Healthy Skepticism Library item: 2021
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
McIlroy A.
Article censored that decried placebo use in drug trials
The Globe and Mail 2001 Apr 18
Full text:
A journal published by the Centre for Addiction and Mental Health refused to run an article it had commissioned that was critical of psychiatric drug trials, says Charles Weijer, an assistant professor in the department of bioethics at Dalhousie University.
Dr. Weijer says he was asked by the Journal of Addiction and Mental Health to write an editorial about a common practice that means half of the patients who participate in clinical trials of psychiatric drugs don’t receive any treatment.
The journal is published by the Centre for Addiction and Mental Health, a teaching hospital affiliated with the University of Toronto that has been criticized for appearing to be too close to the drug industry.
The CAMH revoked a job offer to a respected British psychiatrist after he raised concerns about the use of the popular antidepressant Prozac, manufactured by Eli Lilly, a major private donor, during a speech last year.
David Healy argued Prozac may trigger suicide in some patients, a claim the company denies. The CAMH won’t say why his written job offer was rescinded, but denies it had anything to do with the fact Eli Lilly is a major corporate donor.
Dr. Weijer says what happened to him is further proof that the CAMH’s relationship to the drug industry is “a profound problem.”
In his article, Dr. Weijer criticized the common pharmaceutical industry practice of testing drugs for depression or schizophrenia using a control group of patients who are given a placebo — basically a sugar pill — rather than medication.
Using placebos is a standard way to test whether psychiatric drugs work, and is in fact required by Heath Canada, Dr. Weijer says. But it isn’t done to test drugs for cancer, for example, because researchers believe it is unethical to withhold treatment from the control group of patients.
Dr. Weijer argues the same standard should apply in psychiatric drug trials, because it is unethical to deny available treatments to patients desperately in need of care.
Copies of e-mails provided by Dr. Weijer show that the editor of the journal, Diana Ballon, told him to be as “controversial” as he wished. He turned in his commentary on May 15 last year. The editor sent it back the next day with a few minor corrections, he said.
On May 17, Dr. Weijer said, Ms. Ballon phoned him and told him that a number of psychiatrists at the CAMH had reviewed the piece, were unhappy with it and wanted major changes.
On May 29, he received a substantially rewritten version, which he says modified many of the points he had made. The new article, he said, was in favour of the use of placebo control groups, the opposite view he had argued. He said this kind of treatment is unheard of at other medical journals.
He said he told the journal the degree of interference was inappropriate for an academic journal and withdrew his article.
“I think they had to be concerned that a piece coming out of the Centre for Addiction and Mental Health through their journal that criticized the practices of the industry might make their drug-company funders unhappy,” Dr. Weijer said in an interview.
“The Centre for Addiction and Mental Health’s close relationship with industry is a profound problem . . .”
Ms. Ballon refused to answer questions yesterday, referring inquiries to Christa Haanstra, acting director of public affairs. The Globe and Mail first asked Ms. Haanstra about Dr. Weijer on Monday, but she said she needed more time to respond. Yesterday, she said she still was not prepared to comment.
