But what made the praise bestowed on this PBS documentary particularly troubling were the erroneous, drug-industry serving statements made by Nemeroff within the film—statements which had the potential to negatively affect public health, and which the documentary left unchallenged. During a segment on the FDA’s 2004 decision to require “black box” safety warnings stating that antidepressants can increase the risk of suicide in children and teenagers, a risk it extended in May of 2007 to users under twenty-five, Nemeroff seized the occasion to claim that the federal safety warning was mistaken.
He did so by citing a 2007 study partially funded by Pfizer and published in The American Journal of Psychiatry, a paper ostensibly linking the warning with a subsequent increase in teen suicides. “The FDA put a black box warning for all age groups,” Nemeroff said in the documentary. “I believe this was a mistake, because in hastening our awareness, what we’ve shown is there’s been a marked drop in prescriptions of antidepressants, particularly for children and adolescents…and an increase in suicides and suicide attempts.”
But as critics quickly pointed out
to The Boston Globe and The New York Times, the increase in suicides Nemeroff described actually occurred a year before a drop-off in antidepressant use. (You can’t blame a rise in suicides in 2003 on a drop off in prescriptions in 2005.) At the time, most parties to this debate agreed that the question of whether black-box warnings were inadvertently dangerous would not be further clarified until the release of Centers for Disease Control suicide data from 2005.
That data came out a month later, and showed that suicides have fallen overall; a follow-up report showed that suicides have fallen among youth specifically. The total number remains higher than in 2003, but less than in 2004, when the FDA warning went into effect.
Given the complexity of epidemiological data and the rarity of suicide, those findings prove little except that any effort to link an uptick in suicides to reduced prescribing of antidepressant medications to children and teenagers is not supported by the epidemiological data.
Something about the simultaneously complex and sympathetic nature of mental health reporting is making reputable journalistic organizations and well-meaning reporters sloppy. Last year, NPR aired a documentary on antidepressants and suicide in a radio show called The Infinite Mind. The show featured the comments of experts with undisclosed ties to the drug industry. This alone drew the wrath of observers—yet, as chronicled by Jonathan Leo, Ph.D on the Web site Chemicalimbalance.org, the documentary was peppered with inaccurate statements and drug-industry-serving spin. Its host, the psychiatrist Frederick Goodwin, eventually came under fire for not disclosing his own history of receiving money from the drug industry.
As the cases of PBS and NPR make clear, reporters who hand over their microphones to clinicians harboring such conflicts are the health beat equivalent of Judith Miller handing over her discussion of WMDs to Ahmed Chalabi. “I will not believe anything he says,” a Nemeroff critic and fellow psychiatrist told the Atlanta Journal Constitution following his downfall. “I will not believe anything he writes.”
If a source has critics like this, and if the judges for the Peabody Awards—or reporters they praise—cannot locate these critics, we deserve better awards.