June 25, 2009
by Evelyn Pringle
In a June 24, 2009 letter, Senator Chuck Grassley asked 23 medical schools for information about their policies for conflicts of interest and requirements for disclosure of financial relationships between faculty members and the pharmaceutical industry.
“I recently learned from an American Medical Student Association report, AMSA PharmFree Scorecard 2009, that your institution either had “no response” or “declined to submit policies” when asked to supply conflicts of interest policies,” he said in the letter.
Grassley asked the Universities to respond by no later than July 15, 2009.
Of the 149 schools asked, 126 provided information to the AMSA. The Scorecard 2009 was released on June 16, 2009. Thirty-five schools, or 23%, received an F. Seventeen got a D, 18 received a C, 36 were graded B, and only 9 schools received an A.
“There’s a lot of skepticism about financial relationships between doctors and drug companies,” Grassley said in a press release. “Disclosure of those ties would help to build confidence that there’s nothing to hide.”
“Requiring disclosure is a common sense reform based on the public dollars and public trust at stake in medical training, medical research and the practice of medicine,” he added.
Grassley has been working to achieve uniform and universal disclosure of the money that pharmaceutical, medical device and biologic companies give to physicians. He has conducted extensive oversight of financial relationships, especially among doctors who conduct research with the $24 billion awarded annually in federal grants by the National Institutes of Health, the press release explains.
Institutions receiving federal money dollars are required to track financial relationships, “but Grassley has found enforcement of those requirements often to be either lax or in violation,” it said.
“Beginning last summer,” Grassley wrote in the letter, “I began releasing information that made the point that universities are not managing their professors’ financial conflicts of interest and that change is needed at the NIH.” He listed a few examples as:
- Chairman of psychiatry at Emory failed to report hundreds of thousands of dollars in payments from a pharmaceutical company while researching that same company’s drugs with an NIH grant. The Health and Human Services Office of Inspector General (HHS OIG) is now investigating. [That would be Charles Nemeroff].
- Chairman of psychiatry at Stanford received an NIH grant to study a drug, while partially owning a company that was seeking Food and Drug Administration (FDA) approval of that drug. He was later removed from the grant. [The name here is Alan Schatzberg].
- Three professors at Harvard failed to report almost a million dollars each in outside income while heading up several NIH grants. Harvard plans to release a report and is working to update their conflict of interest policies. [These professors are Joseph Biederman, Timothy Wilens, and Thomas Spencer].
- Host of a show that ran on the National Public Radio (NPR) satellite station received over a million dollars from pharmaceutical companies to give promotional talks. The show had received funding from the NIH and has been cancelled. [That would be Fredrick Goodwin]
- Chair of orthopedic surgery at the University of Wisconsin reported taking more than $20,000 from a company every year, for five years. The actual amount was around $19 million. The University of Wisconsin is revising its rules. [The name here is Thomas Zdeblick].
- Professor at the University of Texas received an NIH grant to study Paxil in kids, while also giving dozens of promotional talks on Paxil. This matter has been referred to Health and Human Services, Office of the Inspector General. [This professor is Karen Wagner]
- Professor at the University of Washington in St. Louis who was formerly at Walter Reed Army Hospital failed to report hundreds of thousands of dollars he had received from a device company to develop their products. [That would be Timothy Kuklo].
“To bring some greater transparency to this issue, Senator Kohl and I introduced the Physician Payments Sunshine Act (Act),” Grassley said in the letter the Universities. “This Act will require drug, medical device, and biologics companies to report publicly any payments that they make to doctors, within certain parameters.”
The latest addition to the Grassley list is Emory University’s Zachary Stowe, for not disclosing money he received from drug makers at the same time that he was conducting federally funded research on the use of antidepressants, such as Paxil, by pregnant and nursing mothers.
Stowe has been the primary investigator of an NIH grant since 2004 to study children delivered by women who may also be taking antidepressants. From 2003 to July of 2008, he was the primary investigator of another grant that looked at fetal exposure to medications consumed by pregnant mothers. In 2008, Stowe was the primary investigator of another NIH grant where the stated purpose was “to stimulate vigorous debate with the emphasis on the reproductive safety of antidepressant medications,” according to a June 2, 2009, letter from Grassley to Emory University.
In 2007 and 2008 alone, Stowe received about a quarter of a million dollars from Paxil-maker, GlaxoSmithKline, mostly for giving promotional talks, the letter shows.
Grassley was especially disturbed by an email between Glaxo employees and a public relations firm Glaxo hired, titled “For your review/Paxil Breast Milk Press Release” which states:
“[P]lease review the attached press release and forward me any comments/edits. As you may know, Dr. Stowe is on board for publicity efforts and NAME REDACTED and I are coordinating time to meet with him next week to arm him with the key messages for this announcement, which is slated for early February. We are sending the release for your review at the same time in efforts to secure distribution on Emory letterhead (as you know, would provide further credibility to data for the media).”
