Antidepressant Withdrawal – The Enemy Within

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November 18, 2019 | 47 Comments


  1. Early in a career…Just dandy

    Later in a career, when one would have expected all the docs and nurses to come out, it is disappointingly obvious that there are so few voices – this is so obvious …

    Get a load of this, look what everyone had to say about it …

    DH 2 DH
    February, 25, 2019 | 35 Comments

    Burn Baby Burn
    March, 13, 2017 | 35 Comments

    So when some future historian in a very few years from now, looks back at this period and wonders about the senior figures in the field – the Jean Delays (Slide 6) – in the UK they will have Sir before their name – will say they say it was a time when the field’s significant figures tweeted while psychiatry burned?

    Simon Wessely‏ @WesselyS 6h

    “Stop telling women they’re mad, when they’re actually ill”. Is this the worst @Telegraph headline ever? Nothing wrong with the story – of course get the diagnosis right – but do I really need to spell out why the headline is dreadful?

    This is the worst form of Psychiatric Analysis that comes from someone totally indoctrinated with Psychiatric bias, and I, for one, am appalled, that this comes from someone who has held back the past, with the young, enthusiastic psychiatrist.-

    This sort of outburst has led Peter Gordon to cease his career as a doctor (undoctored) and I am very mindful that using examples, of two psychiatrists, can only end in tears …

    I am also mindful that David is careful not to criticise his Fellows, but, sometimes, we need to let go …

    70 comments in all, read all about it … get the gist

    Let it all, Fly …

  2. His letter should be the warning label truly. Unfortunate he suffered through this alone or that anyone has to. “Let them” (those in charge of the labeling) “Eat Prozac”. Wonder how long it’d take for labels to state the truth?

  3. The NHS is great but I fear it’s being deliberately destroyed by deceitful politicians who secretly want to privitise it. Big pharma and insurance companies from America want to get their dirty grubby hands on it. Well all I can say is they will be in for the fight of their lives because the general public will not let them have it.

    As for the SSRI withdrawal advice from the NHS I’m sure they get that from either the nice guidelines or the MHRA and we all know how useless and out of touch they are when it comes to antidepressants.

    You used to be able to leave comments on the NHS Website, I left a comment under SSRIS and Alcohol years ago and they did say they would look into it but when I went back to check my comment had been removed along with their reply. I’m not sure you can leave comments there anymore.

    They give very out of date information with the bare minimum of advice for SSRIS

    It’s very poor advice considering its the NHS website.

    • An advert in thebmj today – shame on them

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      • Private healthcare is just que jumping that’s all and you pay a lot for it. Same Surgeons and Drs who also work in the NHS. What they don’t tell you is in the event of an untoward incident the private clinic does not have a Coronary Cardiac Unit, HDU or ITU dept. You will be blue lighted by ambulance to the nearest NHS Hospital.

        But they do have nice carpet and curtains and an in-house chief apparently.

  4. NHS.


    In the interest of the “Duty of Candour”, and “Evidence Based Medicine”.

    Suggested amendment to text: ————->


    “Withdrawal symptoms may include”:

    *”AKATHISIA”. (aka – “Restlessness”.)

    AWARENESS of AKATHISIA, its prompt recognition and immediate management affords the opportunity to save life.

    AKATHISIA AWARENESS is also necessary to prevent the misdiagnosis of this common Adverse Drug Reaction (ADR) as “Serious Mental Illness”.

    Misdiagnosis in psychiatry destroys every aspect of the victims quality of present and future life.
    In addition, misdiagnosis becomes the false justification for an enforced cascade of totally unnecessary, and highly contraindicated, toxic, psychotropic drugs.

    Such a prescription drugging cascade leads to a multiplicity of further serious and/or life-threatening, multi-systems drug injuries, and inevitably, further serial psychiatric misdiagnoses.
    This drugging is likely to be enforced after “Section” for ADRs.

    Surely, involuntary detention for adverse drug reactions, where there is not, and never has been, any mental illness, must equate to False Imprisonment?

    Intercurrent withdrawal syndromes add to the intensity and duration of the victim’s suffering as psychotropic drugs are suddenly stopped and replaced with even more toxic “alternatives”.

    What does “RESTLESSNESS” add to patient safety or to Health and Care Excellence?

    The resultant physical, emotional, societal, financial, relationship, and other ADRs to psychotropic drugs are devastating, and may be lifelong. (Albeit a shortened life).

  5. I have had an idea which might work in the long term in regards to getting the evidence and help needed for those damaged by antidepressants.

    It could also help deal with the more wide scale problem of the damages being caused by prescription drugs in general, and the seeming inability of the medical establishment to acknowledge, or deal, with this very real threat to human life.

    It is a little long to read, and it might be a bit logistically difficult, but here goes anyway.

    I watched a documentary recently which got me thinking.

    The documentary was about the DuPont chemical plant in the USA, and was called “The Devil We Know”.

    It came out in 2018. It is available to watch on Net flicks, but unfortunately I don’t think it is on you tube yet.

    To give a summary of the documentary;

    In 1945 DuPont started making Teflon, a non stick product used on cooking appliances, clothing (to make it water proof), and it is also used in a variety of other day to day appliances.

    Over a number of decades people who worked at the DuPont chemical plant in West Virginia started suffering a whole range of health problems, and also started developing cancer at a much higher rate than the general population, and their children also started being born with birth defects at a much higher rate than the general population.

    Also people living in nearby towns to the chemical plant started suffering from the same sorts of health problems too, also at a much higher rate than the general population. It didn’t take too long for some of these people to start thinking that this might have been from their exposure to some of the chemicals used in the process of making Teflon, when working at the DuPont chemical plant; namely the chemical called C8.

    In 1997 a farmer who lived near the chemical plant started noticing his cows were becoming ill with a variety of strange symptoms, and a large number of them started dying, and also a large number of their calf’s were being born with defects.

    In the late 1990’s to early 2000’s, both the farmer and past employees of the chemical plant started asking questions about the safety of the chemicals used in the plant, and what long term effects might be caused by being exposed to them.

    To cut a long story short they were ignored, fobbed off, were subject to ridicule, harassment and threatening phone calls, and given misleading and irrelevant answers to their questions, for quite a long time, but eventually they started to get some answers.

    What slowly and eventually came to light was that DuPont had not only known since the 1960’s about the dangers to its employees from being exposed to C8 while they worked at the chemical plant, but that they had also been dumping large amounts of the chemical as waste into a large river which supplied many of the nearby towns drinking water, and that they had been doing this for decades, exposing hundreds of thousands of people to dangerous levels of the chemical.

