Prozac, Suicide and Dr. Healy (Yates, Pharmas)

There was a discussion a ways back about the Yates murder
trial. I claimed that she was driven insane by antidepressants
made by psychotic money grubbing pharmaceutical companies that
don't care if their victims ('patients') go whacko on their
joy joice and prescribed by psychotic money grubbing doctors
who don't care if their patients freak out as long as they can
live in a gated community safe from the rampaging hordes of
civilians driven crazed by indiscriminate use of extremely
dangerous mindaltering chemicals like Zoloft Paxil and Prozac
sold to them by drugstores. Others disagreed with me. Here is
more on the subject of interest.

- j

----------

March 20, 2002

Prozac, Suicide and Dr. Healy

By Rick Giombetti

http://www.counterpunch.org/prozacsuicide.html

Dr. David Healy of the Department of Psychological Medicine at
the University of Wales in the UK is hardly a household name
in the United States and that is a shame.

One of the world's leading research psychopharmacologists,
Healy's expert testimony in last year's Paxil civil trial was
one of the deciding factors in the plaintiff's jury victory in
that case. Wyoming resident Donald Schell, 60, killed his
wife, daughter and granddaughter and then himself with a gun
in 1998 after only two days on Paxil. Schell's surviving
family members sued Paxil manufacturer UK-based
Glaxo-Smith-Kline (GSK), the world's largest pharmaceutical
manufacturer, and won. The decisive factor in the case was the
company's own internal data demonstrating that they knew Paxil
could cause agitation and suicidal ideation in research
subjects. A month after the June verdict in the case, GSK
caved in to the British Medicines Control Agency's request to
put a suicide warning on Paxil.

The fact that a jury verdict in a civil trial here in the
United States has led to a suicide warning being put on labels
for a popular psychiatric drug in another country has hardly
been headline news. Two weeks after the verdict in the Paxil
trial, Houston area mother and convicted murderer Andrea Yates
drowned her five children while she was on not one, but two
antidepressant drugs with strong stimulant profiles. What
could have been an opportunity for the mass media to educate
the public about the dangers of antidepressant drugs, instead
has been a non-stop awareness campaign for the mental health
industry about the need for more psychiatric "treatment." The
real story that has been missed in the Yates case is the fact
that it is a story about psychiatric treatment failure. Yates
had been getting psychiatric drugs for her post partum
depression for years. She was on high doses of two
antidepressants drugs at the time she drowned her children but
went ahead and did what these drugs are supposed to prevent
anyway.

Meanwhile, Dr. Healy Hasn't shied away from linking Prozac,
Paxil and the other SSRI's to suicide. He figures at least
250,000 people have attempted suicide worldwide because of
Prozac alone and that at least 25,000 have succeeded. He was
offered a job at the University of Toronto affiliated Center
for Addiction and Mental Health (CAMH) in 2000. Healy was
making arrangements for moving his family to Toronto when he
gave a lecture at the CAMH on November 30, 2000 where he
reiterated his position on Prozac and suicide. He also made a
lot of other statements, backed up by statistical data, that
are politically unpopular with many of his psychiatric
colleagues. Such as the fact that psychiatrists have more
patients in their care then ever before. Healy was
unceremoniously turned down for the CAMH job. Speculation has
it that Prozac manufacturer Indianapolis-base Eli Lilly may
have had a hand in Healy's firing. An international
controversy has ensued about Healy's case and the implications
it has for academic freedom in academic medicine. Healy filed
a multi-million dollar breach of contract lawsuit against the
CAMH and the University of Toronto on September 24 of last
year.

A summary of the entire David Healy affair can be read on the
Internet at http://www.pharmapolitics.com.

I recently completed an e-mail interview with Healy about
Prozac and suicide, the CAMH lecture and many other
contemporary issues in psychiatry today. Below is the
transcript.

--Rick Giombetti Seattle

RG: How do Prozac and the other SSRI's (Selective Serotonin
Reuptake Inhibitors) like Paxil cause suicidal ideation ("We
can make healthy volunteers belligerent, fearful, suicidal and
even pose a risk to others," you wrote in the June 2000
Primary Care Psychiatry. "People don't care about the normal
consequences as you might expect. They're not bothered about
contemplating something they would usually be scared of)?