During a 2008 deposition in a birth defects lawsuit against Glaxo, Stowe confirmed that the press release was written by the PR firm and concerned his research on Paxil, and explained that placing the press release on Emory letterhead would make the data more credible to the public, as opposed to Glaxo letter head, Grassley said.
Stories on the internet show the Emory name was apparently used to add credibility to Paxil studies. For instance, citing a February 2, 2000, press release by Emory University School of Medicine, titled “New Study Shows Paxil Not Found in Breast-Fed Infants of Depressed Mothers,” on March 13, 2000, the StorkNet website featured an article with the headline: “Study Results Show Paxil Safe for Use by Breastfeeding Mothers With Depression.”
The story included the following paragraph with Emory specifically mentioned and Stowe’s comments:
“Due to the increased occurrence of mood and anxiety disorders during child-bearing years, it is imperative that we continue to research and make treatment options such as Paxil available for mothers who want the opportunity and benefit of breastfeeding their children,” said study leader Dr. Zachary N. Stowe, director of Emory University School of Medicine’s Pregnancy and Postpartum Mood Disorders Program.
“This study provides compelling data that Paxil is a viable treatment option for mothers who would like to continue breastfeeding.”
In the deposition, Stowe said he had been on Glaxo’s speaker’s bureau since 1999 and claimed that on top of his $232,000 Emory salary, he earned an additional 20 – 30% more doing work for drug companies.
On June 10, 2009, on the “Carlat Psychiatry Blog,” Dr Daniel Carlat noted that, “Stowe appears to have been deceptive during a recent deposition, when he claimed that on top of his $232,000 Emory salary, he earned an additional 20 – 30% more doing work for pharmaceutical companies.”
If he made $154,400 from GSK alone in 2007, “by my calculation this is already 66% more salary than he got from Emory,” Carlat said. “And Stowe did work for lots of other companies as well.”
Here is his disclosure from a Medscape CME gig he did in March 2007: “he has received grants for clinical research, grants for educational activities, and has served as an advisor or consultant to GlaxoSmithKline, Wyeth, and Pfizer. … he has served as an advisor or consultant for Bristol-Myers Squibb. … he has served on the speaker’s bureau for GlaxoSmithKline, Wyeth, Pfizer, and Eli Lilly.”
“Who knows how much money he was also getting from Wyeth, Pfizer, Bristol-Myers Squibb and Eli Lilly?” Carlat wrote. “He may very well have doubled his Emory salary, or more.”
“Furthermore,” he explained, “the $154,400 disclosed by GSK does not include all the cash they paid Stowe through laundered CME money.”
“For example, here is a CME program Stowe did for Medscape that was funded by GSK,” Carlat said, and wrote:
“The program is entitled “Long-term health risks of antiepileptic drugs in women” and is essentially a commercial for using Lamictal in pregnant women with bipolar disorder.”
“In it, Stowe begins by saying nasty things about Lamictal’s competitors, Depakote and Tegretol, and then minimizes a large study showing that Lamictal causes cleft palate.”
“I’m sure he got paid a lot for this, and that he did plenty of other similar CME programs that are scattered somewhere throughout the internet.”
“The bottom line is that Stowe has run into the same ethical problem as his boss Dr. Nemeroff-he was taking public NIH money to conduct research, while at the same time giving dozens of promotional talks for a company that stood to benefit from the results of that research,” Carlat pointed out.
On June 10, 2009, the Wall Street Journal health blog reported that, “Emory University has disciplined a prominent psychiatrist who was being paid by an antidepressant maker at the same time he was conducting federal research about the use of such drugs in pregnant women.”
The university said its medical school dean issued a letter of reprimand on April 30 to psychiatrist Zachary Stowe related to his “external relationships,” the WSJ wrote.
Emory has reprimanded Stowe, “who was instructed to immediately eliminate conflicts related to current federal grants,” the health blog noted.
Also, “the National Institute of Mental Health said it is reviewing Stowe’s activities, prompted by a letter from a U.S. Senate committee that said Stowe received $253,700 in 2007 and 2008 for “essentially promotional talks” for the drug maker GlaxoSmithKline,” the Atlanta Journal-Constitution reported on June 11, 2009.
ORIGINAL POST (June 14th, 2009)
I’ve been a vocal supporter of home birth for many years.
As a childbirth educator I felt it was my job to tell pregnant women the truth, even if what I said was uncomfortable and painful for them to hear.