    A short while after this, with people still suffering an array of health problems, people started to get in touch with lawyers, and a class action law suit started to form.

    During the court case where lawyers were able to have access to DuPont company files, it became apparent that the level of knowledge that the company had to the dangers of C8 was a lot higher than first thought. They had even done quite extensive studies on rodents showing they developed all sorts of health issues, cancers, and birth defects when exposed to C8.

    There had been people within the company who had raised concerns about this, even suggesting the C8 chemical be replaced with another chemical, but as the company was making so much money from Teflon (multi billions of dollars annually), and because there was no one forcing them to change the chemical, they decided it was better to stick with “the devil we know”, which was a quote from one of their companies memos, and hence the name for the documentary.

    It also became apparent DuPont were also fully aware of the dangers of pumping the chemical into the river, and there had been concerns raised about this too, but disposal of the waste by other means had been deemed too expensive and time consuming, so they continued to do so, knowing the likely harm being caused to hundreds of thousands of people.

    Right to the bitter end during the court case, the people responsible at DuPont and their lawyers tried to bend, twist, and distort the truth, about what had really happened, time and time again. They also tried to avoid responsibility at almost every opportunity. To see the extent of this you will have to watch the documentary.

    It also became apparent that the US Environment Protection Agency (EPA) which was set up to regulate and police companies like DuPont, was in effect in the control of DuPont, and memos and emails between DuPont and the Environment Protection Agency showed that DuPont were telling the EPA to downplay the dangers of C8, and effectively lie to the population about the level of harm they were being exposed to.

    The EPA did indeed lie for DuPont, and by doing so DuPont had gained control of governmental decisions in regards to the safety of their chemicals. The documentary goes into more depth about the corruption, dishonesty, and betrayal of hundreds of thousands of people by the US Environment Protection Agency. ( *I feel this has a lot of echoes with how the MHRA are ineffective in regulating and policing the safety of medicines in the UK, putting millions of people at risk, and as we know, people who are responsible for decisions at the MHRA, often have conflicts of interest with the pharmaceutical industry).

    In 2005 DuPont agreed to settle the case for 343 million dollars, while still trying to downplay the dangers of the chemical C8 etc.

    But something was different with this class action court case.

    In a ground breaking decision the plaintiffs refused to take individual payments.

    What was done instead of spreading the money between claimants, was to use the money to set up a C8 science panel to thoroughly investigate in as much depth as possible the harms caused by C8, and in effect get the evidence needed to conclusively prove these harms.

    It was agreed in the court case that if this conclusive evidence was found by the science panel, that individual claimants could then sue at a later date, using this stronger evidence. If no evidence was found, then individual claimants would not be able to sue at a later date.

    DuPont were quite confident that this evidence wouldn’t show up, as a health study on this scale had never been done before, and so agreed to these terms to end the court case.

    The C8 science panel used some of the money to get people who had been exposed or potentially exposed to C8 to come in and have their blood tested, and to have access to their medical records. 70,000 people agreed and participated in this, making it the largest health study in the world ever done.

    It took 7 years to complete this large scale health study, but in 2012 the results came back.

    The eyes of the world were on the health panel, when they were able to announce that the chemical C8 had been un questionably linked to 6 human diseases. These were; Kidney and Testicular cancer, Thyroid disease, High cholesterol, Ulcerative colitis, and Preeclampsia.

    As a result of these findings, anyone with one of these 6 conditions could then sue DuPont for personal injury. Over 3,500 individual law suits have been filed against DuPont since the C8 panel findings, with payouts of 1.6 million and 5 million being awarded in two individual cases.

    By 2015 the manufacture of C8 was banned, and no one can make C8 anymore.

    This is my idea;

    What if we were to try to do something similar to what happened in the DuPont court case, in regards to the damages caused by SSRI’s, but particularly with PSSD.

    What if when the time is right, and there is enough supporting evidence, we find a way to collectively sue the drug companies in regards to PSSD, in some form of class action type law suit.

    Then instead of people with PSSD accepting individual payments, we could use the compensation money collectively to set up a science panel like in the DuPont case outcome, to further and hopefully undoubtedly prove the harms being caused by SSRI’s.

    Then like in the DuPont case, once we have this hard evidence, individuals who have been damaged by SSRI’s should ideally be allowed to have the option to individually sue for personal injury.

    We could use the compensation money to organize a large scale health study in a similar way as was done in the DuPont case, and once a test has been established showing evidence of small fibre neuropathy or any other abnormality found in people with PSSD etc, we could again use the compensation money to try and get people who have been exposed to SSRI’s in general, to come in and get tested to see if they show signs of any abnormality too.

    We could then ask people who have never been exposed to SSRI’s, to come in and get tested also, and use the results from their testing as a control variable against the people who have taken SSRI’s, showing any abnormality is only present in those that have taken SSRI’s previously.

    We could request access to medical records like the C8 science panel did, to prove they were or were not prescribed SSRI’s, and to rule out other potential factors, strengthening our case further.

    A wide scale health study like this could potentially prove that hundreds of thousands of people may have developed a milder form of PSSD, could possibly pick up other harms caused by SSRI’s, and also un questionably prove the existence of PSSD once and for all, with the hard evidence to back it up.

    Doing something like this could also potentially help develop our understanding of how the nervous system (and possibly endocrine system) works in general, and possibly further our understanding of why withdrawal symptoms can linger on for years, decades or even possibly be permanent in some people, while others are barely affected etc.

    It could also get other scientists and researchers interested, helping to get research into harms caused by prescription drugs carried out more quickly, by a wider variety of people.

    We could also potentially set up our own unofficial drug regulation agency to rival the MHRA, free from conflicts of interest with the pharmaceutical industry, much like Rxisk is trying to do now, but with a large financial backing which would enable us to do the work needed that the MHRA is either unwilling or incapable of doing.

    This financial backing would give us the best chance to prove the harms being caused by prescription drugs, within a much shorter time frame, rather than the many decades it usually takes for the harms from a prescription drug to become known presently.

    This would mean that thousands of people would not have to endure years and decades of not being believed, whilst also being ridiculed and generally treated badly by the medical establishment, which is what usually happens presently.

    It would also mean that potentially the harms and damages caused to people exposed to prescription drugs would be greatly minimized, as people would be warned of the potential risks much more quickly, and hopefully solutions for those already harmed would develop much more quickly.

    What I am suggesting ( based on the DuPont case, and a collection of my own and other peoples previous ideas) is a kind of health revolution, driven and financed off initial compensation from a collective court case.

