Comments from Readers

Subject: Re: Anatomy of an Epidemic

Dear Mr. Benedict

Looks like I missed an interesting discussion.

The difficulty here, and I am not going to get into this, is that I could get one- if not more- reference to contradict these.

Our clinical practices are based on preponderances of evidence and not one trial that shows this or that. The process isn't perfect, but our current treatments help many people.

Again, we can do better, and we need to continue to work on new and more effective treatments with fewer side effects.

Dr. Smith
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Dr. Smith  - Thanks so much for responding to my message to the Wisconsin Council on Mental Health. I should say first that unfortunately there was no time available for any discussion of Whitaker's book other than my brief recommendation that these new long-term outcomes studies are now more conveniently available to the public and to all mental health care stakeholders.

As you no doubt know these long-term outcome studies are in stark contrast to the FDA phase three clinical trials for new medications. The former tend to be more short-term and narrowly conceived and only report on the volunteer patient's short term clinical response to the particular medication under review.

Long-term studies are usually designed much more broadly -- from the onset of treatment to 2, 4, 6, 10+ year follow-ups -- to examine the patients' actual community functioning while or after they stop taking the medication. These are usually based on global functioning rating scales and a set of quality of life indicators including degree of financial independence, over all health, family functioning, education/training, affiliations, etc...

While the federal government has recently made available to NIH and FDA for such long-term outcome mental health research funding, both groups have been slow in making use of such funding.

If you are aware of any such long-term studies beyond what Whitaker has given us, we would very much appreciate seeing even one of them.

I should also add that such studies are much more systemic and go beyond the clinical safety and efficacy of a single drug or regimen. The focus of my particular advocacy is toward encouraging concerned citizens to simply become more aware that such studies now are available to the public.

Again, it was so nice of you to respond to me. I would very much like to continue our discussion.

Most respectfully,
Bill Benedict

(Reader names are fictitious to protect the confidentiality of the reader)