Comment From Dr. Fred Goodwin

Someone saying he’s Fred Goodwin asked me to post the below. I’m assuming it’s the real Fred Goodwin, though I suppose it could be an imposter. Why anyone would want to pretend to be Goodwin is a mystery, but I want to issue that caveat. At any rate, I present it without comment or prejudice.
This is the response I sent to the NY Times 2 weeks ago and was not published. I’d appreciate if you could post it here.
Thanks,
Fred Goodwin MDStatement of Frederick K. Goodwin M. D. regarding the 11-21-08 New York Times article by Gardiner Harris and the follow up editorial of Nov 29:
Mr. Harris’ article is filled with misstatements of fact, and incorrect implications; which also characterize the brief mention of me in the Nov 29 editorial.
Let me first note that I spent nearly an hour on the phone with Mr. Harris, and followed this up with a detailed email providing easily verifiable factual information. While he did quote a few things I said, most of the important information I provided was left out of the story.
Some of the article’s misstatements have been covered in other media reports (e.g., NPR, 11-26-08). I’ll focus on the most egregious misstatements and omissions. First, his story implied that I am and always have been the host of The Infinite Mind. In fact, from April ‘05 through January ‘08 the producer replaced me with another psychiatrist with no ties to drug companies, while I served as guest host for shows unrelated to pharmacological treatment issues. Furthermore the show ended well before Sen. Grassley’s report or the Times story and had nothing to do with them. The show simply ran out of money.
Mr. Harris’ story also implied that I had been a speaker for Paxil, a GlaxoSmithKline product, since 2000. I never spoke for Paxil. Starting in 2001, I spoke about mood disorders and Wellbutrin (now generic) and in January ’04 began giving talks dealing with lithium. Incidentally, I used this as an opportunity to remind psychiatrists about lithium, a forgotten drug, forgotten because it’s been generic for decades and doesn’t make enough money to justify promotion by drug companies. I referred Mr. Harris to my 2007 book (with KR Jamison) Manic Depressive Illness 2nd edition, where my dismay at the fact that many young psychiatrists don’t use lithium is clearly expressed. Later, as Lamictal joined lithium as the only other FDA-approved mood stabilizer, my talks included the FDA indications for both.
More egregious is Harris’ Paxil narrative. The article implied that I asserted on the air that “there is no credible scientific evidence linking antidepressants to violence and suicide” because of my ties to drug companies. Note he did not question the accuracy of the statement because he could not. Both I and the show’s producer (who wrote the script) stand by the scientific accuracy of what the script said. A major focus of the show was the FDA’s “black box” warning about a relationship between antidepressants and “suicidality.” But suicidality as defined by FDA encompasses everything from suicide attempts to any “self harm,” much of the latter having no relationship whatsoever to actual suicide. The concern expressed by me and the guests that the producer had selected was that this “black box” warning might be scaring many doctors away from using these drugs when they were needed for fear of being sued (suicide being the number one reason why psychiatrists are sued). Doctors should be warned about the distressing symptoms that young patients can sometimes feel on these drugs, but many (not all) experts in the field believe that a less charged word would have been better. I made all this clear to Mr. Harris.
I also pointed Mr. Harris to my long-standing, easily accessible record of being quite critical about the overuse of SSRI antidepressants, especially in young people. I referred him to Manic Depressive Illness and gave him references to two recent journal articles I co-authored, all of which expressed major reservations about the overuse of SSRIs. I further pointed out that I had never spoken on behalf of Paxil. All of this information was ignored. Instead, the above quote from the show was paired with the fact that Glaxo has been accused of suppressing data. A careful reading of the article shows that these are unconnected facts, but a casual reader will be left with the impression that I was somehow involved in suppressing data on Paxil.
The article also implied that I was trying to promote Lamictal by pushing the diagnosis of bipolar disorder in kids. I pointed out to Mr. Harris that Lamictal hasn’t yet been properly studied in that age group. The show in question, as I recall, did discuss mood stabilizers that have been studied in kids, especially lithium and divalproex, both now generic drugs and no longer “promoted” by anyone. (For that matter, I also pointed out that Paxil had been generic for some time and is therefore no longer promoted.)
Finally, the article states that my involvement with pharmaceutical companies was “undisclosed.” Again, Mr. Harris simply ignored much of what I told him–that there is ample evidence in the public record disclosing my work with drug companies; it’s never been a secret. It’s extensively acknowledged in papers that I have published, in my book, and in all of my continuing medical education (CME) activities.