    It might take a long time to achieve, and it won’t be easy, but if the people in the USA who were damaged by C8 can do it, why not us who have been damaged by SSRI’s?

    • Thank you for this. It’s hard to believe that regulatory agencies like the EPA and FDA fail to do their jobs and protect companies over individuals in many instances. But history repeats itself. I like the idea. The problem comes in with the linking specifically with PSSD. No empirical testing confirms the damage but we know it exists through thousands of patient accounts. Additionally their failure to warn is not like DuPont because there is mention of it on the label in some way. This protects them. Now suicide with SSRIs May be a different story.

      • Jayme, there has been no mention of persisting sexual dysfunction caused by SSRI’s and SNRI’s in the drug leaflets (apart from one drug company mentioning it in the Fluoxetine leaflet) for people who have taken these drugs since the late 1980’s to the present, so this wouldn’t apply to the people who have PSSD presently.

        They are only now in the process of trying to include the warnings in the drug leaflets since the June 2019 acknowledgement by the European Medicines Agency.

        • Spruce – did you get anywhere with possibly a letter to follow up why the BNF hasn’t included PSSD? Seems the publication is a joint effort involving the BMA and the publishing arm of thebmj? It supposedly updates twice a year on line so it’s not like updated the book entries of years ago….

          • I emailed someone at the BNF, but they then told me they couldn’t deal with it personally, and passed me an email for someone else who deals with the editing at the BNF. I am really caught up with stuff at the moment, but will be getting on the case in early January once Christmas is over etc.

            Don’t worry i haven’t forgotten for a moment, and will let people know the response i get.

  6. Spruce this is a very good idea. I also think there should be another MHRA for the patients, one that listens and reports on every single side effect reported. Rxisk would be a good alternative.

    Having another independent medical agency to report side effects will more likely stop corruption and cover ups from happening in the first place.

    MHRA clearly are not listening to patients.

  7. Addiction or rather habituation with SSRIs is something that is not warmed but a reality that can be attested too. So this could be litigated as there are no warnings specifically that once you start these drugs you may not be able to stop. Also, there is no formal plan by any of these companies for addressing this issue. So if there is evidence (which I’m inclined to believe there is) that these drugs are “addictive” than not only is there a failure to warn but also a neglect in dealing with a problem they’ve created that adds to their profits. I’m pretty sure that’s illegal.

  8. Seroxat is alleged to be defective within the meaning of section 3 of the Consumer Protection Act 1987 (CPA)

    On 8 November 2019, the English Court of Appeal handed down judgment in favour of GlaxoSmithKline (GSK) on the permitted scope of the long-running Seroxat litigation.

    This case relates to an action for damages, brought by a group of Claimants, arising from their use of a prescription-only antidepressant drug, Seroxat. Seroxat is alleged to be defective within the meaning of section 3 of the Consumer Protection Act 1987 (CPA) because of a single aspect of its adverse event profile, namely symptoms upon discontinuation. The Claimants allege that Seroxat is “worst in class” for discontinuation symptoms when compared with other drugs in the comparator class.

    A judgment that will “benefit” manufacturers facing the “risks” of products litigation

    It remains to be seen how the Claimants in the Seroxat litigation will proceed following this judgment. In the meantime, manufacturers of complex products, and their insurers, will take note of a judgment that follows hot on the heels of Wilkes and Gee and endorses using a risk/benefit analysis in determining if a product is defective.

    A copy of the judgment can be found here

    • Thanks for this Annie – Surprise surprise in this case they have just crawled through a loophole. Do you think a class action would get anywhere using this part of the Consumer Protection Act?

      • Thanks for the million-dollar question, Susanne

        For the benefit of everybody, this is how the Consumer Protection Act was viewed by the Judges in relation to the Claimants view that Seroxat

        “Is defective within the meaning of the CPA”

        The hearing, using the CPA, by the Judges, does cause some alarm bells…however, there is no dispute that Seroxat is defective, but, it does look likely that it is problematic, so, yes, using the CPA as a tool, in the Seroxat Group Action, does make the spine tingle used in the way that they, the Judges, have used it

        The Claimants’ Lawyers

        These symptoms often included impulsive suicidal thoughts, thoughts of self harm and uncharacteristic aggressive behavior. Their withdrawal symptoms were so severe that the only way they could be avoided was to return to their previous daily dose. Several of the current Claimants were minors at the time they were prescribed Seroxat for transient mental healthcare problems.

        Several Group Actions have been settled in the US following Court proceedings related to harm caused to individuals who had become dependent upon Paxil (Seroxat in the UK) – an FDA approved and prescribed antidepressant.

        “It is ironic” says Claimant Bob Fiddaman “this British company has compensated Americans for the harm caused to adults and children who became dependent upon its antidepressant Paxil (Seroxat) yet UK citizens have had to fight for years to have their case heard. We may now only be a group of 105 Claimants but we are determined to gain compensation for the harm caused to us.”

        ‘Within the meaning’ of the CPA … ?

  9. Everyone who has had their good health severely impacted by these medicines should have a right to sue and be compensated, accordingly.
    If you, the consumer, were not informed of the implications of ingesting these medicines and you endured pain and suffering, of course you should be rightfully represented.
    If the Viscount sued and was successful, why can’t this be a privilege for all who have suffered?
    In order to be successful, one requires a whole myriad of professionals to back up individual(s) who have suffered by the ingestion of these medicines.
    If it is swept under the carpet, how can one have any hope?
    People need support to receive what they rightfully deserve.

    • Excellent, as always, Carla

      Importantly, for me, was to address all the shortcomings I experienced from medical practitioners ranging from abuse through to medical negligence through to malfeasance …

      It was a ghastly mess.

      I discovered that trying to sue a medical practice/hospital was pretty impossible.
      I went through all the hoops, my lawyer got the legal aid, I told the story, but, everything was based on the evidence of a gp whose job it would be to read my medical records and write a report.

      The report eventually arrived.
      It totally vindicated the doctors.
      She had never heard of Seroxat inducing any harmful side-effects..

      Then there was my MP.
      He was tremendous. Kind, caring, extremely interested and helpful..

      He received a letter from Andy Burnham, MP, Dept. of Health, on 17 July, 2006. and forwarded it to me.


      Dear Alan

      The safety of Seroxat has been under review by the Medicines and Healthcare Regulatory Agency (MHRA) since first marketing. Ongoing concerns about the safety of Seroxat in early 2003, including issues raised by Dr. Healy, the Seroxat Users Group and Panorama, stimulated a review by an Expert Working Group of the Committee on Safety of Medicines into suicidal behaviour and withdrawal reactions associated with Seroxat (paroxetine) and other antidepressants of the same class

      The detailed report of their review was published in December 2004 to coincide with the publication of guidelines on the treatment of depression by the National Institute of Clinical Excellence.

