Psychiatry, DSM and Drug Companies

J0398875There has recently been a lot of hullabaloo about the fact that a large number of psychiatrists associated with writing the guidelines contained in the DSM manual have had past connections to drug companies according to recent reports

I am somewhat confused by this.  I would have thought it would be a headline if they weren’t associated with drug companies, not that they were.  Why wouldn’t we want people familiar with cutting edge research on drug therapies part of the mix in writing the DSM?

I know there is a lot of controversy about whether or not too many drugs are being prescribed for children with depression and ADHD.  I mean, we grew up without those drugs and we turned out all right, didn’t we?  (Didn’t we?)

But in the coverage of this issue, the one thing I haven’t seen is any connection between the fact that these researchers with connections to pharmaceutical companies have had any impact on how the DSM is written.  Rather, I think the reason that this is a headline is because the pharmaceutical industry is viewed so suspiciously by so many sectors and this story is a symptom of that fact. 

Because I have to say, when I walk around the streets of Washington, D.C., I don’t see the ill-effects of heavy mental health drug prescribing.  I see the opposite.  I see under-prescribing.  I see homeless people talking to themselves – about whom I’m forced to wonder whether or not a few pills a day wouldn’t make them happy and productive, or at least, not self-destructive and helpless.  I see a mental health system and criminal justice system that together fail utterly to comprehensively address the needs of the truly mentally ill. 

Did you know that a lot of schizophrenics have an episode of arrest during their lives?  Did you know when a person is arrested they lose their Medicaid?  When they lose their Medicaid, their access to their meds is cut off.  When their access to their meds is cut off, they are more likely to commit a crime.  And then a cycle establishes itself.  Then the chances are increased for them to transition to a life where they become one of those people we see on the streets. 

So I am not alarmed by the revelation that authors of the DSM have connections to drug companies.  I would be alarmed if they didn’t.  And I wish we could inject their influence into some other venues as well for the sake of the mentally ill for whom access is compromised along with quality of life.   

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One Response to Psychiatry, DSM and Drug Companies

  1. My issue is Zyprexa which is only FDA approved for schizophrenia (.5-1% of pop) and some bipolar (2% pop) and then an even smaller percentage of theses two groups.
    So how does Zyprexa get to be the 7th largest drug sale in the world?
    Eli Lilly is in deep trouble for using their drug reps to ‘encourage’ doctors to write zyprexa for non-FDA approved ‘off label’ uses.
    The drug causes increased diabetes risk,and medicare picks up all the expensive fallout.There are now 7 states (and counting) going after Lilly for fraud and restitution.

    Daniel Haszard