Healthy Skepticism International News
Big Pharma Beaten
GSK in Iceland forced to withdraw a drug-promoting depression booklet
by Steindór J. Erlingsson PhD
For the past 9 months I have been sporadically researching a book that I plan to write, where I will criticize DSM and biological psychiatry. This work began at the end of last year when I wrote an article, “Antidepressants and Chemical Imbalance (Þunglyndislyf og efnaójafnvægi)”, for a newspaper in my native Iceland, an island nation in the North-Atlantic with a population of roughly 300 thousand. The article highlights research indicating that SSRIs are no more effective in treating depression than placebo, and the flaws in the “serotonin imbalance” hypothesis [1-4]. It was published in early January 2009 and became the subject of a detailed discussion in a TV program, “Depressed Nation (Þunglynd þjóð)” , later in the month.
This research opened my eyes to the fact that, since 1999, GlaxoSmithKline (GSK) has distributed a booklet in Iceland in drug stores and primary, secondary and tertiary health care facilities containing wrong and misleading information about the causes and treatment of depression. What is most striking about the booklet are the following claims: 1. An imbalance in the neurotransmitter serotonin causes depression. 2. SSRIs treat depression by correcting the serotonin imbalance. 3. Psychological treatment is ineffective in treating the serotonin imbalance. For ten years GSK in Iceland was allowed to give the readers of the booklet the impression that a chemical imbalance in the brain caused depression and that drugs are the only cure. I was recently able to stop this travesty.
Immediately following the newspaper article and the TV program, where the GSK booklet was highlighted, I sent a formal complaint concerning it to the Icelandic Directorate of Health. I met with the Icelandic Medical Director of Health (MDH) and had frank discussions about the GSK booklet. He forwarded my report to leading psychiatrists in Iceland who agreed with me! In a detailed letter that the MDH sent on March 12 to the Icelandic Medicines Control Agency (IMCA) it is argued that “the booklet must be withdrawn. But as the matter has to do with a drug company the IMCA is hereby asked to take appropriate actions.”
This was a great victory for me and the people of Iceland, but the question remained whether the IMCA would do anything about the matter. When I had not received any news from the Agency by the middle of September, I contacted the MDH. He decided to circumvent the IMCA and speak directly to GSK in Iceland, with great results. On September 24 the company sent a letter to all drug stores and health care facilities in Iceland stating that “GSK has received information that its information booklet on depression needs to be improved. The company views favorably well argued suggestions and as a result it is going to review the booklet. While this inspection takes place further distribution of the booklet will be terminated. The company also requests that any further distribution of the booklet in drug stores and health care facilities should be terminated.”
During the following weeks the story continued to develop. After considering the matter for few days I decided to contact a journalist at one of the newspapers in Iceland to try to convince her to write about this defeat of GSK. This was not an easy task but, after more than a week of emails and phone calls, the newspaper bit the hook. On October 13 it published an interview with me under the heading “Company’s Serious Distortions (Alvarlegar rangfærslur fyrirtækis).” The impact of the interview was immediate. The following day a press release from GSK in Iceland was published in the newspaper where the company tried to excuse the booklet affair and promised to put its house in order. Besides the depression booklet, GSK in Iceland publishes booklets on several other mental disorders. In the press release the company pledged that “coinciding with the revision of the depression booklet all this educational material will also be inspected in close cooperation with local specialists.”
Advertisements aimed directly at consumers are illegal in Iceland. Drug companies can indirectly circumvent this ban by publishing information booklets on various mental disorders. GSK in Iceland abused this option by publishing a booklet about depression which contained wrong and misleading information about the causes and treatment of the disorder. This has now been stopped. This victory in Iceland clearly shows that with well-argued complaints mental health advocates can even defeat Big Pharma!
 Barbui, Corrado, Thosihaki A. Furukawa and Andrea Ciprani. 2008. Effectiveness of Paroxetine in the Treatment of Acute Major Depression in Adults: A Systematic Re-Examination of Published and Unpublished Data from Randomized Trials. CMAJ 178(3): 296-305.
 Kirsch, I., B. J. Deacon, T. B. Huedo-Medina, A. Scoboria, T. J. Moore og B. T. Johnson. 2008. Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administraton. PLoS Medicine 5(2): e45; DOI: 10.1371/journal.pmed.0050045.
 Leo, Jonathan and Jeffrey R. Lacasse. 2008. The Media and the Chemical Imbalance Theory of Depression. Society 45: 35-45.
 Lacasse, Jeffrey R. and Jonathan Leo. 2005. Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Medicine 2(12): e392; DOI: 10.1371/journal.pmed.0020392.
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