      Overall, the Expert Working Group concluded that the balance of risks and benefits of all SSRIs in adults remains positive. However, prescribers and patients should be more aware of the side effects profile of these medicines and the need for close monitoring of patients being treated for depressive illness or anxiety disorders. At that time a letter was sent to all health professionals providing the key findings of the Group

      At the same time as the Expert Working Group’s review, a detailed review of the balance of risks and benefits of Seroxat was conducted by the European Commissions scientific advisory committee, the Committee on Medicinal Products for Human Use. The Netherlands took the lead in the review and the conclusions were consistent with those of the Expert Working Group

      The safety of Seroxat remains under continual review and earlier this year GlaxoSmithKline, which manufacturers Seroxat, published an updated analysis of their adult clinical trial database. These data are under consideration by the MHRA, other European Regulatory Authorities, and the Food and Drug Administration in the United States of America and new prescribing advice will be issued as appropriate

      Best wishes, Andy

      A few years later having had diabolical reactions to my complaints from both the surgery and the hospital, including one from Canada, where the owner of the surgery was in the process of folding-up, after a disastrous attempt at running a practice, I wrote to the Scottish Ombudsman.

      Everything that was said, was based on ‘we cannot take your complaint after one year.’.

      Well, my lawyer managed to overcome, that little problem…

      Unless you have an expert with you, fighting your corner, holding your hand, it seems absurdly impossible to sue. Even then…

      Also, Clinical Directors, who have never met the patient, making agreements with NHS Highland, on the phone, who knew nothing of this, wreaks of sabotage..

      It’s tough out there…as Luke Montagu found out…

      • Annie – just sent Andy Burnham a copy of a paper describing years of misdeed and successful legal actions against pharma companies in USA. His response is ‘we take your concerns seriously’ really? and that was that.. just like the football disaster in his constituency took decades to come to court – let’s hope our ‘concerns’ won’t be take that much longer. I went through all the hoops with a complaint not a concern and landed with the ombudsman who advised me to discuss them with the Quakers ‘because they are good at that sort of thing’. Couldn’t get an answer to whether he was a Quaker himself . My last letter pointing out that he needed to act according to his appointment was ignored. The black hole or shredder of letters ignored …

  10. Thank you kindly, Annie.
    Professionals, if they know that these medicines are inducing harm, should not shy away or be afraid of speaking up.
    True, courageous, leaders, speak up on behalf of their patients.
    Prescribing a medicine, should not be a game of chance.
    If one speaks up, then other courageous souls are likely to follow.
    It is about doing what is right and standing up for a cause.
    One day, this is how I see it, the prescriber, may be on the receiving end and wouldn’t it be nice to know that because of ‘us’, their lives take a different road map for the better.
    By educating one person at a time the ripple effect expands exponentially.
    What has happened to us can happen to anyone and when it comes to medicines that harm, they do not discriminate.

  11. Sadly, Annie: The Problem Is Quite Evident~
    There is too much A#s covering!
    Too many lies, too many excuses, too many loop holes etc. etc. etc.

    Totally agree with you, Annie on the below statement:
    Unless you have an expert with you, fighting your corner, holding your hand, it seems absurdly impossible to sue. Even then…
    When you go down a Legal path, you want certainty not ambiguity.
    The ones in denial and the ones who lie, twist everything around and make you into an A#s!
    If you are dealing with liars, you end up with mud on your face!
    I believe in NATURAL JUSTICE, if the LAW has not given us the JUSTICE we rightfully deserve.
    TRUTH prevails in the end, even though it has not been tried and tested in a court of Law.
    The more you know, the more defiant they are!
    People who have great wealth can buy power, so what is the point! ~ Someone, prove me wrong on this theory!
    When the court processes can be sometimes corrupt, Lady justice always seems to have her scales in favour of those who have power and money. ~ Do I really want to associate with people who obscure Justice? ~Hell No!
    Good lawyers with good intentions may get bought out, also.
    Someone, please tell me how can the little man ever have a chance, if they are plagued with corruption within the system. There has to be a loop hole, somewhere…………………..!
    The show must go on, whatever, this may be. We have to outsmart those who have wronged us and thanks to RXISK, I believe this has already been achieved.
    Sadly, the TRUTH upsets those who don’t want to know.

    • Thanks Carla.


      Professor Sir William Osler.

      Regius Professor of Medicine. Oxford – 1905, until his death aged 70.

      Canadian Physician. Advocate of “LISTEN TO YOUR PATIENT”.

  12. You are very welcome, Tim.
    Minimise Risk, is my motto.
    Once the damage is done it is too late :'(
    When something happens and it is out of your control, there is not much one can do.
    However, if you rely on google, glossy brochures, silver tongues and experience, this is not the answer, either.
    If you do not have enough information one can not make an informed decision.
    In an age of information, ignorance is a choice.
    I did not have the information or knowledge back then but now I have a bit of it and I question everything.
    I don’t leave things to chance, anymore.

  13. ‘Chance’, or ‘Chancers’ …

    David_Healy says:
    April 4, 2012 at 10:24 am

    Jamie if you choose to read an increase in suicides that might have arisen by chance as not actually an increase you’re welcome to do so but its rather like regarding a gun as not loaded because some of the barrels are empty and if you take your chances you might be okay. If you can find me a regulator or company person who would join you in such a roulette, let me know.

    When I asked why the two sentence advice from the BNF could not be in the public domain I was told that “it is not feasible to have a public campaign to inform all patients about the side effects associated with all of the medicines on the UK market”. I replied that SSRIs could be classed as a group and are used by so many patients that it was well worth circulating vital information about potential risks. I received no reply to this comment.

    The system… is deemed to be adequate

    The authorities refuse to listen or respond. At a time when the situation is fluid and changing as more information emerges about adverse drug reactions, the authorities are set in concrete or stagnant. If you are not satisfied with their reply, then it is your fault and you are not to bother them again. This institutional heedlessness parallels the stance of the pharmaceutical companies when a patient is not responding well to their drug – it must be down to the patient and not the drug.

    The system is failing patients and doctors. Doctors are not trained to look out for or to deal with adverse drug reactions. Medication is not accompanied by adequate patient information and the doctor is not instructed to outline clearly the potential dangers to the patient. We can’t improve the system unless we recognize the inadequacies.

