by Dr.Harald Wiesendanger– Klartext
What the mainstream media is hiding
“Rented mouths” are by no means exceptional cases in medicine. Among the opinion leaders of the medical profession, the imposing “silverbacks” of their herd of gorillas, hardly anyone is above suspicion of being lucratively connected to the industry. The connections are manifold.
Are “rented mouths” extremely rare in the medical profession? In truth, hardly anyone who has anything to say in medicine is unsuspected of intimate industrial ties – and hardly anyone discloses them voluntarily.
Anyone included in the illustrious circle of “opinion leaders” and “is allowed to speak in a prominent position at a huge congress – can not help but be important to be a leader,” ex-pharmaceutical manager John Virapen sheds light on the depth psychology of belly brushing. “And through the contacts that we make possible for him through our program and through participation in the congress, he rises even higher in the general reputation.” (1) Opinion leaders are “irreplaceable” for Big Pharma, which is why “mostly people from the higher management” to wrap them up, explains the whistleblower. “These are also particularly distinguished people, specialists, and gourmet friends. The means of choice here are symposiums to confirm one’s own status, expensive medical equipment or computers, travel, and quite simply: money.” (2)
The “silverbacks” of the medical profession – alpha males with unbeatable showmanship – can be used in many ways:
– as a consultant on the advisory board of pharmaceutical companies;
– as paid speakers, “keynote speakers”, for lectures, press conferences, symposiums, congresses, and medical training events;
– as official (co-)authors of articles, which in fact, are often written by ghostwriters: employees of the press offices of pharmaceutical companies or PR agencies, often also freelance medical journalists (3);
– as a participant in committees that define “guidelines” for the medical profession on how diseases are to be treated according to the latest state of research – they specify what “good clinical practice” (GCP), “evidence-based” treatment of patients has to consist of;
– as members of those influential commissions that set diagnostic criteria, thresholds, and limit values. For example, every millimeter by which they increase the symptoms of a “disorder” can mean billions in profits with the right drugs. And every newly introduced “fault” opens up additional sales markets.
Sissi says hello
It almost worked, for example, when the “Sissi Syndrome” was invented: an alarmingly widespread mental anguish that was allegedly misunderstood for far too long and is said to have caused the Austrian Empress Elisabeth (“Sissi,” 1837-1898) the most painful problems. Employees at GlaxoSmithKline came up with the idea for this creation: How about a new form of depression that is particularly difficult to diagnose because those affected skillfully cover it up with cheerfulness, increased activity, a pronounced body cult, and apparent contentment? What a happy coincidence: A tablet with a suitable active ingredient was already at hand: paroxetine, trade name “Seroxat.” The serotonin reuptake inhibitor increases the number of stillbirths in pregnant rats, reduces birth weight, and causes newborns to die more often. (4) On the other hand, it was said that he gets human females very well. A PR agency invented the cute name “Sissi Syndrome.”
Now it was just a matter of stimulating demand – and two respected German physicians made themselves available for this purpose. For a handsome fee, A.R., the head of the gynecological psychosomatics department at the University Hospital Bonn, gave a lecture on “Empress Sissi as a prototype of an unrecognized patient image,” presenting psychopathological investigations of the alleged syndrome. The psychologist H.-U. jumped to her side. W., Head of the Institute for Clinical Psychology at the Technical University of Dresden, a contributor to the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), in whose 160-strong expert commission he was in good company: more than half of the physicians involved and Psychologists have acknowledged their monetary ties to the pharmaceutical industry. Three million Germans are affected by Sissi syndrome, so ranted W., who worked as a consultant for six pharmaceutical companies. (5)
But disappointingly, few Sissis let the bear untie. Efforts to place an alleged “Viagra for women” on the market were more fruitful. In August 2015, the FDA cleared it for the US market, which appeared to be heading for billions in sales under the name “Addyi” for a while. The active ingredient flibanserin was initially intended as an antidepressant but proved unsuitable in clinical tests. On top of that, it had nasty side effects: it often caused dizziness, tiredness, nausea, occasional insomnia, anxiety, dry mouth, abdominal pain, constipation, bedwetting at night, tachycardia, persistent stress, and fainting spells.
However, some female subjects claimed to have noticed an increased libido. As is often the case, the invention of a drug and the corresponding clinical picture went hand in hand. “We managed to engage leading thinkers about female sexual dysfunction,” said the executive of one participating company, “and we worked closely with them to develop this disease as a whole in a way that made sense.” 6) Thus, with the help of willing experts, Hypoactive Sexual Desire Disorder (HSDD) – also “sexual desire disorder” – achieved the rank of a mass epidemic, which is said to affect every third adult woman: a “pronounced deficit up to the complete lack of sexual fantasy and desire for sexual activity, which can result in significant distress and interpersonal difficulties. (7) The HSDD arrived in the professional world at the latest when it was included in the International Classification of Diseases (ICD), classification number F52.0.