DH: There is a greater difference between Prozac and other
SSRI's on the one side and placebo on the other side in the
rate in which they cause agitation, than there is between
Prozac and the other SSRI's and placebo and the rate at which
they get people who are depressed better(i.e. the SSRI's cause
more agitation in testing subjects than sugar pills, but they
also tend to outperform sugar pills at getting depressed
people better). The fact that companies have chose to market
them as antidepressants rather than agents that cause
agitation is a business decision rather than a scientific
matter. It is certainly not one that was "ordained by God."
You could say that the fact that some people who are depressed
get better is a side effect.

These drugs are drugs that primarily work on the serotonin
system. There is no evidence for any abnormality in the
serotonin system in people who are depressed. There are
however variations in the serotonin system in people who are
depressed. There are however variations in the serotonin
system in all of us so that some of us will have quite
different effects from these drugs than others. It would have
been a relatively simple matter to do work on this 10 years
ago to find out which of us were more likely to have problems
with the drug than which of us were more likely to do well on
them.

RG: You testified in the Paxil trial in Wyoming on behalf of
the plaintiffs. The plaintiff's position in the case,
vindicated by both the jury and judge in the case, was that
Paxil was the primarily responsible for Donald Schell shooting
his wife, daughter and granddaughter to death before killing
himself with a gun in 1998. Schell had been taking the drug
for two days. Based on the internal Glaxo-Smith-Kline(Paxil's
UK-based manufacturer and world's largest pharmaceutical
company) documentation you reviewed as an expert witness in
that case, what would you have to say about Paxil and suicide
to an individual contemplating a prescription for the drug?
DH: The evidence across the board from all of the companies
producing SSRI's is that their drugs can make 1 in 20 of us
agitated to the extent that we drop out of trials. This
agitation in some cases will include thoughts of suicide,
self-harm or strange out of character thoughts. The agitation
may even develop to psychotic proportions.

Part of the problem with SSRI's is the they have been
prescribed to many people by a doctor who may not be aware of
these side effects and may not have warned you about the side
effects. If you then develop problems on the drugs you many
not link the drug to the problem or you may feel now that you
have a very severe nervous problem that and your physician is
the only way out of the problem. A hostage dynamic can
develop.

There is a particularly difficult scenario where a patient is
faced with a physician who tells them that any increased
nervousness they now have is not being cause by their pills
and that the answer to this is to continue with the pills. In
this case many people may not even let the physician know how
serious this increased nervousness is - as they feel they are
not being listened to. This situation can arise in part
because physicians are dependent on companies for information
about any problems that can be caused by the drugs are
informed that there is no problem of this kind that stem from
the drugs, that any problem of this kind stems from the
illness. In such circumstances where a physician is relying on
what they have been told by the company and not listening to
their patient, there is a real risk of things going badly
wrong. Some people will only escape disaster if they halt
their pills.

RG: The story of Houston area mother Andrea Yates drowning her
five children has led to quite a campaign of awareness about
mental illness in the mass during the past several months.
First, it was post-partum depression and now, with the recent
revelation in the testimony in the Yates' murder trial that
she believes she is possessed by Satan, schizophrenia. What
hasn't happened with the Yates case has been an honest
accounting of what it really is about: Another case of
psychiatric treatment failure. Andrea Yates' post partum
depression had been getting treated with drugs for years and
she was on two antidepressants at the time she drowned her
five children. I'm not asking for much from the mass media on
the reporting of this case. Just the barest mention of two
words with this case would be helpful: Effexor and Remeron.

At the time of the drownings Yates was on 450 mg/day of
Effexor, or 75 mg above the maximum recommended dosage, and 45
mg/day of Remeron, or the maximum recommended dosage. Yates
had been taken off 4 mg/day of the tranquilizer Haldol two
weeks before she drowned the children and the Remeron was
added to her prescription, which continued to include the
Effexor. Now there is a wealth of clinical date out there
about these two drugs but the media has to look at it instead
of helping the mental health industry promote mental health
awareness.

It turns out that a gem of study titled "Mirtazapine(Remeron)
Versus Venlafaxine (Effexor) in Hospitalized Severely
Depressed Patients With Melancholic Features" was published in
the August 2001 Journal of Clinical Psychopharmacology. It's a
gem with regard to the Yates case not only because it compares
two groups of patients put on the same antidepressant drugs
she was on at the time of the drownings, but because it does
not omit the fact that concomitant medications were being
administered to the patient/subjects(a rarity for the
published results of clinical studies, indeed).