    The wider impact of adverse effects of drug treatments | says:
    October 19, 2012 at 5:42 pm

    […] The regulator will refer you to the Department of Health, who will refer you to the licensing body for doctors, who will refer you to the professional body, who will refer you back to the regulator. We have all written to the regulator and the minister for health and we all get the stock letters back (Ed: See Margaret’s Story). […]

    Out in the real world, precious lives are being lost to horrific avoidable deaths.

    This follow up, is worth, a recent repeat

    It makes no difference to a bureaucratic machine if Margaret and others write forever.


    You pays your Money, and you takes your Chance…

    • Annie,

      First let me say we’re on the same team here. I hardly think creatively labeling suicide as emotional lability and just plain leaving the data out and not adhering to original study protocols to suit a companies end game is ok. I’ve read restoring329 and the paroxetine 352 bipolar article Amsterdam wrote enlightening me to the games of our friend Sally Ghostwriter and that hot shot money power loving psychiatrist Nemeroff play where the original trial data was horribly interpreted. It’s quite disturbing and frankly disappointing. That’s science? Yes we’re in trouble then. I absolutely believe these meds SSRI SNRI accutane singulair seizure meds can cause aggression and suicide and in rare instances induce homicidal actions in some. I fight every day to keep patients safe and speak to actual data where I can find it (quite a treasure hunt these days) to educate others. My point perhaps was misinterpreted or lost. Suicide is not expressly warned in adults as it is with black box warnings in kids. This is my point. I’m playing devils advocate because what is prosecutable depends on existing laws and case law. Looking for nuances where one can thread a needle if you see my point but I’m not a lawyer. Missed another calling. Too busy trying to survive psychiatry. My best to you. I’m in this with you!

    • Annie – thanks for putting it so plainly – those like yourself know what a twisted system it is – not so much nuanced as managed corruption. Jayme your response initially was ambiguous to some readers- why introduce ‘habituation’ Those who have/are suffering the effects of psych drugs or many psychs and other health workers are muddling the waters if this is being used. Also that you (I) am ‘inclined to believe’ is problematic for those who are aware of the evidence which has been extensively documented although also ignored by members of colleges and used as evidence in legal actions mainly by lawyers in USA. The UK is not there yet as Annie points out.
      It is though heartwarming to realise some like you are spreading the word and doing their best to protect those who consult them. You say you access data with difficulty – could you let us know where you are able to access the reliable data you refer so we can share on the blog?

      • Susanne -I also suffered immensely from effects of a drug and withdrawal. Habituation and addiction are two sides of the same coin. Identical except for craving. This is why I chose a different word. Yes perhaps habituation sounds a bit weak for what these things do. Agreed. We need a new word. Ideas? The effects are perhaps more devastating with psychiatric med withdrawal for quite a few reasons. 1. Harder to quit than cigarettes which I’ve heard is worse than heroin. I quit cigarettes more than 25 years ago. Not easy but much easier than this protracted nightmare. 2. This problem is not recognized by mainstream docs prescribing. A nightmare and tragedy as the PSSD study showed on Dr. provider responses. My favorite was “if you want to keep having these problems”… etc. etc. Just unbelievable. 3. Thus re: 2 there are no formalized plans for withdrawal or means to do so as to not have people suffer immensely and in some cases break their brains and souls. As for evidence that these drugs were previously known to be addictive by those who aggressively marketed and sold them I’m sure it’s there. What I’m taking about is finding a smoking gun in pharm documents. Do we have that specific to withdrawal and admission of addiction? Related to information on drugs – well it’s a bit complicated because what I use to resource these things is sometimes even foreign to my colleagues MDs NPs and pharmacists alike. Not everyone is a biochem pharm nerd like me with the invested incentive of being a victim of a med that nearly killed them. It’s a bit of a pooling of resources then I’ve got to figure it out. We obviously need people who more consciously prescribe or know when to say “ie let’s try an ice pack” but it’s a hard sell. It involves thinking beyond the routine. It involves not drinking the koolaide that the FDA protects us here in the US.

  14. Did anyone see Pleasure, Pain… BBC 4 with Micheal Mossley…. No mention of PGAD or for that matter PSSD… PGAD was called something else….??

  15. Exemplary, as always, Annie.
    If patients are not well informed, it is like you stated: It is like having a loaded gun in your hand. One does not know if you are going to get a blank or one that is going to put your life at risk.
    If patients do not have all the information, how can one make an informed decision?
    If one does not have all the information, the onus is on you to decide whether it is worth the risk?
    Does the risk outweigh the benefits?
    It is like a game of chance and we who have been impacted understand better than those who prescribe and manufacture.
    Sadly, I did not get a blank.
    I got the bullet that harmed me and no one was there to support me.
    It was swept under the carpet, so to speak and no one ever came out and said it as it is, except for ‘I’ who was severely injured by the bullet.
    Thanks to risk, our stories would not be told and people would not be well informed.
    At the time of the unfortunate incident, I could not articulate well or defend myself in a weak and vulnerable state however, those who were supposed to have my back all played ‘dumb’ and refused to admit that the tools they use, ever created a health risk.
    It was all blamed on some other health condition(s) that presumably fell out of the sky. Even back then I could not make a connection until I took full responsibility for my own health because if I continued to go through the Western Medicine, I would not be here writing or sharing my story.
    It is not a choice to come here and courageously write about our experiences.
    I would like to think that we are the ones who have a moral responsibility and obligation to say it as it is!
    If we care for one another, we do not shy away from our moral responsibilities.
    We are happy and delighted to share so that others may learn from our experiences.
    If things are hidden from the ‘all seeing eye’ and the truth is not spoken, games of chances are bound to be taken every day.
    Movers and shakers, shifters and makers ~ We are playing our bit no matter how big or small and if we can create that ripple that is programmed into the consciousness of our fellow beings, we are creating the necessary changes, although it is well hidden from all to know.

  16. The article is worth a read – even more so the final paragraph in the respones. Well intentioned maybe but they are still saying the same things over and over again with the same names cropping up over and over again ….
    Commercial Influence in Health: from Transparency to Independence
    Pathways to independence: towards producing and using trustworthy evidence
    BMJ 2019; 367 doi: (Published 03 December 2019)
    Cite this as: BMJ 2019;367:l6
    All rapid responses

    Re: Pathways to independence: towards producing and using trustworthy evidence
    Dear Editor

    Moynihan et al. proposed some possible pathways to financial independence from commercial interests in the aspect of research, education and practice in a relatively comprehensive and systematic way. After reading the article, we think the three following points might be considered to further enhance the pathways.

