March 24, 2025 - Epoch Times
07:05
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| Time | Text |
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| If you have ambitions to be a professor at Yale, Harvard, one of these big institutions, the way you do that is mostly by getting funding for research. | |
| It's by getting a lot of publishing a lot, flying around the world to talk about something. | |
| You need all of these things to bolster your reputation as an international expert in this area. | |
| Now, the best way to do that, at least in psychiatry, but I suspect in other areas in medicine, It's actually to collaborate with pharmaceutical companies to run clinical trials. | |
| They write the publications for you, most of it. | |
| They do a lot of the grunt work. | |
| They give you the protocols. | |
| And essentially, they fund you and fly you around the place. | |
| And I used to remember, as a junior doctor, looking up to the professors and they would say, you know, these drugs, they're safe and effective. | |
| There's not a lot of problems there. | |
| And I don't know that they're doing this. | |
| I don't know that their careers and their career success has been tied to running these trials and that they could be biased in a way where they're going to want to talk about the drugs in a more favorable light because if they started saying negative things about them, they would compromise their ability to run more of this research and kind of be picked to do this thing. | |
| And so I would be looking at these professors saying, They must be clinical experts. | |
| They must know more about the totality of psychiatry and how to help patients. | |
| But what I've seen more and more is that they've been compromised and that they have incentives tied to the money and to career advancement that means that they can't be as forthright as they ought to be about these things. | |
| And it's gotten to a problem where... | |
| These are the professors who are training the doctors, who are setting the tone for what is acceptable care out there. | |
| And I think that's one of the biggest problems out there, because that's why I got ostracized at the start, because it was like, why is Joseph saying these things that all of these esteemed professors around the place, if what he was saying had any weight, surely other people would be saying this. | |
| But you're going against the grain, and it's because there's... | |
| Perverse career and financial incentives there. | |
| Right. If you're financially incentivized to believe something, it's a lot harder to change your mind. | |
| Not because you're doing it deliberately even, but just because there's so much benefit caught up in maintaining the belief. | |
| And you also see it with news organizations. | |
| If you're getting a lot of advertising revenue from pharmaceutical companies, are you really going to run that story? | |
| If you're a medical journal and you make a lot of money from reprints about clinical trials that are kind of skewed to tell a more favorable story, are you going to maybe lean into some of your suspicions that it hasn't really been represented right? | |
| Or are you just going to go with it because financially it works for you? | |
| And so you kind of see how this billion dollar industry has Money has sort of subtly corrupted all of these things to a point where people are getting hurt, and doctors think they're helping people, but they haven't been given accurate information. | |
| Many people that are being placed in high positions in HHS, whether it's FDA or NIH, which come to mind immediately, are change agents. | |
| In this area of yours where you're looking at these rare injuries related to using antidepressants or coming off of antidepressants, what would you say to these change agents about what they might want to look into right off the bat? | |
| Well, let me start with something softer. | |
| I think the culture... | |
| There needs to be a change in the culture where people are looking a lot more closely at the incentives of the pharmaceutical industry and how that has swayed public opinion and research. | |
| Directly in psychiatry, we need studies on the long-term benefits and risks of these medications right now. | |
| Without getting too in the weeds, the rationale for using psychiatric medications long-term is based off something called a relapse prevention study, where essentially you get 100 people on the drug, and then you split them into two groups. | |
| One group continues the drug, the other group gets tapered off the drug, usually on an average of five days. | |
| Some of these people have been on the drugs for quite some time. | |
| And then they look at relapse. | |
| These studies are completely confounded by the fact that pulling people off the drugs quickly can look like relapse. | |
| They're completely compromised. | |
| This is the evidence base right now that we use to justify putting people on medications for several years. | |
| And so we need people there who could be brave enough to say, we've been doing this wrong at the FDA. | |
| We have not been designing these studies in a way that... | |
| It's sufficiently solid and scientific, and we need to do things differently. | |
| We need to ask these drug companies to do longer studies that match the duration of use, you know, I think two years, three years. | |
| Let's look at how these drugs perform compared to things like lifestyle interventions, diet, exercise. | |
| And so we need this long-term data. | |
| NIMH, at the moment, it's meant to be our public, you know, the people generating Research to help the public. | |
| It's meant to be independent of the pharmaceutical industry, the government protecting the people through research. | |
| We need that organization to be doing this research. | |
| Right now they're doing something called RDoC, which is esoteric brain-based research, but there are a lot of problems affecting Americans right now. | |
| Right at the center of it is how effective are these drugs long-term. | |
| It needs a fresh look, and that's really where... | |
| Personally, I would start. | |
| I mean, on top of that, I think we need education campaigns out there. | |
| We need the NIMH or another government group to endorse a slow tapering guideline to get people safely off the drugs, and then also to inform family medicine doctors and psychiatrists and different practitioners to say, The evidence for long-term use is kind of shaky. | |
| There are these new risks that you should be aware of. | |
| Share this with your patients. |
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