Out of the group of 78 patient/subjects put on Remeron, 56
percent of them were administered the benzodiazepine
tranquiler Oxazepam to counter agitation and 35 percent were
administered the hypnotic Zolpidem to counter insomnia. Out of
the 79 patient/subjects in the Effexor group, 49 percent were
administered Oxazepam and 41 percent were administered
Zolpidem.

Here are the other vital statistics provided by the article:
62.8 percent of the Remeron group were female and 68.4 percent
of the Effexor group were female. The maximum dosing of the
Remeron group ranged from 45-60 mg/day and 300-375 mg/day for
the Effexor group. The study lasted eight weeks and 23.1
percent of the Remeron group dropped out, plus 35.4 percent of
the Effexor group dropped out of the study.

Well, am I on to something here? Is it unreasonable to suggest
that Yates was suffering from extreme agitation and/or
insomnia, given that she was taking high doses of both Effexor
and Remeron, and that this might have been a factor in her
actions the day she drowned her children? What do you know
about Effexor and Remeron? (Effexor is known as a "Serotonin
and Norepinephrine Reuptake Inhibitor" or "SNRI" and Remeron
is known as a "Noradrenergic and Specific Serotonergic
Antidepressant," "NaSSA")

DH: The European tradition had been that all antidepressants
could cause a problem. This included the tricyclic
antidepressants which like Venlafaxine (Effexor) inhibited
both serotonin and norepinephrine reuptake. The clinical
trials of Mirtazapine (Remeron) submitted to the FDA that got
it a license contain an excess of suicides and suicide
attempts in those trials compared to placebo. I don't know the
details for Venlafaxine (Effexor).

Your point about it not being unreasonable to suggest that
Yates was suffering from extreme agitation and/or insomnia on
the combination of Effexor and Remeron is a reasonable one.
(At this point Healy thanks me for the reference to the study
and asks me for the name of the first study author in order to
find out more details about it -RG)

RG: "No Such Thing As An Antidepressant" is the title of one
of the chapters of Peter Breggin's book The Antidepressant
Factbook. Breggin writes, "Is it possible that there is no
such thing as a genuine antidepressant? Before the scientific
data had confirmed my suspicions, I doubted that a drug could
actually 'treat' depression. After all, if depression is a
product of our conflicts, stressful life experiences, and
stifled choices, a drug would have no direct effect on
treating it. Meanwhile, study after study has confirmed that
antidepressants typically perform only a little better than
sugar pills. In some studies, antidepressants actually turn
out to be less effective than the lowly sugar pill." Breggin
then goes on to cite the clinical data in a review of the
performance of seven antidepressants in 45 clinical trials. Is
there such a thing as an antidepressant drug and is controlled
clinical testing anyway for us to answer this question?

DH: The Breggin line that there is no such thing as an
antidepressant because depression arises from conflicts and
you couldn't expect a drug to treat that does not follow a
coherent medical logic. The problem with a wide variety of
nervous states we are faced with is that we don't know the
origins of these. To say that they arise from conflicts is too
simplistic.

But even if they did arise from conflicts it is not clear that
an entirely artificial solution that had little to do with
conflicts wouldn't be a way of treating the problem. In many
medical states from broken legs through to cardiac problems
the answer may be to insert something artificial like a metal
plate or a plastic valve in order to produce a new modus
vivendi(manner of living). The origins of these problems are
not a deficiency of metal in the leg or plastic in the heart
but the metal in one case and the plastic in another may
provide a workable solution. However, having said this
antidepressants are not a cure in the sense that they do not
correct either the biological abnormality that may be involved
in depression or event the biological predisposition to
depression. Some antidepressants are energy enhancing. Others
like Zoloft, Prozac and Paxil are more anxiolytic(anxiety
relieving). This may or may not be helpful thing to do in the
case of someone who is depressed.

Controlled clinical testing doesn't answer the question of
whether there is such a thing as an antidepressant or not.
What trials do is to show whether a drug can do something or
not. Whether it is wise to then do that something or not is an
entirely separate question and it is probably the case that
many clinicians don't take the time to make a clear decision
as to the wisdom of using an antidepressant in the case of
each of the patients that they ultimately go on to prescribe
for. The overwhelming majority of who are prescribed
antidepressants are at little or no risk for suicide or other
adverse outcomes from their nervous state. Treatment runs the
risk of stigmatizing the person as well as giving them
problems that they didn't have to being with.

