A new analysis finds that a notable portion of treatment guidelines issued in recent years by medical societies and government agencies for combating mild depression were compiled by individuals with financial conflicts of interest or lacked other safeguards to ensure impartiality.
Of 172 people who participated in 14 guidelines committees, 18 percent had ties to drug makers that sell antidepressants, and some had connections to more than one company. Five guidelines, meanwhile, recommended antidepressants as a first-line treatment for mild depression, and four of those — or 80 percent — had panelists with some type of financial connection, according to the analysis in Psychotherapy and Psychosomatics.
Meanwhile, none of the organizations that recommended antidepressants had a methodologist or research analyst involved. But seven of nine — or 78 percent — of those that did not recommend antidepressants did include such experts, who should be used to bring inter-disciplinary scrutiny to the guideline process, according to recommendations issued several years ago by the National Academy of Medicine, a non-profit that provides advice on health issues.
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One reason the guidelines for antidepressants are subject to influence is that the current FDA Guidance (below) is antiquated, written in 1997. Doesn’t even mention the DSM, and uses terms like endogenous versus exogenous depression, distinctions that have little meaning for the way that modern psychiatry treats depression.
https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM071299.pdf
Most antidepressants are prescribed by primary care physicians most of whom don’t know the first thing about psychopharmacology. The patients often wind up seeing the shrink due to medication mismanagemen by the idiot GP who produces an iatrogenic serotoninergic crisis because they were unaware of the taper guidelines for SSRI’s.