Friday, 27 June 2014

Umm. Do I smell a lab rat?!

I see there is a new study out (Funded by the Agency for Healthcare Research and Quality, and the National Institutes of Health) that suggests that there is "no substantial increase in the risk of cardiac malformations attributable to antidepressant use during the first trimester" of pregnancy.

As this conclusion appears to go against the grain of what I have already heard about the risks of SSRI anti-depressants, I am left wondering if I have previously been misinformed - or whether I am now being misinformed. So often it is more about what is not being said, rather than what is presented in a study report, that governs the conclusions we might come to.

When I see the potential for conflicts of interest in studies I do wonder about research bias. Of course this is not necessarily so, but I ask myself: "Do I smell a rat?!"

I look forward to reading comments on the New England Journal of Medicine website in due course (hoping they will publish readers' responses) that might enlighten me.

But should a rat eat just one grain of truth - are we left with truth?

Mick Bramham is an Existential Psychotherapist based in Dorset, UK.

He has a particular interest in ethical issues and also how our lives are shaped by the society, circumstances and culture in which we live.
He trained at Regent's College London, and is a member of the Society for Existential Analysis.
Although he has serious concerns about the inappropriate and excessive use of mental health medications, he supports the freedom to choose (to take or not to take these drugs) and the right to be fairly informed of their limits and the risks. He offers support for people who are considering reducing or coming off psychiatric drugs.
He has a long-standing interest in non-clinical (and non-coercive) responses to mental and emotional distress.
You can read more about his work and find his contact details here. Follow Mick on Twitter @MickBramham

1 comment :

  1. Can’t read the whole article, just the abstract. But I see 2 big problems right away. First, they weaken their initial figure of a 25% increased risk by “adjusting” for the “confound” of depression, as if it were somehow known that depression itself caused heart defects. A more responsible approach would be to find some women with depression not taking drugs … or women taking SSRI’s for conditions other than depression, like social anxiety. Second, they deal only with live births. Paroxetine in particular has been linked to cardiac defects so profound they can lead to a miscarriage or convince a mom-to-be to abort. I don’t know how they chose the two cardiac defects they focused on, but they ain’t the only ones, for sure.

    It’s disheartening to see Dr. Jerry Avorn’s name on this very evasive-looking paper. They may have sought him out for ethical window-dressing. He of all people should have his radar up on these issues. If you decide to write to any of the authors, he might be the right guy.

    Johanna Ryan, @RxISK


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