Wikipedia Editor Inserts Foot in Mouth

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July 7, 2014 | 16 Comments

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  1. All drugs have side effects and adverse effects. Serious adverse effects usually lead to a product withdrawal. If a medicine manages to get through to its loss of patent then it is probably likely in most cases that be relatively safe for sensible and hopefully appropriate utilisation. Side effects with finasteride are hardly to be unexpected when its mode of action is appreciated. It can avoid unnecessary prostate surgery. Such decisions are made and should continue to be made with appriate clinical oversight.

    • Jon: As the author states, PSSD (and the analogous PFSD) should be considered a life-long disability that severely negatively impacts a person’s capacity for intimacy and therefore quality of life. It can and often does lead directly to suicidal thinking and in some cases a carrying out of the act, a tragedy. I think this would place the condition firmly in the category of a serious adverse event. Even if the incidence is rare, the population of SSRI/finasteride users is so vast that a large sub-population is affected, so it is only a matter of time until this becomes a systemic problem. The argument that side effects should be expected, and thus the risks are known, is extremely weak. If the risk of a severe and permanent side effect were truly appreciated, health professionals would not prescribe the drug, or at the least a well informed consumer would not venture to take that risk.

  2. Sadly Wikipedia has become a vehicle for the ‘official’ viewpoint, which is often far from the truth. In this case, the storyline is that SSRI’s are virtually free of side effects, and anyone trying to suggest otherwise will be rapidly censored.

  3. Please consider the dutch article published by the dutch health authorities on pssd. It has been published in a creditted journal.

  4. I have translated the English page in Italian and I put it on wikipedia.
    Hoping that they do not take away it.

  5. Ah, I’m a topic of discussion again. Why not send me an email and invite me to participate? Wasn’t it on your own blog that you stated

    “Science moves ahead, when people with different biases have their views challenged by the data. This is the very definition of science as opposed to philosophy or the humanities or business.”?

    So to respond to Dr. Bahrick, to whom I meant no disrespect:

    1) “The available sources of information include case reports, Internet message board themes, incidental findings, animal studies, and the only empirical studies available that systematically assessed sexual functioning before, during, and after exposure to SSRIs.”

    Please take a look at the “Reliable sources for medical information” page over at Wikipedia. Irrespective of whether one is making claims of efficacy or adverse effects, Wikipedia does not permit internet message boards, incidental finding, or animal studies to be used to make medical claims. The reasons for this are obvious if you think about it. The clinical studies can be used, but only if they have been cited in an independent review. This is to provide a minimum level of assurance that the findings are mainstream.

    2) The successful treatment of premature ejaculation with an SSRI in an RCT is far, far from compelling evidence of long term genital anesthesia, anorgasmia, and erectile dysfunction. I can’t agree with you on this point at all.

    3) “With an estimated 30% of men as a potential market for a drug to treat PE, it comes across as disingenuous for Formerly 98 to suggest, as he or she did, that there no longer exists any credible financially-motivated interests in seeking to contain information about the pervasiveness of SSRIs’ sexual side effects.”

    It makes perfect sense if the drugs involved are all generic and sell for pennies a pill, irrespective of how they are used.

    4) “The description of my position and credentials is diminishing and distorting (i.e. use of the terms “college” as opposed to “university”, and “counselor”–an unregulated term instead of “psychologist”, a title requiring a doctoral degree), and in the case of the review article being my only lead author publication, is false. ”

    I apologize if I mis-stated your credentials. Not working in your field, I was unaware of the status difference between “psychologist” and “counselor”. In chemistry, we are all just “chemists” irrespective of degree. I did not find any other articles in Pubmed, which is the only source I normally use. And I went to a “college” for my B.A. so that was certainly not meant as a slur. Frankly, the college I went to was more selective than almost any University in the country.

    5) “Are Psychotherapy and Psychosomatics and the Journal of Sexual Medicine not WP:MEDRS compliant?”

    It would depend on the content of the article. Primary research citations are not normally acceptable.

    6) “As I am sure Formerly 98 is aware, once drugs are on the market, serious post-market drug risks are generally first recognized by an accumulation of case reports.”