I also explained that The Infinite Mind producers were aware of my connections to pharmaceutical companies. While he did quote me in the article to this effect, he failed to cite an important, easily verifiable fact: Mr. Lichtenstein recruited another psychiatrist without any ties to industry to be the host starting in 2005, and serving through January 2008. This action was taken to deal with Mr. Lichtenstein’s concern that my industry ties could become a problem for the program. Given this fact, Mr. Harris’ report that Mr. Lichtenstein knew nothing of my activities on behalf of drug companies is clearly not accurate. It is true that Mr. Lichtenstein may not have known all the details, but he was generally aware of my activities.Sincerely,
Frederick K. Goodwin, MD
liz | 12:13 PM | Uncategorized




I’ve seen these same remarks by Dr. Goodwin on Dr. Daniel Carlat’s blog. These seem to be the real deal. Liz, it is good that you posted his side of the story.
It would be good if Gardiner Harris would respond here.
Okay, he’s promoting more use of lithium by younger psychiatrists and this is supposed to make me feel better about him? Not working, not working at all. Maybe it’s the lack of veins in my left arm from failed dialysis accesses or the incision in my belly or the years when I could not work, I don’t know, or maybe it’s the other folks I know personally who lost their kidneys to lithium, but I think promoting lithium should be a crime.
Dr. Kay Redfield Jamison, who is Dr. Goodwin’s co-author, presented for local clinicians and our Cincinnati NAMI group in February 2008. Her talk focused on her personal struggles with medication, and spoke of lithium as the “gold standard.” Dr. Jamison’s presentation can be viewed online at http://www.nami-hc.org/video.
Goodwin’s letter is very defensive. Imagine spending paragraphs defending things that he thinks Gardiner “implied” but didn’t actually say. He must really be sensitive; as far as I’m concerned he had an agenda for that show and he knows it. I still say that show was packed with, as Philip Dawdy on Furious Seasons puts it, “howlers,” misrepresentations, idiotic arguments, gross assertions and all the things that he and his cohorts were accusing the media of. I just listened to it again — it was painful. The problem is he and his buddies believe their rubbish and can’t even see the flaws in their own arguments.
What was bad about the show was not so much literally what they said although some of it was almost juvenile and full of assertions, but the tone and the patronizing, arrogant attitude they had both to the media and to victims. They seemed insulted that anyone would even dare to bring up that a school shooter was on an antidepressant as if somehow this was an affront to their profession. As for the scores of victims and survivors who testified at FDA hearings in 1991, 2004 and 2006, of which I was one, when one of the guests was asked about it, he actually never directly replied about what it was like to hear those stories. They seemed to think that if someone was troubled then ergo the medication could not in any way be implicated in the violent act that followed which is a non sequitur. Also they seemed to be at pains to treat suicidal ideation and suicide as two distinct and almost opposing phenomena which is just ridiculous. It’s not credible. Finally they latched on to prescriptions going down and suicides up as if this were some holy grail of proof that antidepressants prevent suicide when countless other factors could be at play. It’s not even clear that those trends move in synch over time anyway. Even if they did it’s no proof of anything. To say that warnings should not be in place because they frighten people away from treatment when we already have 25-30 million people taking antidepressants is absurd. We have a serious overtreatment problem, not an undertreatment problem. Finally their assertions of efficacy were just that — assertions. I agree with one comment about the show — that there was no science in it whatsoever and that it reflected religion more than anything else, biological psychiatric religion. These guys were out to protect their territory, not provide any new insights into the relationship between antidepressants, suicide and violence. And they should be ashamed of how they did it.
“…as Philip Dawdy on Furious Seasons puts it, “howlers,” misrepresentations, idiotic arguments, gross assertions” — Sara
Hmmm…as if Dawdy’s blog isn’t filled with much of the same… as I certainly feel it is missing different and/or contrarian points of view through his need to excommunicate those who do not agree with his thoughts.
I came across an interesting piece relating to an investigation of one of those doctors, who in Dawdy’s blog comments amongst other attributions labels the individual a “Nazi,” and yet no one cares to take the time to share the information or in the words of Paul Harvey share “The Rest of the Story”. Most importantly at least in my opinion are whether the research was tainted and/or the care for patients.
“The University’s investigation, to date, has found no evidence that Dr. Nemeroff’s outside speaking activities affected clinical care for patients or persons enrolled in clinical trials, and no evidence that his activities biased scientific research in which he was engaged. Dr. Nemeroff has contended that his lectures were not product-specific but were limited to general medical topics such as depression and bipolar disorder. A review to date, based on his speaker slides and on interviews with attendees at presentations, supports that contention.”
http://www.emory.edu/home/news/releases/2008/12/conflict_of_interest_action.html
It is shameful that individuals are often easily led to judgment lacking facts and/or evidence.
A belated Happy Chanukah to you Liz and your readers as well as a Merry Christmas and a Happy, Healthy, Peaceful and Prosperous New Year.
Warmly,
Herb
VNSdepression.com
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