Is your doctor a ‘high flyer’ or a ‘rule bound’?

The latest on AstraZeneca, who are having to pay 198 million US dollars to patients who have developed diabetes on the anti psychotic drug quetiapine is only one bit of a long story. The challenge being made is that the weight gain and tendency to diabetes for some patients was known by AstraZeneca but not acknowledged fully on the information they gave to doctors. This paper from the journal Bioethical Enquiry may make you weep. Doctors are well known to reps as who is likely – and unlikely-  to prescribe most new drugs. Guess where they focus their attention? A doctor and ex manager of AZ has made public his views on how he was asked to approve what he thought were non evidenced claims.We might moan that it is pharmaceutical companies who are responsible for not being open about side effects and instead marketing medicine to doctors and patients. And that’s true. But it also is a failure of the other doctors and politicians who have allowed this situation to happen.

The non publication of clinical trials is ethically wrong and fundamentally dangerous – yet legal. This non publication means that a pharmaceutical company can complete a clinical trial, not like the results, disregard them, and carry on regardless. But of course, triallists include doctors who have an ethical obligation to their patients. Doctors must know what non publication is going on.

I am keen to do good research in primary care and over the last decade have been approached by at least two pharmaceutical companies doing what may have been useful research – but who expected me to sign a confidentiality document which would have meant that I was not allowed to talk about the research except with their approval. I said no, but this is legal, and it seems normal – many other doctors have reported the same thing. I don’t depend on research for income – but others do; not just for themselves personally but for their departments.

Why has no politician petitioned for legislation? Why aren’t doctors more upset about this? And why do some doctors STILL see drug reps?

3 Responses to “Is your doctor a ‘high flyer’ or a ‘rule bound’?”

  1. Dr Edmond O`Flaherty December 26, 2010 at 8:28 pm #

    Quetiapine (Seroquel) is a popular antipsychotic which certainly puts on the weight in my experience as a GP with a a big interest in psychiatry. This leads to Diabetes Type 2 in some cases. I go to many psychiatric meetings in Europe and they seem to be almost owned by the drug companies so you get such topics as the X company lecture on schizophrenia. I use biochemical therapy to relieve the condition as much as possible and then one needs much less medication. Common chemical imbalances include high copper, low zinc, low B6, low fish oil, low caeruloplamin and methylation disorders. My admisison rate has dropped significantly and the work is far more enjoyable. I save the government hundreds of thousands of pounds every year.

  2. Margaret McCartney
    margaretmccartney December 29, 2010 at 9:22 pm #

    please do post your evidence for that preferably from decent sized rcts.

  3. Joe January 11, 2013 at 11:30 am #

    Interesting Post Edmond – I see that your company carry out tests at around €500 a pop.( )Thats quite a hefty charge to a troubled vulnerable person looking for help.
    Yet my own Dr. Google (I quote) – Serum serotonin levels can be obtained (as ordered by a physician or nurse practitioner or physician assistant). However, serum serotonin levels do not possess much utililty since they vary widely – some people having low levels despite being on significant doses of setonergic medications, and other people have high levels despite being on very low doses.
    I have a personal interest in this.Can ypu tell us about your expectations for the LOndon Lab Tests and how they work in developing a treatment plan? Thanks.