genes or developing vaccines meant to quell drug addiction.
Some of this year's candidates target the usual rogues' gallery of killers, such as malaria, lung cancer and HIV.
Many of the disorders targeted by the following treatments are becoming increasingly widespread. These disorders include diabetes, which the Centers for Disease Control and Prevention projects will someday afflict one in three children born today; Alzheimer's, which has become more common as life expectancy has increased; and the dengue viruses, which are causing larger and more frequent epidemics, especially in the tropics.
One of this year's drugs even has the potential to serve as a safer replacement for the painkiller Vioxx.
The link to the entire article and the list of all the drugs in development (until price controls or IOM like FDA reform proposal kill them off) here
http://www.sciam.com/print_version.cfm?articleID=7271FB84-E7F2-99DF-38227214BDE0DE78
The Commonwealth Fund -- why don't they just call themselves the Single Payer Society and get it over with? -- claims there are only 1 million people in consumer directed health plans, that most of them were forced into them at gunpoint and all of them just hate being in them (as opposed to be in a Canadian paradise or something like Medicaid). The Fund ignores data from various plans including UnitedHealth Group showing patients under high-deductible health plans with a health savings account (HSA) are more likely to seek preventive care and are far less likely to visit emergency rooms for non-emergency care.
Moreover, it turns out that half of all people without insurance have chosen to go without despite having been offered it by their employers or by a state run health program. Now that's really consumer directed health care.
Moreover, it turns out that half of all people without insurance have chosen to go without despite having been offered it by their employers or by a state run health program. Now that's really consumer directed health care.
On the heels of the hysteria about anti-depressant, suicide and black boxes....
Genes May Alter Antidepressant Effects
Study May Help Find Way to Select Antidepressant Most Effective for Patient
By Miranda Hitti
WebMD Medical News Reviewed By Louise Chang, MD
on Wednesday, December 06, 2006
Dec. 6, 2006 -- Variations in certain genes may affect how well depressed people respond to different antidepressants, new research shows.
The report comes from Francis McMahon, MD, of the National Institute of Mental Health (NIMH).
"Medications to treat depression are widely available, but no one treatment works for everyone," McMahon says in a news release
There is no test to predict which of the various antidepressants will work best for a particular patient. It can take trial and error over weeks or months to find the right one.
"We are seeking to better understand why this is the case, and, using genetic markers, develop personalized treatments that give patients the best chance at remission," McMahon says.
"Ultimately, our goal is to put together a panel of genetic markers that can guide treatment decisions and help doctors choose an antidepressant that will work best for an individual patient," he says.
That panel of genetic markers isn't complete yet. But McMahon's findings may help."
And there is this comment....
"There is a heritable component to suicidal behaviour, encouraging the search for the associated risk alleles. Given the putative role of the 5-HT (5-hydroxytryptamine; serotonin) system in suicidal behaviour, serotonergic genes are leading candidates. "
Psychol Med. 2003 Jul;33(5):775-83. Links
Deliberate self-harm is associated with allelic variation in the tryptophan hydroxylase gene (TPH A779C), but not with polymorphisms in five other serotonergic genes.
Genes May Alter Antidepressant Effects
Study May Help Find Way to Select Antidepressant Most Effective for Patient
By Miranda Hitti
WebMD Medical News Reviewed By Louise Chang, MD
on Wednesday, December 06, 2006
Dec. 6, 2006 -- Variations in certain genes may affect how well depressed people respond to different antidepressants, new research shows.
The report comes from Francis McMahon, MD, of the National Institute of Mental Health (NIMH).
"Medications to treat depression are widely available, but no one treatment works for everyone," McMahon says in a news release
There is no test to predict which of the various antidepressants will work best for a particular patient. It can take trial and error over weeks or months to find the right one.
"We are seeking to better understand why this is the case, and, using genetic markers, develop personalized treatments that give patients the best chance at remission," McMahon says.
"Ultimately, our goal is to put together a panel of genetic markers that can guide treatment decisions and help doctors choose an antidepressant that will work best for an individual patient," he says.
That panel of genetic markers isn't complete yet. But McMahon's findings may help."
And there is this comment....
"There is a heritable component to suicidal behaviour, encouraging the search for the associated risk alleles. Given the putative role of the 5-HT (5-hydroxytryptamine; serotonin) system in suicidal behaviour, serotonergic genes are leading candidates. "
Psychol Med. 2003 Jul;33(5):775-83. Links
Deliberate self-harm is associated with allelic variation in the tryptophan hydroxylase gene (TPH A779C), but not with polymorphisms in five other serotonergic genes.
According to a report in today's New York Times, "Public health officials, psychiatrists, grieving parents and outraged former patients will fill a hotel ballroom in Silver Spring, Md., this morning to argue the most bitterly divisive question in psychiatry: do the drugs that doctors prescribe to relieve depression make some people more likely to attempt suicide?"
