Friday, March 27, 2009

Negative findings about ADHD drugs downplayed by researchers on drug companies' payroll

Thanks to unsealed documents from legal proceedings, we now know that many drug makers routinely hid negative findings about antidepressants and anti-psychotics (ranging from Paxil to Seroquel) from doctors and consumers. Now comes evidence that the researchers who conducted a long-term study on the effectiveness of drugs for attention-deficit disorder (ADHD) also sought to play down results showing that these drugs are not particularly effective over the long haul.

According to an article in The Washington Post today, researchers involved in a large federally funded study knew by 2007 that drugs like Concerta and Adderall are not effective in treating ADHD over the long term (i.e., the children in the drug group did no better than a control group who received no medication). This negative data came from a study that followed up on a well-publicized 1999 report showing that these drugs were initially effective in treating ADHD. The 2007 followup study also showed that children who took these drugs for 36 months were about an inch shorter and six pounds lighter than those who did not.

While the 2007 data were duly reported in a medical journal, a news release from the National Institute of Mental Health (NIMH) presented the study in a far more favorable light than it deserved, playing down the negative findings about the drugs' lack of long-term efficacy as well as their disconcerting side effects, according to The Washington Post article by Shankar Vedantam.

In reading Mr. Vedantum's excellent story, I couldn't help but wonder whether any of the researchers in this study, some of whom continue to minimize the drugs' negative effects, were getting paid on the side by the companies who sell them. Sure enough, a quick glance at the latest published results of the federal study in the Journal of the American Academy of Child and Adolescent Psychiatry show that seven of the principal researchers disclosed myriad conflicts of interest. For example, Peter Jensen, the former Columbia University researcher who so fervently defends the drugs in The Post article reports receiving consulting and speaking fees from Shire (which makes Adderall), Janssen (which makes Concerta) and a host of other drug companies.

Indeed, the list of conflicts disclosed by these researchers takes up a sizable chunk of fine print at the end of the article. If you're a subscriber to JAACAP, you can see for yourself at MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study. Hat tip to Peggi Johnson for alerting me to The Washington Post article.

On a completely different note, I was asked to write a piece for the spring issue of the Nieman Reports about whether the blogosphere will be able to reproduce the watchdog role that newspapers have so honorably fulfilled over the last 100 years (now that many of them can no longer afford to perform that function). Here is my answer: Blogs, Watchdog Reporting and Scientific Malfeasance.

1 comment:

Quiact said...

Documents should never be sealed. It delays the restrictions that should be imposed. Blogging is good:

Published on: www.beforeyoutakethatpill.com

The Prevention of Ignorance

Historically, information sources provided to American citizens were limited due to the few methods available to the public, such as radio, TV, or news print. And also this information was subject to being filtered and, in some cases, delayed. This occurred for a number of reasons- which included political ones.
Now, and with great elation, there is the internet, which can be rather beneficial for the average citizen.
Soon after the advent of the internet, web logs were created, that are termed ‘blogs’. At that time, about a decade ago, the blogs were referred to as personal journals or diaries visible on line. As time passed, blogs became a media medium, and blog communities evolved on topics that often were not often addressed in mainstream media.
In addition, blogs provide immediate contributions by others, the readers of the posts of the blog authors, instead of the cumbersomeness of opinion and editorial pieces historically and not always presented in such media forms as newspapers.
The authors of blogs vary as far as their backgrounds and intent of what they present are for exactly, just as with other media forms. Furthermore, they are not exonerated from the legalities of what is written, such as cases of libel. While we can presume that they like to write, they may not be quality writers. But to write is to think, which I believe is a good quality one should have.
Yet presently, blogs have become quite a driving force for those with objectives often opposed by others, and are a threat to others at times, such as big business and politicians- both who presently monitor the progress and content of blogs that provide instant information on events, which might affect their image and activities not yet exposed, as blogs have become a medium of disclosure by whistleblowers, and what is written is typically authentic.
While one disadvantage of blogs is the potential lack of reliability, blogs however do allow in addition to the comments of its readers the posting of authentic documents that typically are not created to be viewed by the public.
For example, blogger Dr. Peter Rost, a whistleblower himself, not long ago posted a newsletter published by pharmaceutical company AstraZeneca on his blog site, and this newsletter was given to him by AstraZeneca's employees who called themselves the ‘AZ Group of Seven’, with the intent of this group being to bring to the attention of others the illegal activity of off-label promotion of one of their cancer drugs promoted by their employer.
Yet this by amazement is not what caught the attention of so many who viewed the posted newsletter read with great interest by others. It was instead a comment included in this newsletter that was stated by former regional AZ manager Mike Zubalagga, who in this newsletter posted on Dr Rost's blog site, referred to doctors’ offices as ‘buckets of money’.
This and other statements by this man were written during an interview with him by another and then published in this newsletter. Again, the statement was authentic and in writing in this newsletter, which added credibility to the proof that it actually happened.
Mr. Zubalagga was fired the next day due to this comment and it's potential effect on the image of his employer. His manager resigned soon afterwards.
And there have been other whistleblower blog cases in addition to this one, so blogs have become a very powerful and threatening medium of information release that does not allow others to prevent such releases. This is true freedom of information- free of alteration or omission- perhaps one step closer to a form of communication utopia, perhaps, and with the ability to both harm and protect others.
Yet again, the information on these blogs should not be taken as absolute truth without proof to verify claims that may be made. Of course, documents that are authentic will be realized by others, as illustrated with the above example.
And this, in my opinion, is the blog’s greatest value, combined with the comments on blogs from the growing number of readers who are allowed to contribute to the subject matter so quickly, which fuels the objectives of the blogs.
Like other written statements, some on such internet sites are composed with respect of the written word. Others are not. It's the freedom that may be most appealing of this new medium which has the ability to convert citizens into journalists who want to contribute to an issue of their concern they share with the blogger.
Because we, the public, have a right to know what we are entitled to know and what we want to know. This is especially true if the information could potentially be adverse to our well-being.
Ignorance is bliss, but knowledge is power.
“Information is the seed of an idea, and only grows when it’s watered.” --- Heinz V. Berger
Dan Abshear