The US regulatory authorities ignored the continuing severe side effects: Dizziness and tiredness set in four times more often; the risk of nausea doubles; together with alcohol, Flibanserin causes blood pressure to drop dangerously. Equally unimportant to the FDA were the somewhat disappointing results of a total of eight clinical studies with almost 6,000 participants: these had by no means measured a stronger sexual desire after ingestion but only a slight increase in sexual satisfaction. And what was it? Within two months, women who took Pink Viagra experienced, on average, one more orgasm than those who did not. (8) At least one thing is not: too much.
Nevertheless, luminaries in sex research and gynecology – as, embarrassingly, women’s rights organizations (9) – shamelessly lent themselves to hailing Flibanserin as an epoch-making miracle pill that would finally free female lust from its shackles. They swept under the rug how much sexual desire depends on partner behavior and relationship quality. And they disregarded an essential difference: Viagra helps the man who wants to but can’t by improving the blood circulation in the sexual organs within an hour so that an erection occurs. On the other hand, Flibanserin only sensitizes the brain of the woman, who could, but does not want to, after weeks of regular use – a little. The preparation ended, deservedly, as a maliciously ridiculed shopkeeper. (10)
Being so willing to serve pays off in abundance for silverbacks: the donations by no means end with the reimbursement of conference fees, travel, and hotel expenses. They range from invitations to fine restaurants to luxury trips, also for the wife, to the Caribbean and free tickets to major cultural and sporting events to relaxation and pleasure tours, better without a wife, with “diving, surfing, sailing, pretty girls and hot Nights” (11), as well as share packages and lavish remuneration for author and speaker activities, occasionally in the high six-digit range.
(Harald Wiesendanger)
Remarks
1 John Virapen: side effect death. An ex-manager of the pharmaceutical industry unpacks, Kleinsendelbach 2009, p. 70 f.
2 viruses: loc.cit.
3 J.S. Ross/K. P. Hill et al.: “Guest authorship and ghostwriting in publications related to rofecoxib: a case study of industry documents from rofecoxib litigation,” Journal of the American Medical Association 299/2008, pp. 1800-1812; S. Sismondo: “Ghosts in the Machine,” Social Studies of Science 39/2009, pp. 171-198.
4 Deroxat: “Information for professionals,” as of June 2009.
5 Der Spiegel 20/2011, pp. 118-119.
6 Quoted from Marie Schmidt: “What does she want then?”, Die Zeit No. 35, 27 August 2015, p. 42.
7 Adapted from J.J. Warnock: “Female hypoactive sexual desire disorder: epidemiology, diagnosis and treatment,” CNS Drugs 16 (11) 2002, pp. 745-753.
8 According to Loes Jaspers et al.: “Efficacy and Safety of Flibanserin for the Treatment of Hypoactive Sexual Desire Disorder in Women: A Systematic Review and Meta-Analysis,” Journal of the American Medical Association, online 29 February 2016: http://archinte. jamanetwork.com/article. aspx?articleid=2497781, accessed 3/1/2016.
9 Apotheke Adhoc, September 22, 2015: “Women’s rights activists lobbied for ‘Pink Viagra’,” www.apotheke-adhoc.de/nachrichten/detail/internationales/pink-viagra-addyi-flibanserin-sprout-pharmaceuticals-even-the-score/ , retrieved on 18.5.2019.
10 Apotheke Adhoc, 10/22/2016: “Addyi: Lustpille as a slow seller”, www.apotheke-adhoc.de/nachrichten/detail/internationales/pharmaunternehmene-unlust-auf-lustpille/, retrieved on 05/18/2019.
11 John Virapen: side effect death, loc.cit.
This text is part of a series of articles with the following additional contributions:
1) Trained demigods – How doctors become drug dealers
2) Visit from the Rep – Mendacious Friendship based on the script
4) Off label – crossing borders as routine
5) Purchased Observer – When the doctor becomes the “researcher.”
6) How easy – When doctors play “Kick-back.”
7) “As you do to me, so do you” – reciprocity as the secret of success
8) Softened – education and training as brainwashing
9) Insatiable Renters – The uncanny power of paid opinion leaders
10) Among Gorillas – Silverbacks call the shots
11) As KOL to the Golden Nose – Why “Key Opinion Leaders” have taken care of it
rented mouths, Opinion Leaders, Pharma Marketing, Big Pharma, advisory board, key note speaker, Sissi Syndrome, Pink Viagra, Harald Wiesendanger