A few months ago I read a blog post by Heather Armstrong AKA Dooce. Heather is considered an expert on post partum depression and motherhood. She is also a liberal ex-mormon – sort of the anti-Jenny Hatch. She regularly stands against just about everything that is important to me.
I found that she was an articulate, smutty, sometimes funny but mean spirited blogger. And that those who tended to comment on her blog also used tons of profanity and were hostile to my LDS religion.
I was intrigued by the amount of conversation going on about Antidepressants. It felt like her readers were asking her drug consultation questions as if she was some sort of a medication guru. I was extremely dismayed to read that she was pregnant with her second child and had been taking anti depressants during her pregnancy.
But as with all of my personal judgements around issues with pregnancy etc al…I did not feel the need to contact her personally and let her know how deadly and damaging her choice would prove to be to her unborn daughter.
I get annoyed when others write me emails telling me how I am a bad mother for giving birth at home, and I am a very live and let live person.
When she wrote a vitriolic post about Freebirth on friday, I read through the comment section and decided to jump in the pool, as I usually do when unassisted childbirth is being discussed in the blogosphere.
I defended freebirth and shared some links about orgasmic birth.
In the post and the comments we were called stupid, crazy, and some of the language was extremely insulting to our home birth community.
My inner childbirth educator decided to share the facts about antidepressant use in pregnancy and how it is a BAD thing for the baby and then linked to several sites where readers could learn more. Heather has a loyal following of dedicated commenters and many became indignant that I would heckle her for her lifestyle the same way that she had judged me and my friends in the home birth community.
“Heather has chosen to be a shill for Big Pharma by loudly proclaiming her addiction to Prozac and her use of this dangerous drug during pregnancy….do I care? Sure, I feel bad for her unborn daughter, and any potential heart problems she may have, but does that mean I am going to go on a campaign to convince or tell her I won’t tolerate her lifestyle? No.”
I summed up the conversation by explaining to those reading that we all make choices every day that impact the health of our kids. Some choose to give birth medically and use drugs for all that ails them, and we who give birth at home have decided that the medical people don’t have a whole lot to offer our children.
But ultimately I said that we should all live and let live.
Before Dooce locked the thread to more comments, a few more readers were talking about anti-depressants andthe tone was this almost pleading tone in the comments…”Dooce, take the blue pill, please oh please, take the blue pill….Dooce tell me I’m on the right meds, tell me I’m doing the right thing. Tell me the reality Jenny Hatch has just described does not exist….help me to know that the drugs I am eating every day are not deforming and killing my child…”
The emotion was real, and Heather did not respond, perhaps because she is at the hospital right now birthing her second child.
All I know is that I completely agree with Peter Breggin and his wife Ginger who in July of 2007 at the Huffington Post made the case that PREGNANT WOMAN SHOULD NEVER TAKE ANTI DEPRESSANT DRUGS.
They summed up their excellent post with these words:
“No one can or should blame the parents. But when the mother has been taking an SSRI antidepressant, increasing her risk by 240%, we must hold responsible the doctor who prescribed it, the drug company who manufactured and falsely promoted it, and the medical establishment that covers up and minimizes the drastic hazards associated with these toxic chemicals, including risks to adults, children and the unborn.”
I don’t judge ignorant women who eat antidepressants while pregnant, but I do have a sense of wanting to smack them upside the head and scream “how dare you judge me and my mothering choices when you are killing your child every single day with the toxic POISON you are eating! Wake up woman!”
I would like to challenge Heather Anderson to take the red pill and find out how far down the rabbit hole goes in terms of the truth of the coverup surrounding pregnant women taking antidepressants.
The media largely trashed Tom Cruise when he suggested alternatives to drug therapy to a mentally challenged Brooke Shields. And millions of women daily dope and numb themselves with chemicals designed by thieves who have made billions from the mental challenges of birth traumetized women. And here we are a couple of years later and come to find out in the Wall Street Journal this week that the very scientist charged with conducting the government research on antidepressants for pregnant mothers is getting paid hand over fist by the drug company that makes the drugs.
“In a letter earlier this month to Emory, Sen. Charles Grassley (R., Iowa) said he learned the school had informed the NIH last summer that Dr. Stowe had financial conflicts of interest. The senator said records he obtained from GlaxoSmithKline PLC, the maker of the antidepressant Paxil, indicated Dr. Stowe was paid $154,400 by the drug company in 2007 and $99,300 during the first 10 months of 2008. The totals included payments for at least 95 promotional talks on behalf of the company. A Glaxo spokesman was unavailable for immediate comment.”
Parents, it is time to wake up and throw the shackles of medicine off our backs!
