Manufacturing Consensus – Adult ADHD in the UK

The excerpt below is from David Healy’s Marketing Drugs and Changing Lives in the US… you can read more here.

CONSENSUS CONFERENCES

Consensus conferences aimed at producing guidelines for clinical practice came into existence in the late 1980s (Sheldon and Smith 1993). A range of bodies took up this apparently academic development. Within psychiatry, groups such as the British Association of Psychopharmacology and the European College of Neuropsychopharmacology, for example, produced guidelines on the treatment of a range of conditions from depression through to schizophrenia. This may have happened in part in an effort to establish a political profile. In a number of the organizations that produced guidelines, the influence of key individuals with links to pharmaceutical companies is apparent.

At the same time pharmaceutical companies began to sponsor meetings aimed at producing expert consensus on issues such as the appropriate use of medication in schizophrenia. These company sponsored meetings have often resulted in products that may appear almost indistinguishable from non-company sponsored guidelines or algorithms. While this might be thought as an exercise designed to confound the recommendations of independent committees, in fact committees that should be independent have come up with recommendations that barely differ from explicitly company-sponsored exercises.

And my point is…?

A couple of posts ago I wrote about a news item that I saw last week – Adult ADHD Marketing Reaches the UK. I wondered where the story had come from – what the “strong evidence” and “research” is…

It is only in the last few years that strong evidence has emerged about the extent of ADHD in the adult population. It is thought up to 8% of children may be affected, and research suggests that half or more may have symptoms past adolescence into their twenties, thirties or even forties.

Yet the condition is barely recognised by the health service beyond 18 years of age.

Professor Anthony Hale, professor of psychiatry at the University of Kent, said patients are being failed by the system. “There are huge numbers of people across the country who are on waiting lists to see adult psychiatrists who don’t have the expertise to deal with them. The 4% of the adult population figure is very real.”

…Dr Marios Adamou, whose clinic is due to close in October due to lack of funding, said poor access to treatment is a real problem.

“For some people it may mean catastrophe, because some people without the medicine are prone to offending behaviour, and prone to aggression. So a few people may end up being arrested, being imprisoned. Others may fail in their courses, others may fail in their occupation.”

Dr Adamou says Britain is years behind most other European countries in dealing with this problem.

Most of the medication is licensed for use only in children, and many of the treatments are controlled drugs, so GPs – and many adult psychiatrists – are often reluctant to prescribe them.

The “strong evidence” and “research” mentioned, comes from a consensus meeting of 2006 (ADHD in transition from child to adult), organised by the British Association for Psychopharmacology (BAP) and funded by Cephalon, Janssen, Lilly, Shire UK and Shire US – all drug companies that manufacture ADHD drugs – Adderall, Modafinil, Concerta and Strattera. All of the drug companies also supplied ‘observers’ who attended the meeting to… ‘observe’, I suppose.

The Consensus Group was headed by Professor David J Nutt – would this be a good time to mention the Professor’s links, I wonder? - Professor Nutt has acted as a consultant to Pfizer, GSK, MSD, Novartis, Asahi, Organon, Cypress, Lilly, Janssen, Lundbeck, Wyeth. He has speaking honoraria (in addition to above) with Reckitt-Benkiser and Cephalon. Grants or clinical trial payments from MSD, GSK, Novartis, Servier, Janssen, Yamanouchi, Lundbeck, Pfizer, Wyeth, Organon. He has 300 shares with GSK (ex-Wellcome). Professor Nutt also promoted Seroxat at Glaxo’s launch of Seroxat for “social anxiety disorder”.

Also at the consensus meeting were Professor Anthony Hale and Dr Marios Adamou, who work together in Kent. In 2003 in a letter they co-wrote to the BMJ they signed off: Competing interests: M. Adamou is a co-investigator to pharmaceutical companies producing or developing neurotropics. A.S. Hale is an investigator and advisor to pharmaceutical companies producing or developing neurotropics.

I just can’t help thinking that maybe things might not be quite so clear cut as they seemed when this story was first published.

Adult ADHD – coming to a UK GP near you ASAP.