    Yes, but there are usually more than 20 or so after the drug has been taken by hundreds of millions of people over 25 years, and they are often objectively observable and not readily assigned to other causes.

    So I apologize if you feel disrespected. I believe you are motivated by the best of intentions, and in all probability, an excellent psychologist. But we profoundly disagree on the nature of medical evidence.

    Respectfully,

    F98.

    • Just seeing this correspondence now. I note the following:

      1. Formerly98 failed to respond to the request that he or she identify him or herself.

      2. On 21 January 15, Formerly98 deleted substantial sections of the Wikipedia article on Syngenta reporting a New Yorker article on Syngenta’s efforts to discredit research on effects of atrazine on endocrine function. Formerly98 describes himself (or herself) as a “chemist,” but does not describe any training or experience in physiology. His (or her) stated reason for the deletion was violation of neutral point-of-view rules for Wikipedia; however, the sections in question cited a well-researched article from a national publication that is renowned for its fact-checking practices and clearly meets Wikipedia’s definition of a reliable source.

      3. Formerly 98 has used the same approach for “editing” multiple Wikipedia articles: deletion of material based on claims that the source used is biased or not “reliable.” This approach is invariably applied to material that is implicitly or explicitly critical of industrial manufacturers; I have not yet seen an article in which Formerly 98 has added material implicitly/explicitly critical of such manufacturers, or deleted material that is inappropriately positive.

      4. Although Formerly 98 cites Wikipedia policies as the basis for the edits that he (or she) makes, he (or she) is highly selective about which policies he (or she) follows. Wikipedia’s guidance on handling NPOV disputes explicitly states that deletion is “not” the first resort (http://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view/FAQ#Lack_of_neutrality_as_an_excuse_to_delete). Formerly 98 does not seem to follow this at all.

      5. Finally, given 1-4, it is possible that Formerly 98 is not a single individual, but a convenient handle for more than 1 person (cf. Samantha West – http://newsfeed.time.com/2013/12/17/robot-telemarketer-samantha-west/).

      5. Items 1-3

      • [Hi David (Healy) – a slightly pissed off comment, so you might not want to post it…but I actually find the F98 thing quite spooky]

        I support all the points you make, David Ross. And post this comment in frustration.

        I have always used Wikipedia as a quick source of information – bearing in mind inevitable inaccuracies that must result from multiple editors and writers. Every time I want to check something about a drug, or a drug company – it doesn’t sound quite right. Then I look at the talk page – and find some berk called Formerly98 lurking there. This evening I just wanted to get a date for when olanzapine was launched in the US – just a date. There is no history of the development of this drug on the Wikipedia page and the information given is generally pretty thin. No mention of its widespread use as a ‘mood stabiliser’ in severe depression, for instance. And F98’s little fingers have been active again, just a week or so ago.

        Does anyone out there know who Formerly98 is in real life? I would dearly love to know. He doesn’t sound quite sane on the talk pages to me, which is slightly worrying. Maybe because he is actually a number of people….

        And I now spread the word: never trust anything on Wikipedia about the pharmaceutical industry.

        • Sally

          Formerly 98 is John Alan Tucker. He lives in San Diego. He used to work for a number of pharmaceutical companies. He has his own consultancy now.

          He goes around the place editing the Wikipedia pages on drugs such as Levaquin, Cipro and the Fluoroquinolones and eliminating pages such as the PSSD page in addition to editing the page on David Healy to credit James Coyne’s view of Healy and just a few days ago to suggest that where Healy witters on about ghost-writing in fact ghost-writing is not all that common.

          He has the idea that anyone who has been harmed by drugs is dangerous and he wouldn’t want you to know his identity as you might come and attack him and his family.

          As a shrink this suggests to me a man who is pretty angry about something.

          David

          • Did he ever stop to think that had we not been harmed by the creations of those like him that we wouldn’t be dangerous in the first place? I’m beginning to think that the more knowledge biochemists obtain about genetics the more likely they will use it to create drugs that create more problems than they solve. Oh wait, this is already happening.

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