GSK in Iceland forced to withdraw a drug-promoting depression booklet
by Steind? J. Erlingsson PhD
steindor@akademia.is <mailto:steindor@akademia.is>
http://www.raunvis.hi.is/~steindor/
<http://www.raunvis.hi.is/~steindor/>

For the past 9 months I have been sporadically researching a book that I
plan to write, where I will criticize DSM and biological psychiatry.
This work began at the end of last year when I wrote an article,
"Antidepressants and Chemical Imbalance
<http://timarit.is/view_page_init.jsp?pageId=4016471&issId=278675&lang=i\
s> (?nglyndislyf og efna?afnv?i)", for a newspaper in
my native Iceland, an island nation in the North-Atlantic with a
population of roughly 300 thousand. The article highlights research
indicating that SSRIs are no more effective in treating depression than
placebo, and the flaws in the "serotonin imbalance" hypothesis
[1-4]. It was published in early January 2009 and became the subject of
a detailed discussion in a TV program, "Depressed Nation
<http://www.visir.is/article/20090120/FRETTIR04/594123587&sp=1>
(?nglynd ??)" [5], later in the month.

This research opened my eyes to the fact that, since 1999,
GlaxoSmithKline (GSK) has distributed a booklet in Iceland in drug
stores and primary, secondary and tertiary health care facilities
containing wrong and misleading information about the causes and
treatment of depression. What is most striking about the booklet are the
following claims: 1. An imbalance in the neurotransmitter serotonin
causes depression. 2. SSRIs treat depression by correcting the serotonin
imbalance. 3. Psychological treatment is ineffective in treating the
serotonin imbalance. For ten years GSK in Iceland was allowed to give
the readers of the booklet the impression that a chemical imbalance in
the brain caused depression and that drugs are the only cure. I was
recently able to stop this travesty.

Immediately following the newspaper article and the TV program, where
the GSK booklet was highlighted, I sent a formal complaint concerning it
to the Icelandic Directorate of Health. I met with the Icelandic Medical
Director of Health (MDH) and had frank discussions about the GSK
booklet. He forwarded my report
<http://www.raunvis.hi.is/~steindor/LL.pdf> to leading psychiatrists in
Iceland who agreed with me! In a detailed letter
<http://www.raunvis.hi.is/~steindor/GSK_LL.pdf> that the MDH sent on
March 12 to the Icelandic Medicines Control Agency (IMCA) it is argued
that "the booklet must be withdrawn. But as the matter has to do
with a drug company the IMCA is hereby asked to take appropriate
actions."

This was a great victory for me and the people of Iceland, but the
question remained whether the IMCA would do anything about the matter.
When I had not received any news from the Agency by the middle of
September, I contacted the MDH. He decided to circumvent the IMCA and
speak directly to GSK in Iceland, with great results. On September 24
the company sent a letter to all drug stores and health care facilities
in Iceland stating that "GSK has received information that its
information booklet on depression needs to be improved. The company
views favorably well argued suggestions and as a result it is going to
review the booklet. While this inspection takes place further
distribution of the booklet will be terminated. The company also
requests that any further distribution of the booklet in drug stores and
health care facilities should be terminated."

During the following weeks the story continued to develop. After
considering the matter for few days I decided to contact a journalist at
one of the newspapers in Iceland to try to convince her to write about
this defeat of GSK. This was not an easy task but, after more than a
week of emails and phone calls, the newspaper bit the hook. On October
13 it published an interview with me under the heading
"Company's Serious Distortions
<http://www.raunvis.hi.is/~steindor/MBL_GSK.html> (Alvarlegar
rangf?slur fyrirt?is)." The impact of the interview was
immediate. The following day a press release from GSK in Iceland was
published in the newspaper where the company tried to excuse the booklet
affair and promised to put its house in order. Besides the depression
booklet, GSK in Iceland publishes booklets on several other mental
disorders. In the press release
<http://www.raunvis.hi.is/~steindor/GSK_Svar.html> the company pledged
that "coinciding with the revision of the depression booklet all
this educational material will also be inspected in close cooperation
with local specialists."

Advertisements aimed directly at consumers are illegal in Iceland. Drug
companies can indirectly circumvent this ban by publishing information
booklets on various mental disorders. GSK in Iceland abused this option
by publishing a booklet about depression which contained wrong and
misleading information about the causes and treatment of the disorder.
This has now been stopped. This victory in Iceland clearly shows that
with well-argued complaints mental health advocates can even defeat Big
Pharma!