Is APA treatment advice tainted by pharma ties?

Are the guidelines doctors use for treating psychiatric conditions corrupted by pharma influence? That's the implication of an upcoming study that found close ties between the docs who write the guidelines and the drugmakers that benefit from their recommendations. Researchers found that the vast majority of those docs earn money from pharma. And they point out that the guidelines focus on psychotropic meds, giving short shrift to nondrug treatments and to discontinuation of psych drugs.

"[O]ur study raises the question: Is that decision based in science, or is there a financial incentive behind it?" the paper's lead author, Lisa Cosgrove of the University of Massachusetts, told the Boston Globe. This is an important question because the lack of biological tests for mental disorders renders psychiatry especially vulnerable to industry influence."

Some prominent psychiatrists have come under fire recently for thousands in unreported income from drugmakers. Critics have said that these influential doctor-researchers led the way toward off-label use of some powerful psychiatric drugs--and perhaps their recommendations weren't objective judgments but biased by their financial ties to pharma. Meanwhile, some researchers proposed this week that medical societies--such as the American Psychiatric Association, whose guidelines are at issue here--sharply limit funding from drugmakers to purge any suspicions of conflicts of interest.

The APA told the Globe that its guidelines are carefully vetted and that doctors and researchers who get "significant" portions of their income from industry are excluded from the panels developing the treatment advice. "We work very hard to ensure that the guidelines that we develop and publish are free of bias to the greatest possible extent," said Dr. John S. McIntyre, chairman of the guideline steering committee.

Still, of the 20 guideline authors, 18 had at least one financial relationship--defined as consulting, research grants, speaking fees or stock ownership--with drugmakers. Twelve of them had financial relationships in at least three ways. Whether these ties led to guidelines biased in favor of drugmakers is open to debate. And you can be sure that the debate will come.

- read the Globe story
- check out the Health Blog's take

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