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12 Responses to “Manufacturing Consensus – Adult ADHD in the UK”

  1. truthman30 Says:

    Professor Nutt ?

    Yeah that would be about right…

  2. Matthew Holford Says:

    ADHD? I’m sorry, I’ve lost interest and have an urgent need to run around, screaming random obscenities. Does that qualify me?

    Matt

  3. Nat Says:

    Matthew is missing the point somewhat with his lighthearted response to this, because ‘ADHD’ as it is categorised can be subdivided into ‘hyperactive’ or ‘inattentive’, which requires no running about at all. Preferably avoid stereotypes.

    The drug companies certainly have first responsibility to their shareholders i.e. profits, and certainly not truth. However, in the absence of anything to actually ‘cure’ ADHD which can be very serious in some cases, and natural remedies that – at best – mitigate some of the symptoms, and then only in some people, what do you suggest as an alternative to drugs?

  4. truthman30 Says:

    The drug companies certainly have first responsibility to their shareholders i.e. profits, and certainly not truth.

    I would have to disagree…
    Surely their first responsability should be “safety”…
    If it isn’t then.. they shouldn’t be allowed a trading licence…

  5. truthman30 Says:

    and on the subject onf “ADHD”…
    Its more psychiatric pseudo-bollox..
    ADHD is a label to put on kids and adults with conduct, behavioural and learning difficulties…
    And Ritalin is poisonous…

  6. Daniel Says:

    @truthman30

    What a pathetic thing to say!

    And I suppose you think depression is a label for lazy adults who refuse to pull themselves together? Or that Autism is just a result of bad parenting? Or that new cancer drugs are only effective because of witchcraft?

    You are clearly a judgemental idiot devoid of any compassion for others less fortunate than yourself.

    The drug companies may or may not be corrupt, but conditions are real for many people, and comments like yours only encourage ignorance and bigotry.

    Get out of the dark ages, moron.

  7. john Says:

    Quote “and on the subject onf “ADHD”…
    Its more psychiatric pseudo-bollox..
    ADHD is a label to put on kids and adults with conduct, behavioural and learning difficulties…
    And Ritalin is poisonous…”

    Sounds like an internet troll to me

    Despite the large amount of increasing evidence regarding ADHD and the thousands of sufferers you still get the same idiots proclaiming it doesn’t exist. Their arguments are usually heavily intertwined with anti-drug company or anti-American xenophobic ideas and not very scientific. There will always be people looking to blame/hate one group or other, its easier than trying to understand, confront or deal with the problem.

  8. truthman30 Says:

    Ahh, must have missed these two ..

    Believe what you want to believe, If you want to believe you have Adult ADHD, or have a psychiatric illness then you will be playing straight into the hands of the drug companies, thats just what they want… desperate, naive and gullable people..( helps fill their pockets with money soacked from fear and misery)

    Maybe you should check out a well respected Irish psychiatrist called Michael Corry, he seems to agree with me on most things, would it help if it came from the proverbial horses mouth?…

    http://www.depressiondialogues.ie/

    (and no im not a troll, more of a hobbit … )

  9. truthman30 Says:

    On the subject of depression Daniel, having suffered from it, and also having been “fraudulantly” drugged for it at one time, I think i have as much a right as anyone else to speak about these things…

  10. ross Says:

    to mr adhd is for desperate gullabull people. look into the research done on a cross section of the public and adhd suffers. both were tested for frontal lobe dopamine responses the adhd sufferers not only had lower production levels but also the cells that administer the dopamine werent as spread out as on the non sufferers. there are many functions of the left frontal lobe and the symptoms of adhd are generally within there e.g organizational skills, rationalization. so you see you silly boy it pays to do your research not just be a lemming. goodnight

  11. Seroxat does not work in majority of depressed patients says latest study - Prof Nutt disagrees « seroxat secrets… Says:

    […] about Nutt and adult ADHD here. Posted in Anti-depressant, Drug Marketing, GlaxoSmithKline, Paxil, […]

  12. Garret Smyth Says:

    You may not believe in adult ADHD, but DSM IV and ICD 10 do, and you might be a bit more compassionate if you knew some people’s life stories. Take a look at http://www.aadd.org.uk


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