RG: I'm looking at a copy of the August 2001 issue of Primary
Psychiatry. Of course, it's filled with psychiatric drug ads
almost exclusively featuring middle-aged and older female
models. Most of the models are smiling widely because of the
happy pills they are on (Effexor, Risperdal, Remeron, Celexa,
Vivactil). The Zoloft add features a portrait painting of a
female face filled with anxiety and depression. The Paxil ad
features a model whose face is filled with anxiety and worry,
obviously because she hasn't had a prescription filled for her
happy pill yet(Of course, there is no suicide warning anywhere
to be found in the ad, which I assume is now required by law
in the UK). There is one ad featuring a male model for the
narcolepsy drug Provigil. In one frame the professional
looking male model with thick glasses is overcome with
fatigue. In the next frame he is as happy as can be with a
wide smile across his face.

Has the aggressive marketing of psychiatric drugs as happy
pills(to the general public as well as doctor's in
professional journals) over the past decade and-a-half turned
MD's into Dr. Feelgoods?

DH: I spend a good deal of time cutting out adverts for
psychotropic drugs to use to illustrate my talks. The
marketing of psychiatric drugs and the change of climate that
this marketing brings about has turned what used to be
physicians into what lawyers now refer to as pharmacologists.
It has become standard practice in the US for you to get your
drugs from a pharmacologist and to get therapy from a
psychologist or counselor paid at a lower rate. This split is,
I would have thought, disastrous. It means that the people who
monitor the impact of therapy on you are not trained at all to
know about the hazards of that therapy.

RG: Out of curiosity, I wonder if you have any analysis and/or
opinion about Loren Mosher's Soteria experiment (This was an
experiment in drug-free psychiatric treatment conducted under
the auspices of the National Institute of Mental Health during
the '70s. The experiment went well by all accounts. It's just
that not only was Soteria drug-free, but Mosher staffed the
experiment with non-professional counselors. Soteria was
quickly defunded and forgotten by the late '70s). I bring this
up because I don't recall it being mentioned in The
Anti-depressant Era and it is a case often brought up by
critics of the politicization of clinical testing in
psychiatry (The most recent example being Robert Whitaker's
book Mad In America).

DH: Unfortunately, although I have recently met Loren Mosher,
I haven't analyzed or come up with a view on the Soteria
experiment. This is an omission, particularly in the light of
the fact that I have a new book out from Harvard University
Press this month on the antipsychotics called The Creation of
Psychopharmacology. It picks up many of the issues touched on
in a variety of your questions but unfortunately not Mosher's
Soteria Experiment.

It sounds like Whittaker's book Mad in America is one that I
need to get.

RG: At the press conference announcing your lawsuit against
the University of Toronto and the CAMH, you said that any
punative damages you might win in your suit would be put into
an academic trust fund. The reaction to the events of
September 11 has lead to new threats to academic freedom. For
example, a Palestinian professor was recently fired from his
tenured position at the University of South Florida and calls
for the firing of University of Texas journalism professor
Robert Jensen soley for his anti-war beliefs have been made
(here in Seattle by right-wing talk radio host Michael
Medved). How would such an academic freedom trust fund be made
available to professors who believe their academic freedom has
been violated?

DH: I have no idea how academics suffering from violations of
academic freedom post-September the 11th would be able to
access an Academic Freedom Trust Fund into which I've made
contributions. I have no idea for the simple reason that if
there is money that results from the lawsuit I will be handing
it over to others to manage and would not wish to have any say
on how it should be accessed or who should be able to access
it. My plans would be to walk away from the management of any
such funds so that no one could argue that I was using it to
further my own ends.

The CAMH Lecture

RG: In The Antidepressant Era you took exception to Breggin's
argument in Toxic Psychiatry that pharmaceutical companies
exercise undue influence over research and the medical
literature that gets published. Has your treatment by the CAMH
changed your position on the influence of the pharmaceutical
industry over research and academic freedom in publication?
DH: The Antidepressant Era is all about the extraordinary
influence that pharmaceutical companies can have over research
and the medical literature. The difference between the
position I take in this book and Peter Breggin's argument is
that I believe that psychotropic drugs can be helpful where he
seems to think that physical treatments generally are both
unhelpful and ethically dubious. My treatment by the CAMH
hasn't altered my perceptions on this issue.

RG: At the beginning of the CAMH lecture you mentioned a
couple of the crucial laws passed during the 20th century that
were landmarks in the "War On Drugs" here in the United States
(The 1914 Harrison Narcotics Act, which made the opiates and
cocaine available by prescription only and the 1951
Humphrey-Durham Amendment to the 1938 Food, Drugs and
Cosmetics Act, which made the new antibiotics,
anihypertensives, antipsychotics, antidepressants, anxiolytics
and other drugs, available by prescription only).