I was at the agency the last time this debate took place. Very emotional. But emotions mustn't get in the way of the facts. Politicians love emotions. The media loves emotions. But science demands facts. Hard facts. Facts that may not tell people what they want to hear.
And anecdotes, even terrible ones, are not science. In June we blogged on a major new study, the first of its kind, finds that rather than boosting suicide rates, SSRIs have actually saved thousands of lives by preventing suicides since they were introduced in 1988.
And before you ask, no, the study was not funded by a pharmaceutical company. The funding came from the NIH and the Dana Foundation. The full study appears in the June issue of the journal PLos Medicine.
For this study, the authors analyzed federal data on suicide rates since 1960, along with sales of fluoxetine (Prozac) since it became available in 1988. Analysis was continued through 2002. Prozac was used as a benchmark for the broader class of drugs.
Between the early 1960s and 1988, suicide rates held relatively steady, fluctuating between 12.2 per 100,000 and 13.7 per 100,000.
Since 1988, however, suicide rates have been on a gradual decline, with the lowest point being 10.4 per 100,000 in 2000. During the same time frame, Prozac prescriptions rose, from 2,469,000 in 1988 to 33,320,000 in 2002.
Using mathematical modeling, the investigators estimated the rates of suicide if the pre-1988 trends had continued, estimating that there would have been an additional 33,600 suicides if the pre-1988 trends had been maintained.
With that in mind, moves to restrict the use of SSRI antidepressantscould have a harmful effect, the authors stated.
“I don’t think these claims that antidepressants increase suicide have a solid base,†said Dr. Julio Licinio, lead author of the study and Chairman of the Department of Psychiatry and Behavioral Sciences at the University of Miami.
“If you have a drug that’s supposed to be causing something, the more of the drug that’s used, the more of the bad outcome you would have. What we show is the converse.â€
While this new science will provide little solice to those who have suffered through a suicide, it will help mental health professionals, their patients — and their patients’ loved ones — better understand the value of available therapies.
I grieve, I truly do, for the parents and spouses, friends, and relatives who have lost loved ones to suicide. And their grief is beyond my comprehension. But warping the science to fit anyone's emotional needs is just plain wrong. Hopefully this hearing will be held and reported on based on the science.
But I doubt it. Let's see what tomorrow's news stories focus on. Will the reports focus on the anecdotes of families or the science of anti-depressants? We shall see.
I was at the agency the last time this debate took place. Very emotional. But emotions mustn't get in the way of the facts. Politicians love emotions. The media loves emotions. But science demands facts. Hard facts. Facts that may not tell people what they want to hear.
And anecdotes, even terrible ones, are not science. In June we blogged on a major new study, the first of its kind, finds that rather than boosting suicide rates, SSRIs have actually saved thousands of lives by preventing suicides since they were introduced in 1988.
And before you ask, no, the study was not funded by a pharmaceutical company. The funding came from the NIH and the Dana Foundation. The full study appears in the June issue of the journal PLos Medicine.
For this study, the authors analyzed federal data on suicide rates since 1960, along with sales of fluoxetine (Prozac) since it became available in 1988. Analysis was continued through 2002. Prozac was used as a benchmark for the broader class of drugs.
Between the early 1960s and 1988, suicide rates held relatively steady, fluctuating between 12.2 per 100,000 and 13.7 per 100,000.
Since 1988, however, suicide rates have been on a gradual decline, with the lowest point being 10.4 per 100,000 in 2000. During the same time frame, Prozac prescriptions rose, from 2,469,000 in 1988 to 33,320,000 in 2002.
Using mathematical modeling, the investigators estimated the rates of suicide if the pre-1988 trends had continued, estimating that there would have been an additional 33,600 suicides if the pre-1988 trends had been maintained.
With that in mind, moves to restrict the use of SSRI antidepressantscould have a harmful effect, the authors stated.
“I don’t think these claims that antidepressants increase suicide have a solid base,†said Dr. Julio Licinio, lead author of the study and Chairman of the Department of Psychiatry and Behavioral Sciences at the University of Miami.
“If you have a drug that’s supposed to be causing something, the more of the drug that’s used, the more of the bad outcome you would have. What we show is the converse.â€
While this new science will provide little solice to those who have suffered through a suicide, it will help mental health professionals, their patients — and their patients’ loved ones — better understand the value of available therapies.
I grieve, I truly do, for the parents and spouses, friends, and relatives who have lost loved ones to suicide. And their grief is beyond my comprehension. But warping the science to fit anyone's emotional needs is just plain wrong. Hopefully this hearing will be held and reported on based on the science.
But I doubt it. Let's see what tomorrow's news stories focus on. Will the reports focus on the anecdotes of families or the science of anti-depressants? We shall see.
Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.