I wonder about Heather….and how this next postpartum will go for her and her child. See, it’s not just about the mother and her feelings. It is about the health and well being of the baby too. And if the baby is born without a frontal lobe, or has a heart defect or painful drug withdrawal for days in the NICU, I think a Self Righteous, know it all blogging Mom perhaps needs to accept just a bit of responsibility for her choice to eat deadly toxins and live as a psychiatric slave.
I wonder if she will take the blue pill – go back to bed, wake up, and continue with psychiatric care for her emotional issues. I wonder if she will continue to be a loud voice for drugs, gleeful in her mania, confident that none are as funny, wise, and all knowing as she in her “all is well in ZION” psychedelic high, and I wonder if she and her readers will continue to judge, hate, and mock us homebirthers and psychiatric survivors for our choice to live free.
Time will tell.
Blue Pill/Red Pill reference from the Movie: The Matrix
UPDATE: July 1, 2009
It appears that Heather Armstrong is eating her doctor approved blue pill and perhaps even the zoloftian, “breastfeeding friendly”, light blue pill…
But hey…she’s happy and free…
“So he made a minor tweak to my meds and asked me to come back and see him in two weeks, and I am not even kidding, I felt better that night. In fact, better does not do what I was feeling justice. I felt free.”
I’m glad Heather feels free on her meds. I was court ordered to take my toxic cocktail and it felt like slavery to me.
“So what about breastfeeding? That’s what you’re all wondering, I know, and this is what I’m going to say: he thinks that what I’m taking is perfectly safe to take while breastfeeding. He’s prescribed it before to women who are breastfeeding and everything has been perfectly fine. No, I’m not going to talk about what I’m taking because one, it’s no one’s business, and two, I don’t care that you think I’m poisoning my baby. I also think that anyone going through this needs to consult their own doctor and make an informed, personal decision about their individual situation. And then go on and live a better, happier life.”
Since I was the only person on Heathers blog who mentioned antidepressants being toxic in the comment section of her Freebirth post, and since I shared links to articles that proved this was the case, I can only presume that she is responding to what I wrote when she says that she does not care what I think.
That’s cool, I also do not care that she thinks I’m “stupid” for being into Freebirth. But she may want to pause for a sec and think about how her daughter will feel about her casually taking toxic poison every day while she is pregnant and nursing, and she may want to consider how her husband might feel about her eating her big bowl of prozac flakes with zoloft milk every morning while nursing her daughter, especially when true healing is to be found at the local Whole Foods market.
“Sorry hunny, I know you can’t put two thoughts together in order to solve that math problem and you started menstruating when you were five, and now as a sixteen year old you are growing a beard… but it was just so important that I not be panicked when you were a newborn, and dammit, only stupid people ignore doctors advice and go looking for alternatives to drugs.”
Hey, to each her own.
“I’ve been on the new meds for over five days, and I haven’t had a panic attack once. I feel like a regular person who has an infant and can handle it, and during my pregnancy that was exactly what I was aiming for. Turns out I needed a little help, a tiny adjustment, but here I am and I am loving it. I love what it has done to my relationship with Leta, what it has helped me see and appreciate in Jon, and I love that I can barely stand to be away from that baby for a minute. Jon has been watching Marlo so that I could write this, and a little bit ago he came rushing downstairs with this kicking, yelling, hungry bundle in his arms, and it was like I hadn’t seen her in years. And that yelling… that raucous, staccato, one-too-many-beers yelling… it didn’t make me cringe, it made me laugh.”
As the fake ad for Zoloft says “Zoloft does EVERYTHING!” (I’m only guessing that Heathers doc put her on Zoloft because it is considered the safest to take while nursing.)
Everyone should watch Amy Philos Zoloft movie to hear her story about that nasty drug…
Pills, Pills, Pills…
“Perfectly Safe”, according to Heather’s doctor…
Please Mommies, Heather Armstrong is NO EXPERT on drug use during pregnancy and breastfeeding. (Neither am I, I only consider myself an expert on my own body and brain.) And it sounds like her doctor has drunk the big pharma koolaid when it comes to nursing moms eating this crap.
Please take the time to research, pray, and thoughtfully explore alternatives to drug therapies when making the choice whether to eat antidepressants during pregnancy and lactation.
No amount of symptom relief from panic/depression/anxiety will help you overcome the guilt and horrifying feelings you will experience when you realize that your child has been permanently brain damaged by these toxic medications. Alternatives do work! And the biggest lie of all is that only drug therapies can be used when a Mother is in the throes of postpartum emotional illness.
Listen to Jenny Hatch
To end on a funny note: (Well, funny if you have not experienced these side effects)
I was sexually dysfunctional taking Prozac. Very, very sad place to be when you are newly married…