    First, we think we should consider the influence of commercial companies on the academic conferences, whose functions are not only to provide training or education, but also to provide a platform to exchange ideas and share progress, one example of which is the annual Cochrane Colloquium. Academic conferences may involve at least one of three aspects of research, education and practice. As we know, academic conferences need a significant amount of money, aside from registration fees, to support many important aspects, such as renting the venue and devices. On average, thousands of academic conferences, workshops, and meetings are held in different health fields at different levels (i.e. international, national, provincial and local). We should be cautious about the potential influence of commercial companies on academic conferences, especially when they are sponsors of these conferences. Cochrane is the model of freedom from industry funding, and it has strict policies and rules on sponsorship, the Cochrane Colloquium is not allowed to accept funding from conflicted sources, such as pharmaceutical companies or the medical device industry. Therefore, the inclusion of commercial companies on the financial independence of academic conferences should be considered.

    Second, we should assess the reliability of the sponsorship models with financial independence. Moynihan et al. listed many useful models, one of which was characterized by “public and philanthropic donors” and “driven by patient needs”. Another appropriate model in China, building a public foundation to support the development of guidelines was proposed and implemented. Such independent sponsorship models need to be assessed its reliability, and to identify whether they are free from commercial influence. For example, if such sponsorship models consisted of funding from commercial industries, it is hard to tell whether these models were of financial independence. Another example, patient-oriented model could be influenced by drug companies in many ways, such as changing the patient needs or convincing patients to advocate for approval of new drugs from the government, even though the drugs were not well-evaluated. To avoid the influence of such “hidden” or “anonymous” components or relationships, it is necessary to explore and assess such sponsorship models and to identify whether there are relevant mechanisms for managing the potential conflicts of interests. One of the responses to address the problem may be developing a conceptual framework to guide how to construct and assess the unbiased sponsorship models. The conceptual frameworks might involve several domains, such as relevance, transparency, relationships or connections, independence, separation, etc. Based on the framework, the standards or criteria might be warranted to develop and assess the reliable sponsorship models.

    Third, we need to consider properly using research evidence that funded by commercial industries. On the one hand, we hope we produce more and more independent research in the future through relevant reforms and policies as Moynihan et al. proposed; on the other hand, we should make appropriate use of research evidence without financial independence from commercial interests. There are many reliable evidence assessment tools to help users identify whether the research results might be influenced by the funding. For example, the AMSTAR (A MeaSurement Tool to Assess systematic Reviews), a popular appraising instrument for systematic reviews, includes two items (from a total of 16 items) considering the possible influence of funding sources for the review and included individual studies]. The AMSTAR tool, plus other tools, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the Appraisal of Guidelines for REsearch & Evaluation (AGREE) instrument, could help us identify the possible influence of funding sources in original studies, synthesized evidence, and clinical guidelines.

    As Moynihan et al. pointed out, the pathways to independence need long-term and comprehensive collaborations among different stakeholders in multiple fields globally. The above three points we proposed might be useful to better enhance financial independence from commercial interests in the aspect of research, education and practice.

    Competing interests: No competing interests

    04 December 2019
    Qi Wang
    PhD candidate
    Xiaoqin Wang, Liang Yao
    Health Policy PhD Program, Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University
    McMaster Health Forum’s Impact Lab 1280 Main St West, CRL-209 Hamilton, ON Canada L8S 4K1
    Re: Pathways to independence: towards producing and using trustworthy evidence
    Marketing of placebos in the guise of evidence-based medications seems to be on the increase. The problem is a difficulty of distinguishing between reliable and unreliable
    reports due to declared or non-declared conflicts of interest. In such circumstances, theoretic considerations gain importance:

    Competing interests: No competing interests

    04 December 2019
    Sergei Jargin
    medical reviewer
    Clementovski per 6-82
    Re: Pathways to independence: towards producing and using trustworthy evidence
    I am writing on behalf of NoGrazie (, an Italian movement of health professionals and citizens active since 2004 and networking with similar movements in other countries (MEZIS, NoGracias, etc).

    We fully agree with the analysis by Moynihan and collaborators, and we lend support to their proposals. For the past 15 years, NoGrazie has been disseminating information on the bias in policy, research, education and practice associated with industry funding. Some of our members have stopped seeing industry reps in their clinics. Some others ran courses for GPs and medical students on this issue. We are currently screening the websites of all Italian medical schools to rate them in terms of rules regarding the prevention and management of conflicts of interests.

    Finally, after the approval and enforcement of the US Sunshine Act, we submitted a draft text for an Italian Sunshine Act to several political parties. Our proposal was picked up in 2016 by a group of MPs and a revised text was approved in early 2019 by the Congress; the Italian Sunshine Act is currently waiting for final approval by the Senate.

    NoGrazie is proud of the work done so far and of the above-mentioned achievements. Unfortunately, there is great resistance by the majority of professional associations to do without sponsors in their educational activities. NoGrazie would support a EU-wide initiative to advocate for the withdrawal of accreditation to educational activities supported by industry. We would like to be informed of other initiatives taken by organizations and groups supporting the call to action on commercial influence in health in order to learn and collaborate, if at all possible.

  17. The BMJ, Down-Under …

    Juan Gérvas Retweeted

    Ray Moynihan‏ @raymoynihan 13h

    The Age and The Sydney Morning Herald report on new campaign to seek more independence from commercial interests in medical research, education and practice. @bmj_latest @PreventingODx

    ‘Cannot be trusted … causing harm’: Top medical journal takes on big pharma

    By Liam Mannix
    December 4, 2019 — 12.01am

    The BMJ says doctors are being unduly influenced by industry-sponsored education events and industry-funded trials for major drugs.

    Those trials cannot be trusted, the journal’s editor and a team of global healthcare leaders write in a scathing editorial published on Wednesday.

    “Medicine is always going to need pharma companies. We cannot be too brutal on them.”


    Joining The Fray

    The elephant in the room is anti-depressants that doctors prescribe willy nilly, with no tailored monitoring, discussion of length of treatment, or investigation of contraindications with other medical conditions. Doctors have prescribed me anti depressants for unrelated medical conditions, in other word, off label treatments. Investigation on medical sites revealed there was no way I should have been given them, considering other matters of my health. This article just raises more serious (perhaps fiscal) questions as to why that occurred. In my experience, the best thing for my health is avoid doctors like the plague. Which I can’t. I have basically had to become my own doctor, work out what tests I have needed, they confirmed serious conditions I had suspected for years if not decades. So in other words, I’m doing their job. For which in turn I have been basically emotionally abused by the last two GPs I have seen because I understand my own health. And if you have to wonder what you have said/done or tip-toe over fragile egos, you know it is abuse. But prescriptions, absolutely no problem.

