4.3 Matters arising: correspondence with government

What of the response of authorities and experts on the issues discussed in The Antidepressant Web? Before and since publication of this paper, correspondence has developed with some of the main authorities concerned - mainly organisations representing government, the medical profession and pharmaceutical companies.

The correspondence with government began in July 1997, and has developed mainly as an exchange of views with the Medicines Control Agency/Committee on Safety of Medicines. Supporting representations were made to the Secretary of State for Health, the Prime Minister and Chief Medical Officer of Health, also  the European Medicines Evaluation Agency. See also correspondence with the Select Committee on Health, the Select Committee on Public Administration and the Committee on Standards in Public Life.

See also correspondence relating to an important underlying issue - health problems caused by the abuse of secrecy, and the need for freedom of information. The correspondence arises now because the government published a White Paper on Freedom of Information in December 1997. The spirit of this paper is good and firm, but there seem to be real problems with the suggested definition of "commercial confidentiality", one of the main exceptions to the proposed new openness rules. See letters to Dr. David Clarke, Chancellor of the Duchy of Lancaster, and the Cabinet Office.

4.4 Matters arising: correspondence with medical organisations

One month before publication of the paper, essentially similar letters were sent to the Presidents of both the Royal Colleges of Psychiatrists and General Practitioners. Questions about the involvement and perspective of the Colleges were raised, and comments requested. The RCGP sent a couple of postcards saying these matters were "receiving attention", but never replied. Attached to the reply from the Royal College of Psychiatrists is an independent opinion from Professor Malcolm Lader. (He was one of the first to identify dependence problems with benzodiazepines. See The Antidepressant Web paper at 3.1).

4.5 Matters arising: correspondence with pharmaceutical companies

At an early stage in preparing the ADWEB paper, letters were sent to all manufacturers of SSRIs requesting "full prescribing information". Perhaps this request was misinterpreted: companies sent data sheets only. Requests were then made for the Product Monograph and/or for comments on a few specific questions. The generally slow and guarded responses made this seem an unpromising avenue of enquiry. Neverless, most companies made an effort, particularly Pfizer Ltd.

SmithKline Beecham (paroxetine) altogether refused to treat on the grounds that this would contravene the Code of Practice of the ABPI (Association of the British Pharmaceutical Industry). These were professional matters, not for lay people. This ill-tempered correspondence is reproduced in full. Click here

After several reminders, Wyeth (venlafaxine) eventually responded seven months after the original request. They had clearly taken trouble in responding. The main paper enclosed is briefly discussed in section 4.2, but the Company declined to discuss matters arising and asked that correspondence not be posted on this website on the grounds it was "confidential". We agreed, not because it seemed confidential, but because we hadn't advised them about (or even planned) publication on this site when we first contacted them.

See also the review of four trials, sponsored by Eli Lilly & Co - posted during November/December, 1998.

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