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Re: I never say never - advice from a pharmacologist madeline

Posted by Larry Hoover on May 10, 2006, at 10:59:37

In reply to I never say never - advice from a pharmacologist Larry Hoover, posted by madeline on May 10, 2006, at 7:58:05

I do appreciate hearing all that you have said here, Maddie. I spent a few years under contract for one of the big NGOs, basically being the ultimate critic of all published work in specific and narrowly-defined environmental realms. My work permitted them to ask the right questions, you see. Things get changed when you ask the right questions, the right way. About one third of the studies I examined absolutely failed to support the published conclusions. Another third of the studies were suggestive, but inconclusive, notwithstanding the conclusions published (methodology/analysis problems). I'm feeling generous to offer that the remaining one third advanced our knowledge in any way. I do sometimes revive the cynical critical viewpoint in discussions here. Many mountains of opinion have been generated in response to molehills of data, and the culture we currently populate often allows the substitution of the opinion over the data themselves. An example is dietary advice. You don't know what to eat any more.

You've given excellent advice, that waiting a few years for experience with a new drug to come into existence, before joining with the rest of the guinea pigs, is preferable. To verify all the information you gather. To become an informed consumer. I think we're lucky, though, to have the training and experience to make those informed decisions.

I did not mean to vilify big pharma. The drug studies that are used to obtain FDA approval were never designed to collect data about e.g. suicide or suicidal ideation, as an example. They were designed to demonstrate efficacy. They were designed to demonstrate a significant difference in treatment outcomes, based on some a priori standard. We ought not to fault these studies for failing to do that which they were not designed to do.

Drug companies could not make the discoveries that they do without the cash generated from patented research that also made it to market. That cash funds the ablest minds in the world, not only in their own laboratories, but academics, too. But it also funds marketing. And accountants. And all the suits on Wall St. And, in the end, it is the accountants that make the decisions, IMHO. In the end, it all comes down to money.

I'm reminded of a conversation I had with a professor who discovered that certain people with mood disorders are especially sensitive to the artificial sweetener, aspartame. His preliminary work was suspended, for ethical reasons, as the adverse effects were pronounced. In the aftermath, he was unable to obtain funding for any follow-up work. Moreover, none of his recurrent research grants were funded again, after the existing terms expired. Without funding, he was effectively "retired". It's all about the money.

I came by my cynicism honestly, but I did not mean to generalize my opinion quite so literally. I apologize for any ill feelings arising from my remarks.





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