    All over the World, people understand the meaning of ‘Brutal’…

    ‘Occasionally in medicine, analyses of data have consequences so weighty and far-reaching that the outcome lasts for years, involves several countries and regulatory agencies, and has massive implications for patients, doctors, and the pharmaceutical industry.

    The just-published reanalysis in the British Medical Journal ….. ‘

  18. I have just ready Dr Thomas Stockman’s article on coming off Duloxetine. I was prescribed this drug also for low mood. Instead of my GP trying to find out why I had low mood he just gave me a script for Cymbalta – I was actually seeing him for some other reason of which I cannot remember but ended up with a script for this. At no time did he discuss with me potential withdrawal issues if I was to stop taking the drug or even how to go about stopping taking the drug in a safe way. I had tried twice to stop the drug, the first time cold turkey which resulted in every one of Dr Stockman’s symptoms and more and the second time trying to wean myself off slower, obviously not slow enough, I ended up in a deep dark hole of despair that makes me feel ill to think about. I truly understand how people take their own lives. Sleep was the only relief, waking up again was a nightmare to say the least. I found a FB site called Cymbalta Hurts Worse which has thousands of members! go figure! It helps you wean off PROPERLY not the way the GP’s tell you which is so wrong. I remember my GP smirking at me when I mentioned this FB group and how to wean off the drug, to be honest I felt like punching him in the face. I am mad at him for putting me on this in the first place. I weaned from 60mg to 30mg counting these fricken beads that nearly drove me insane. I have stuck at 30mg for a very long time now too scared to go lower. I feel I have lost a big chunk of my life whilst on this drug as I can’t remember things and my memory used to be so sharp. I have just started reading Katinka Blackford Newman’s book The Pill That Steals Lives and had to stop a few times as it brought back so much to me when I was in that horrible dark place. Everything she says is so true and doctors still insist it isn’t the drugs, please listen doctors it IS THE DRUGS!!!!!! If I had my time again I would NEVER have taken this drug.

    • Alison,

      Hi! Stay at the dose you are at for right now. I had to taper slowly over more than a year. Only when I could mentally and physically stand it did I drop the dose again. My body kind of told me when I was ready. Let your body & brain recalibrate. I found avoiding stimulants coffee and things that calm like chamomile were good. Avoid things that mess with neurotransmitters except for exercise and micronutrient. Up those. I felt that upping my intake of foods full of micronutrients like liver spinach kale almonds walnuts and sometimes simple sugars like fresh OJ helped immensely. I used physical activity, meditation and also music, an app called Beltone also helped with terrible tinnitus I had. It sucks.

  19. PS -Bearing in mind that thebmj still has commercial interests in allowing adverts on the pages of the journal –

    Call to action on commercial influence in health
    We note the vital role of tests, treatments, and technologies in healthcare and the importance of industry-researcher collaboration. However, extensive financial conflicts of interest are distorting research evidence, medical education, and patient care, and it is time to move towards independence from commercial influence in the production and use of healthcare evidence. We support the development of health system reforms, which would include but are not limited to, ensuring that healthcare products are tested independently from companies which make or market them; that professional education is entirely free from industry support; and that clinical policies, guidelines, and decisions are free from commercial influence.

    Please indicate below if you support this call to action. Please also share any thoughts about how this might be achieved.

    You are also welcome to send a rapid response to individual articles, or to email us at

    Thank you and best wishes,

    Fiona Godlee and Helen Macdonald (Editors, The BMJ)
    Ray Moynihan and Lisa Bero (Guest editors of this BMJ collection)
    Please add your name
    Please add your role and/or organisation or affiliation
    For example “researcher”
    Please add your email address if you are happy for us to contact you (this will not be shared publicly)
    About you
    Please tick as many as apply
    Healthcare professional
    Policy or decision maker
    Member of the public, a patient, or a carer
    Please share your ideas on how greater independence could be achieved
    Tell us about something, or suggest something which others could do, to foster greater independence from commercial interests. This might include reforms, strategies, or priorities. (We will use these to inform a follow-up article. Please only post your idea here if you are happy to share it publicly with your name).

    • O.M.G!
      Rapid response to:
      A winter’s tale of promises
      BMJ 2019; 367 doi: (Published 05 December 2019)
      Cite this as: BMJ 2019;367:l6808
      Rapid Response:
      Claret advertising: an outdated stereotype and an unfortunate health message
      Dear Editor
      We were surprised and disappointed to see an advertisement for claret in this week’s BMJ (7th December 2019). If the BMJ views itself as a scientific journal, private adverts have no place. Conversely, if the BMJ is simply a publication representing the British Medical Association, then our union appears to be propagating a James Robertson-Justice image of claret-drinking doctors that bears little relation to the reality of being a modern doctor and plays into media representations of overpaid privilege. Furthermore, with alcohol problems being more recognised in middle-aged drinkers, and at a time when there is acknowledgment and concern over the stresses of being a doctor, should alcohol advertisements be anywhere near a medical journal?

      Competing interests: No competing interests

  20. What incredibly intelligent people RXISK has : )
    Insight, understanding, awareness, compassionate, passionate, emotional intelligence and a whole gamut of other beautiful traits, rxisk is endowed with.
    I bet you have all developed and grown, in a way which is second to none.
    Just look at the knowledge RXISK has given you and how many insightful people contribute to this informative community that is willing to share everything they know.
    I would assume that some of you are academics. (Experts of your field)
    Your knowledge comes from experience and a willingness to learn ‘above and beyond’.
    Do you ever wonder why we share our experiences on RXISK?
    What can we achieve by sharing what we know?
    How can health professionals learn from what we have experienced?
    Why do some feel threatened or overwhelmed by what we have experienced and what we know?
    Will our experiences benefit future healthcare?
    Will people start to question the rigid paradigms of medicine that do not work anymore?
    Will technology advance in the ‘grey areas’ especially, in determining whether a particular medicine(s) is suitable for an individual, given their genetics?
    Most importantly, will all the negative clinical data trials, pertaining to each and every medicine, be visible, for all to see?
    Without the effort, contribution or experiences, how can people who have not been impacted understand the enormity of the complexities at hand?
    It is only through RXISK that one day, the changes we have all been seeking will happen unexpectedly.
    I would like to think and believe that we are all in this, together.

    Psychological Support for Psychiatric Drug Withdrawal
    James MooreBy James MooreDecember 4, 20195
    FacebookTwitterEmailPrintFriendlyRediff MyPage
    This week on MIA Radio we turn our attention to support for those who are struggling to withdraw from psychiatric drugs. Recently in the UK, this issue has become headline news with more and more attention being given to the work of groups such as the Council for Evidence Based Psychiatry and peer-led initiatives such as the Bristol Tranquilliser Project.