I argue I should have the right to go across the street to the
coffee shop I frequent and have my afternoon cup of coffee
spiked with 5 mg of Ritalin or 5 mg of Prozac or 5 mg of
Remeron or 5 mg of Cocaine or whatever I want. It's laws like
the one mentioned above that stand in the way of me being able
to do this. Furthermore, my government shouldn't be granting
exclusive patents over drugs I paid to develop. Public Citizen
has pointed out that the majority of the costs of brining a
prescription drug to the market is put up by tax payers and
our reward for this is to have to pay the the extortionately
high prices for drugs made possible by exclusive patents. In a
decriminalized free market, I don't have to pay the Mob's high
drug prices or have the blessing of a doctor to take a drug. I
can report any adverse event I might experience to a doctor
without fear of legal sanction against me. If the FDA made
adverse event reporting mandatory for doctors and adverse
event forms widely available to the public for the purpose of
voluntary reporting, then researchers could probably get more
good data on drugs than they currently do from the clinical
testing controlled by the pharmaceutical industry.

What is your opinion of a free market for drugs (I ask because
you mentioned in The Antidepressant Era the fact that you
could prescribe anything you want for yourself while your
patients don't have this privelege)?

DH: My use of the idea of making all these drugs available
over the counter was as a thought experiment to try and bring
home to people how much prescription only status channels us
down a disease model. This shows up clearly in the difference
between the marketing of St John's Wort and the marketing of
Prozac. You can get St John's Wort to treat yourself for
stress and burnout, to get Prozac you have to be made
depressed. There are implications for this.

There are a whole lot of other ways to solve many of the
problems we have however. One would be to insist that
pharmaceutical companies have to make their data and not just
their trials publicly available. It would be a simple matter
to say that the data is inherently unscientific while it
remains proprietary. There is no other branch of science in
which the raw data remains inaccessible to investigators
generally and indeed essentially to the public.

The whole area of how to handle drug misuse etc. is a complex
and fraught one. I see my role in the debate as trying to
bring certain angles of the problem to light, angles that are
not ordinarily commented on. I don't presume to know the
answers.

RG (The following are two question for Healy that are answered
below) "Coming from my perspective the antipsychiatry
arguments that madness does not really exist are simply
wrong." All right, then define what a mental disorder is. Your
colleagues at the American Psychiatric Association haven't
helped with this issue with each new edition of their
burgeoning Diagnostic and Statistical Manual of Mental
Disorders. Having read about a third of the DSM-IV-TR so far,
it's easy to see the politics and difficult to see the science
driving the most popular diagnoses such as AD/HD for unruly
school boys, Delusional Disorder of both the Grandiose and
Persecutory Type for the homeless or JFK assassination
conspiracy buffs, Generalized Anxiety Disorder for middle and
upper income women, etc., etc.,.

"In the same way fear of God was once seen as a good thing
that held social order in place. The fear then became anxiety
and anxiety disorders - something to treat. What this shows is
that there are forces at play, that can change not only the
kinds of drugs we give, not only the conditions we think we
are treating, but our very selves who are doing the giving.
Forces that can change us more profoundly than we can be
changed by a handful of LSD containing dust," you said near
the end of the CAMH lecture. You are sounding a lot like
Thomas Szasz here(author of the "Myth of Mental Illness") yet
you don't see eye to eye with him on the existence of madness.
I mean something like the above quote suggests that mental
disorder has been invented to replace the Church in managing
social order, i.e. Szasz's "Therapeutic State." Elaborate
further on what mean by the above quote because something like
it could confuse people about your position on these issues.

DH: In the case of Thomas Szasz he was arguing that it was
unreasonable to say that psychoneuroses were diseases. I agree
with him. However I have not been a psychotherapist earning my
living out of treating minor mental disorders. I'm at the
coalface in a District General Hospital setting managing
psychoses. Many of these patients can end up in states of
rigid immobility that we know can last for months or years if
left untreated. Others are consumed by nihilistic delusions of
various sorts. Yet others have thought disorder of a kind that
most clinical observers looking at it have said indicates
frontal lobe dysfunction. It is these states that I am happy
to say look like real diseases.

Saying that these look like real diseases does not mean that
they have to be treated with physical means. I am happy to
respect a person or their families wish to leave the state
untreated. I also believe that when we finally understand the
biological underpinnings of things this will put us in a
better position to know how to handle many of these states by
non-physical means. Genetic testing for disorders like
phenylketonuria makes it possible to avoid the damage that
this illness causes by simply managing your diet properly.

