Sunday, June 15, 2008

Drug company under fire for Paxil research

A perfect storm seems to be gathering over GlaxoSmithKline and research it funded to determine whether its antidepressant drug Paxil was effective in treating depression.

In March of this year, Australian researchers published an article in the International Journal of Risk and Safety in Medicine on one particular study of Paxil, known as study 329, that purported to show that the drug was more effective than a sugar pill or placebo in treating depression in adolescents. After re-examining raw data from the study, obtained from GlaxoSmithKline under subpoena, the IJRSM researchers instead concluded the data showed that Paxil was no more effective than placebo on all eight of the study’s pre-specified clinical outcome measures. They also found that after the study blind was broken, the researchers added a number of new outcome measures in order to show a statistically significant difference between Paxil and placebo. In other words, as the IJRSM paper concludes, the authors of study 329 manipulated the data. Shortly after this finding was published, Dr. David Egilman, a clinical associate professor at Brown University, filed an ethics complaint against Dr. Martin Keller, the principal investigator of study 329 and chief of psychiatry at Brown. Egilman says Brown’s provost wrote him a letter in May saying that the university reviewed the allegations against Keller, but declined to say what, if any, action it was taking against its long-time psychiatry head.

Likewise, in my book Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial, due out Tuesday, I also reveal new information showing that Keller and his co-authors misrepresented data in study 329. In essence, Keller et al miscoded several teenagers as being noncompliant when in fact they were in fact suicidal, thus further skewing the results of this controversial study. Furthermore, as I show in my book, at the very same time Keller was touting study 329 as a positive finding for Paxil (even though the actual data showed the opposite), GlaxoSmithKline was paying him thousands of dollars in personal consulting income.

Finally, just last week, Senator Chuck Grassley (D-Iowa) released a report by Joseph Glenmullen, a Harvard psychiatry instructor, alleging that Glaxo researchers misrepresented data in an earlier study comparing the effectiveness of Paxil and placebo in treating depression in adults. In this 1989 clinical trial, which was used to gain FDA approval for Paxil, Glaxo counted as suicides in the placebo arm of the study, deaths that had actually occurred during the wash-out period of the study. The suicides, thus, occurred before the official start of the study and should not have been counted as placebo suicides, Glenmullen's report contends. Glenmullen prepared his analysis for a law firm who is suing GlaxoSmithKline, and he concludes that the wash-out suicides were included in the study to make Paxil look safer and more effective than it really was, according to The Wall Street Journal. The Journal quoted Glenmullen as saying, “Glaxo was aware of this risk and hid it.”

Taken together, all of this new evidence indicates that the real risk of suicidality from Paxil was far greater than its risk for patients on placebo. As Glenmullen notes in the Journal article, if the FDA had had the correct information back in 1991, when the agency first examined suicidal risks of the SSRI antidepressants, it might have issued warnings about these drugs then. Instead, the FDA didn’t require black box warnings about the suicidal effects of these drugs until 2004. And that raises the haunting question: How many young people’s lives were lost to suicide in the intervening 13 years?

5 comments:

dorothy said...

Congratulations, Alison! I look forward to reading your book. A friend of mine, Jim Gottstein, has taken on Eli Lilly, the drug company responsible for Zyprexa. I so well remember your excellent mental health reporting back in 1987-90.
Best wishes to you,
Dorothy

Truthman30 said...

I am so so happy to see someone has finally put the Paxil Scandal in Book format, I have been aware of all of this for the past 6 years and I had planned to write a book about the Seroxat Scandal (paxil is called Seroxat in the UK).

I myself was prescribed Seroxat(Paxil) in 1998, I was 21 at the time, It most definately made me more suicidal, and also It made me aggressive, agitated and hostile. After 4 years on the drug, the withdrawals were horrific.

I have been blogging about all the Seroxat-Paxil stuff for over a year now and have been researching it all for 6 yeas as have many other UK campaigners. Please check out my blog

http://truthman30.wordpress.com/

and the others

http://seroxatsecrets.wordpress.com/

http://fiddaman.blogspot.com/

Godd luck with the book, I hope it gets the exposure it deserves and thanks again for writing it!
:)

I'll be ordering my copy as soon as I can!

Fiddy said...

Well done for standing up to be counted Alison. Much respect to you.

I'll be purchasing a copy of your book at the end of the month :-)

Fid

Author of Seroxat Sufferers Blog

Rodney Wilson said...

What I find so sad is that these reports and your book make it clear that our faith in the FDA, the drug companies, researchers and others is at times unwise. One cannot be up on everything, so we depend on the professionals to tend to these things. We don't expect them to feed us false data, improperly interpreted data, conflicts of interest, money-driven outcomes, and the like. So sad.

Dr. L Gary Hart & Michelle Hart, RN said...

Alison,
Hat tip to you (if I wore one!). Please take a look at my husband and I's blog. We are writing a book on Paxil withdrawal stories. So glad you covered all the "nonsense". This compliments our book perfectly.Check my husband's CV link. We are devoted to public health as he is Director of Rural Health for the State of Arizona and Director of Public Health at the University of Arizona.
Shelly Hart, RN