    December 4 2019, marks the release of guidance which has been specifically written to support psychological therapists and their clients in having discussions about taking and withdrawing from psychiatric drugs. The comprehensive guidance is a collaboration between psychologists, peer support specialists and psychiatrists and aims to provide important context and evidence-based support to psychological therapists, whatever their particular modality.

    In this interview, we chat with psychotherapist and project lead Dr. Anne Guy, Peer Support Specialist Paul Sams and Professor of Psychology John Read.

    We Discuss:
    How the project to create guidance for psychological therapists got started.
    The need to address a significant gap in knowledge and experience, particularly given the numbers of clients who work with psychological therapists and are already taking or thinking of coming off psychiatric drugs.
    That therapeutic training previously hasn’t addressed the intersection of psychiatric drugs and the practice of therapy.
    How a recent survey showed that 96% of all therapists are seeing at least one client who is taking psychiatric drugs.
    That the guidance is not prescriptive but provides an opportunity for a therapist to respond to drug issues that other professionals may not have time available to address.
    The important distinction made between giving medical information and giving medical advice.
    How the guidance will be launched in Westminster, London on December 4 2019, and that people can read the guidance and view a Q&A here.
    That next year will see some Continuing Professional Development activities.
    How lived experience and peer support knowledge has been applied in developing the guidance.
    How the guidance opens up the conversation such that no go areas are addressed as part of the overall therapeutic discussion.
    That the approach is one of empowerment and supporting conversation rather than defining or being prescriptive.
    How the evidence-based part of the guidance came together and that there was a fairly consistent finding that around 50% of people coming off psychiatric drugs will experience some sort of withdrawal with around half of those describing the withdrawal effects as severe.
    That the guidance has provided the chance for psychologists, counsellors and psychotherapists to work together.

  22. October 2, 2019
    Association of Antidepressant Use With Adverse Health Outcomes (Ref for above comment) space for comments but they refused mine,

  23. The cure is worse than the disease. The solution or proposed solution to a problem produces a worse net result than the problem does, especially via unintended consequences.
    If only we had the foresight, before health problems occur, the implications or risks of ingesting a medicine(s) or having a particular procedure, could be minimised.
    Not all medicines or procedures, are going to benefit everyone and it all depends on time, place, the people you know and the genuineness/sincerity of the people who are taking care of you.
    Health care SHOULD NOT BE A GAME OF CHANCE and everyone is vulnerable if the circumstances or situations, are not right.
    It is our HEALTH, OUR MIND & OUR BODY & everyone has a right to question everything. Going blindfolded into something and just relying on blind faith alone does not cut the mustard for me.
    Thank you to everyone concerned who has let so many people down, including the patient who had put so much trust and faith in the people who are suppose to care.

  24. you are here: science media centre > roundups for (lazy)journalists > expert reaction to study on association of antidepressant use with adverse health outcomes

    OCTOBER 2, 2019
    expert reaction to study on association of antidepressant use with adverse health outcomes
    A study, published in JAMA Psychiatry, examined the existing evidence on antidepressants and links to negative health outcomes.
    The SMC declares no conflict of interest yet one of the authors of this article has an association – plus they might have added that the authors of the article in Jama have links with pharma
    Includes a bit of nonsense from Wendy Burns of coll of psychs

  25. Roundup for lazy journalists – if they bother to read the original article they will notice most of the authors have links to pharma This article by the so called science media centre might have mentioned that.

    OCTOBER 2, 2019
    expert reaction to study on association of antidepressant use with adverse health outcomes
    A study, published in JAMA Psychiatry, examined the existing evidence on antidepressants and links to negative health outcomes.
    OCTOBER 2, 2019
    ‘expert reaction to study on association of antidepressant use with adverse health outcomes’
    with a bit of nonsense from Wendy Burns as usual

  26. Intended for healthcare professionals
    Edition: UK
    Academic publishers urge Trump not to demand open access for federally funded research
    BMJ 2019; 367 doi: (Published 20 December 2019)

    More than 125 journal publishers and scientific and medical societies have signed a letter to Donald Trump asking him to reverse a policy they believe is being prepared that would require any journal publishing research that received US federal funding to make the article freely available without a subscription, immediately on publication.1

    Currently, under the terms of a 2013 agreement, journal publishers may charge readers for federally funded research articles for 12 months from publication, after which the paywall must come down.

    The revenue from those 12 months is essential to pay the costs of publication, the letter’s signatories argue. But, they write, “we have learned that the Administration may be preparing to step into the private marketplace and force the immediate free distribution of journal articles.”

    “Going below the current 12 month ’embargo’ would make it very difficult for most American publishers to invest in publishing these articles,” the letter warns, suggesting that the government would then feel obliged to take on the task of publication.

    “This cost shift would place billions of dollars of new and additional burden on taxpayers” and could force some scientific societies to close their doors, the letter argues.

    The letter also appeals to the president’s economic nationalist instincts. Requiring immediate open access, it argues, would “effectively nationalise the valuable American intellectual property that we produce and force us to give it away to the rest of the world for free.”

    But, the letter adds, “publishers make no claims to research data resulting from federal funding,” and they also support open access business models “as important options within a larger framework that assumes critical publisher investments remain viable.”

    Signatories include the science publishers Elsevier and Wiley, the American Medical Association, the American Heart Association, the American Cancer Society, the US Chamber of Commerce, the New England Journal of Medicine, and dozens of specialist medical societies.

    A planned change in the rules has not been officially announced. The White House Office of Science and Technology Policy, which is believed to be drafting the new policy, said only that it would “not comment on internal deliberative processes that may or may not be happening.”

    The International Association of Scientific, Technical and Medical Publishers, based in The Hague, has also written to OSTP director Kelvin Droegemeier, protesting against the rumoured policy change.2

    The publishing industry in Europe already claims to be threatened by Plan S, a European initiative in which a consortium of major national and international grant funders have agreed to require open access publication of any research they support.3

    A Republican senator, Thom Tillis of North Carolina, joined the publishers’ cause, sending his own letter to the commerce secretary, Wilbur Ross.

    The BMJ is not a signatory to either of the publishers’ letters. All original research published in The BMJ and in its sister journal BMJ Open is immediately available through open access with payment of an article processing charge. Other BMJ journals also offer open access publication.

    The BMJ’s editor in chief, Fiona Godlee, said, “We support the shift to open access publishing for biomedical research, recognising that there will be winners and losers and that the priority must be to safeguard the quality and integrity of academic communication.”

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