Many of our most commonly used drugs, from painkillers to antidepressants, are dangerous and are killing us off in large numbers, says a leading researcher visiting Australia next week.
Peter Gotzsche, a co-founder of the Cochrane Collaboration, the world’s foremost body in assessing medical evidence, arrives in Australia on Monday for a whirlwind speaking tour warning Australians about their use of prescription medications.
He estimates that 100,000 people in the United States alone die each year from the side-effects of correctly used drugs. Similar figures are not available in Australia, although the Australian Bureau of Statistics estimates that 3000 people died after complications with medical and surgical care in 2012.
“It’s remarkable that nobody raises an eyebrow when we kill so many of our own citizens with drugs,” Professor Gotzsche, who heads the Nordic Cochrane Centre, told Fairfax Media ahead of his visit.
Two of Professor Gotzsche’s biggest targets are antidepressants and the painkillers described as “non-steroidal anti-inflammatories”, such as ibuprofen, diclofenac and celecoxib. Another, sold under the brand name Vioxx, was withdrawn after it emerged it had caused up to 140,000 cases of serious heart disease in the US alone in the five years it was on the market - during which time its manufacturer, Merck was withholding information about its risks. About half the cases were thought to be fatal.
Professor Gotzsche says those deaths are only the tip of the iceberg and are representative of a system of drug regulation that simply does not protect patients.
Even the name for these drugs, “anti-inflammatory”, is not supported by evidence, he says. He has conducted a clinical trial and review of the evidence that has found there is no proof they reduce inflammation.
“These terms for our drugs are invented by the drug industry,” he said. “They had a huge financial interest in calling these things anti-inflammatory. It lured doctors into believing that these drugs somehow also had an effect on the disease process and reduced the joint damage.”
In a paper last year in the Lancet Psychiatry journal, Professor Gotzsche argued our use of antidepressants is causing more harm than good.
He said as the evidence against drugs such as Valium and Xanax emerged, they have been replaced with antidepressants that are equally as addictive and their side-effects just as dangerous.
Furthermore, he says research that showed small benefits over placebos was biased, as it did not properly hide whether patients were in the active or placebo group.
Professor Gotzsche said the biggest victims of over-prescription are the elderly. For every 28 elderly people treated for a year with an antidepressant, one will die who would have lived otherwise, from causes including heart attacks, stroke and falls.
“Those who use arthritis drugs are mostly the elderly who are most at risk of dying of a heart attack caused by the drug or a bleeding ulcer,” he said. “We have a high use of psychiatric drugs by the elderly and we kill an enormous amount of them.”
Freedom-of-information requests lodged by Fairfax Media have shown more than 4 million antidepressant prescriptions a year are recorded for people aged over 67 - twice the rate for young Australians.
“These people get shoved in a nursing home and they get aggravated, so they’re knocked out with an antipsychotic drug - it’s very inhumane,” Professor Gotzsche said.
Professor Gotzsche has been criticised for his stance that people should consider slowly going off their antidepressants if they are supported by their doctors in doing so.
He believes many doctors mistake withdrawal symptoms for depression, immediately returning patients to their normal medication dose if they experience symptoms, despite the fact antidepressant medications are supposed to take some time to begin working.
“If you get depressed by lowering the dose and then immediately increase it to the normal dose, you will usually be well in a couple of hours,” he said. “But if you get better straight away it is withdrawal, not depression.”
But Peter McGeorge, the director of the St Vincent’s mental health service, said the hospital will host Professor Gotzsche on Thursday “in the spirit of open inquiry”.
“I have seen people respond dramatically to the use of antidepressants so I’m certainly not opposed to the use of medicine,” he said.
“But I do think we have to be careful - and I’m talking more generally now - about just seeing medicine as the answer and prescribing it on the smallest indication it might be successful”.
He said many hospitals, including the mental health service at St Vincent’s, now did not accept drug company representatives, and there was increasing interest in other forms of psychological therapies to help people with mental illness.
Professor Gotzsche’s list of what to avoid
- Antidepressants for all, as they very likely don’t even work for severe cases of depression
- All brain-active drugs in children
- Anti-psychotics and other brain-active drugs for the elderly. Psychotropic drugs should be used as little as possible and mostly in very acute situations, as they are very harmful when used long term Anti-dementia drugs, as they very likely don’t work
- Non-steroidal anti-inflammatory drugs used for arthritis, muscle pain and headaches, including over-the-counter, low-dose ibuprofen. These drugs should be used as little as possible.
- Mammography screening, as it doesn’t prolong life whereas it makes many healthy women ill through overdiagnosis and leads to the premature death for some because radiotherapy and chemotherapy increases mortality when used for harmless cancers detected at screening
- Drugs for urinary incontinence, as they very likely don’t work
Professor Gotzsche will appear at a number of events, including the University of Adelaide Club, South Australia on Tuesday the 10th, the State Library of Victoria on Wednesday the 11th, the Garvan Lecture Theatre next to St Vincent’s Hospital in Sydney on Thursday the 12th (free), the University of Sydney Law School on Saturday the 14th, and the Adina Apartment Hotel, in Brisbane on Wednesday the 18th. Booking details are available here.