First, a disclosure: When my father died back in 1998, I took Prozac. At the time, I was finishing up a PBS television documentary and could not focus on the task. My physician suggested that I might try taking Prozac to see if it would help. I don't know if it helped or not, but I did finish up the program in the month after I began taking the pills. Perhaps my grief was running its natural course and would have abated on its own, or perhaps the anti-depressants were effective, or both. Four months later, I took a look at the bottle and put in back in the medicine cabinet, never taking another pill. I have not used any anti-depressant medication since then.
So why the disclosure? A front page article, "Pills for grief, and a boon for drug firms," in today's Washington Post is going on another conflict of interest witch hunt in which pharmaceutical companies are once again the bad guys. In this case, a committee of the American Psychiatric Association (APA) has decided to change its guidelines and suggest that people experiencing deep grief over the death of a loved one might benefit from using anti-depressants. As it happens several of the experts on the committee have had financial relationships with various drugmakers, e.g., consulting fees and/or research grants. From the Post:
While no evidence has come to light showing that committee members broadened the diagnosis to aid the drug companies, the process of developing the handbook was fraught with financial links to the industry:
What follows are the details of some of the relationships that the committee members had with pharmaceutical companies. Simplistic QED: The decision must have been corrupt.
I note that the Post article does not in fact say that the industry-funded studies that suggest that anti-depressants might help people cope with grief are wrong.
Look, pharmaceutical companies are not to be confused with angels. They do have financial interests at stake and sometimes do unethical things. When they do they must be held liable. I did a long analysis, Scrutinizing Industry-Funded Science, [PDF] for the American Council on Science and Health back in 2007 in which I reviewed pretty much the entire peer-reviewed literature on scientific conflicts of interest. I turned that research into a Reason article, "Is Industry-Funded Science Killing You?" Basic conclusion: No.
Nearly all medical journals now require declarations of potential conflicts of interest (mostly financial) when publishing a research article. In addition, most are now requiring that all clinical trials be registered. I further recommended continuous open peer-review modeled on the Public Library of Science journals.
Considering that very few new drugs are in fact removed from the market and that newer drugs tend to work better than older ones, the sort of conflicts of interest identified by the Post do not appear to have caused significant harm to research subjects or patients.
Back in 1998, there were no guidelines with regard to using Prozac to cope to with grief. Perhaps Eli Lilly made a few bucks off of me and perhaps I succumbed to the placebo effect; nevertheless, I am glad that my physician gave me the option to try that medication. Until other researchers can show that the results of the scientific studies cited by the APA committee are flawed, mere reportorial innuendo of possible corruption is not useful for physicians or patients.
Another disclosure: I own shares in various biotech and pharmaceutical companies (no more than 1,000 in any one company, alas). I purchased all of the shares with my own money and all are held in my retirement accounts. May your deity of choice have mercy on you if you even think about cribbing any investment advice from me.