| The Independent:
Hundreds of thousands more schoolchildren should be treated for attention deficit hyperactivity disorder (ADHD), say leading experts.
A recent BBC File on Four program on Antidepressants in Children, presented by Paul Connolly, has drawn disparaging comments on posts here. Here is some background detail. I was interviewed for the program. My messages were as follows:
It was clear to me that Paul Connolly, although expressing shock just like Chris van Tulleken some months before at what I laid out, was not going to include this material. Chris was somewhat the braver of the two. He rather subtly skewered NICE – but probably too subtle for most people. A week before the programme ran, there was an email from File on Four saying that owing to space constraints I was one of several people being omitted.
What File on Four ended up was a combination of the irritatingly anodyne and bizarre. What is the definitive answer about whether antidepressants work, Paul Connolly asked – no one knows he said. There are definitive answers the public deserve to be told about but FoF bottled it. Doctors are all at the mercy of clinical trials, he said, before turning to Ian Goodyer, someone who has pushed antidepressants for children for years who said on the basis of the biggest trials with 475 children he could tell us that fluoxetine (Prozac) worked in 67% of cases rising to 80+ %. I’d fail a medical student who offered me this answer if presented with the results of the TADS trial – the one Goodyer was talking about. There is no good evidence fluoxetine worked in this trial. Goodyer omitted to tell us that there were 34 suicidal events on fluoxetine compared to 3 on placebo. Goodyer made something of the fact this was the biggest trial of Prozac which sounds good but isn’t the biggest – not by a longshot. Even if it were the biggest, Goodyer fails to appreciate that the bigger the trial the greater the chance you can show snake oil works. If drugs are worth it, small trials are all that is needed. Prozac, fluoxetine, is in fact the drug with more negative trials than any other. These points are irritating. The bizarre one was that FoF made Andrea Cipriani out to be the radical outlying voice. AC’s work is totally controlled by industry – he knows he has no access to the data and his work is based on ghostwritten or company written reports . He’s a very nice man but the idea that he is a voice for caution as regards the use of antidepressants is bizarre.