I believe the real concern the antipsychiatrists had was not
so much whether mental illness was real or not, but rather a
concern at the extension of the psychiatric reach out into the
community that took place in the 1960s. Who were these guys
who were telling us how to live our lives - what training do
they have in how to live life.

If you read The Creation of Psychopharmacology you realize
that the origins of operational criteria as found in DSMIII
and IV etc etc are not because the people who came up with the
idea of operational criteria knew what these diseases really
were. Operational criteria are a confession of ignorance. They
do not legitimate the existence of any of the disease entities
that people are particularly keen about nowadays.

RG: One of the more controversial aspects of the CAMH lecture
was your assertion that psychiatric patients in Britain are
being detained at 3 times the rate today than they were 50
years ago. What prompted me to contact you was a report about
suicide in the UK I read at Organon's <PsychiatryMatters.md>
website back in January(Organon is the manufacturer of
Remeron). The report stated that the number of patients being
admitted to John Radcliffe Hospital in Oxfordshire for self
inflicted harm had increased from 1,000 per year in 1990 to
1,600 per year by the end of the decade. The annual suicide
rate for men aged 15-24 in the UK increased from 10 deaths per
1,000 in 1983 to 15 deaths per 1,000 in 1992. Today the
suicide rate for young men in the UK is double what it was in
1968. Do these kinds of statistics buttress your argument that
psychiatrists now have more patients in their care than ever
before? Could one argue that this is an example of treatment
failure on the part of psychiatry(The 60 percent increase in
suicide admissions at one hospital in the UK during the '90s,
a decade when medical science had purportedly made on
revolutionary pharmacological break through after another in
the treatment of depression, hardly comes across as something
for psychiatry and the pharmaceutical industry to write home
about, much less to use as the basis for bankrolling awareness
campaigns about the need for people to seek "treatment" for
depression)?

(Healy provided me with the text of a lecture he gave at the
University of Toronto a year ago. This lecture went over the
statistical data underlying Healy's claim that psychiatrists
are treating more patients than ever before. It compares
admission statistics at North Wales Hospital in 1896 to 1996.
The implications from the data are clear enough. Patients in
1996 were being discharged from the hospital with
prescriptions for neuroleptic and antidepressant drugs that
can cause agitation and suicidal ideation. This may be the
reason why the 1996 patients have much higher suicide rates
than the 1896 patients. The most embarrassing implication of
all for modern psychiatry is that psychiatric patients of 1896
may very well have had better outcomes in the area of death
rates than patients of 1996 when the lack of antibiotics in
1896 are taken into account. One conclusion to draw from this
data is clear: psychiatric patients at North Wales Hospital in
1896 were dying primarily from physical causes while a century
later they were dying far more often from self inflicted harm.
A major indictment of the claim that the past half-century has
been a golden age in the treatment of psychiatric illness. I
would recommend everybody interested in this subject e-mail
Healy for a word copy of this interesting lecture at:
Healy_Hergest@....

RG: You noted the unceremonious retirement of Thorazine's
co-discoverer Jean Delay. His office was ransacked during the
May 1968 strikes and protests in Paris and that at the time
"he has no sympathy for the new world, in which students can
expect to address the professors in informal terms." You go on
to argue that "Both psychiatry and antipsychiatry were swept
away by a new corporate psychiatry. Galbraith argues that we
no longer have free markets; corporations work out what they
have to sell and then prepare the market so that we will want
those products. It works for cars, oil, and everything else,
why would it not work for psychiatry? Prescription only status
makes the psychiatric market easier than almost any other
market - only a comparatively few hearts and minds need to be
won."

Do you think your firing by the CAMH and your suspicions that
Eli Lilly had a hand in it vindicates your argument about the
take over of the profession by what you call corporate
psychiatry?

DH: I have never voiced suspicions that Eli Lilly had a hand
in my firing from CAMH. Lots of other people have voiced those
suspicions. Yet others again have made strong cases for the
possibilities that Pfizer or SmithKline may have brought
influence to bear on this issue.

It's a bit too early to judge whether my firing by CAMH gives
a good indication of where the profession of psychiatry
generally is at. Leaving my case aside however I think the
takeover by corporate psychiatry is fairly complete at this
point in time.

Rick Giambetti lives in Seattle. He can be reached at:
rickjgio@...