Dr. Fred Goodwin Update

I have little to add, but wanted to provide a roundup of updates about Dr. Fred Goodwin, the one-time director of the National Institute for Mental Health, a well-respected bipolar researcher, and host of a public radio program called The Infinite Mind. An episode of The Infinite Mind was called on the carpet earlier this year for what was largely a biased program emphasizing that there was little evidence linking suicidality to antidepressants (contrary to what the actual research shows). Undisclosed to listeners of the March 2008 broadcast (Prozac Nation: Revisited) was that all four of the commentators — including Dr. Goodwin himself — received funding from the very same pharmaceutical companies whose products they were defending. You can read a very interesting point-by-point analysis of this program — and the fallacies promoted by its discussants — done by Jonathan Leo.

All of this was old news until Senator Charles Grassley’s office began investigating Dr. Fred Goodwin’s ties to the pharmaceutical industry (as reported by The New York Times on Nov. 22) — ties that the producer of The Infinite Mind show denied having complete and full knowledge of.

A few days ago, Dr. Goodwin released his his own defense of his ties and how he was portrayed in the Harris NY Times story (you can download the Fred Goodwin statement here, PDF). Most of the letter deals with minor details, including the meaning of the word “suicidality,” which seems tangential to the main issue of receiving $1.3 million in money from drugmakers, income not mentioned on the program despite his discussion of products made by the same companies providing him such funding. There’s nothing wrong with receiving such money, but you have to disclose it to your listeners so they know about your conflicts of interests and where your biases lie.

Here’s the most egregious part of his defense statement:

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.

Great, but how about for the listeners to your radio show? Where are they supposed to learn of these conflicts? Certainly not from Dr. Goodwin’s CV, his bio or anywhere else on his website. It may be no secret if you attend a CME class Dr. Goodwin has given or read a paper Dr. Goodwin has written, but barring such digging, it would be difficult to discover this information otherwise. If you did do that research, you’d find statements similar to this one:

FKG has received research grant support from Abbott, Forest, GlaxoSmithKline, Janssen, Eli Lilly & Co., Pfizer, Sanofi, and Solvay Pharmaceutical Corporations; has received speakers honoraria from Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly & Co., and Pfizer Corporations; and has also served as a paid consultant to Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly & Co., Pfizer, and Solvay Corporations.

As Philip Dawdy over at Furious Seasons noted today, John McManamy again came to Dr. Goodwin’s defense, basically just quoting from Goodwin’s letter and reinforcing whatever he says with little critical commentary or skepticism. At the end of the article, McManamy notes that Goodwin has written and will write a future blurb for McManamy’s books — an important endorsement from one of the leading researchers in bipolar disorder. (Which, ironically, McManamy discloses, but completely misunderstands why it was just as important for Dr. Goodwin to disclose to his listeners a similar conflict whenever he was discussing drug treatments on his show.)

Dr. Goodwin was paid to give promotional lectures for its mood stabilizer drug, Lamictal (according to the NY Times article), a drug that apparently also may have been no more effective than placebo according to new clinical trial data that was previously undisclosed by its maker, GlaxoSmithKline (GSK). GSK was previously found to fail to disclose important suicidality data related to its antidepressant Paxil.

Last, I link you to Dr. Carlat’s bizarre story related to Dr. Fred Goodwin, when he appeared as a discussant on a professional psychiatry panel last year:

But instead of discussing our talks, Goodwin decided to use Marcia Angell’s book, The Truth about Drug Companies, as target practice. Angell was not on the program, and her book was only mentioned in passing by one of the presenters. But Goodwin seemed to despise her and her book. He went through her main points, rebutting them systematically, arguing that pharmaceutical companies are wonderful, that medications are very helpful, that there is nothing wrong with making money, and that drug companies are not as profitable as everybody thinks. Then, he went on a bizarre tangent about how one of the major networks is filled with scientologists.

Odd.

Edit: An article in the GW Hatchet (a George Washington University student newspaper) carries a few more quotes directly from Dr. Goodwin and from Harris, continuing to go back and forth about the allegations. Dr. Goodwin, again nitpicking, claims that the $1.3 million figure is not entirely accurate, since it includes reimbursement for travel expenses. Really? This is what you’re arguing when your hand is caught in the cookie jar? “Well, sure, I took a few cookies and didn’t tell anyone, but one of those cookies was really just a bunch of crumbs, so it shouldn’t count.” (Dr. Goodwin really should just stop trying to defend himself at this point, or at least hire a PR firm, because he’s only making matters worse.)

Sadly, Dr. Fred Goodwin will likely be remembered for this episode as much as for his definitive textbook on bipolar disorder.

A quick reminder to any researchers reading this entry — disclosure of conflicts of interest and pharmaceutical funding = Good. Nondisclosure, coverup or failure to report conflicts of interest = Bad. Can’t make it any simpler than that.