Monday, December 12, 2016
Q&A With Matthew Holford
Continuing with the Q&A's from people that have played a role in my life for the past ten years or so that I've been writing this blog...
Intelligence: the ability to acquire and apply knowledge and skills.
Matthew (Matt) Holford is an unsung hero, of mine at least. Much of Matt's interaction with the British drug regulator, the MHRA, is legendary. It stemmed from a visit to his Dr and being prescribed Prozac - it wasn't for him so he decided to write to the regulator because he had some pertinent questions that he needed answers to.
Matt's blog, 'It's Quite An Experience', features much of his correspondence with the MHRA and although Matt doesn't blog any more it's well worth the read, if only to see how Matt rattled the MHRA so much that they labelled him 'vexatious' - ie; they believed Matt was causing or tending to cause annoyance, frustration, or worry.
It was one simple question that they could not, and still cannot, answer - What are the benefits of Prozac? - a question that they have since answered (for me) that it "can" improve symptoms of depression by raising the level of the neurotransmitter, serotonin, in the brain. ((Notice their use of the word 'can')
It's laughable when you see that Matt was just trying to get answers to straight forward questions regarding the safety and efficacy of a product that the MHRA had granted a licence to.
I miss Matt, his wit, wisdom and use of colourful language both on his blog and in his correspondence with the MHRA was refreshing. For too long the MHRA were defending their corner and people (patients) were accepting what they had to say. Matt, along with the inimitable Charles Medawar (Social Audit) changed all of that.
For this reason alone, we should all feel indebted to Matt Holford - his exchanges with the British drug regulator highlighted just how incompetent they were and, to some, still are.
Holford, to me at least, is a legend.
Full Name: Matthew Holford
Q: Tell me about your experience with SSRIs
A: My direct experience is limited... I had cause to visit my GP and asked him to prescribe something for anxiety/depression. I don't know why, because I knew what the issue was, and I knew that no chemical could deal with it. I took two or three, came to my senses, and binned the rest.
However, my indirect experience is well-documented (not least, on your blog!). My encounters with the MHRA, and my "reading around the subject" have enabled me to see the bigger picture, as it were.
Q: Do you believe that people who are depressed have a disease of the brain?
A: No. Depression is a phenomenon caused by what might be described as a "double bind"... conflicting or contradictory signals, which are electrical, rather than chemical. We've all experienced this phenomenon, whereby we are placed in a situation where we are required to act other than in accordance with our best interests - the bully's ultimatum of "give me your dinner money, or I'll hit you," is an obvious example. On the one hand we don't wish to be hit or give over our cash, and on the other we have the ideal scenario of keeping our cash and not getting hit, but the bully's options are the only ones being offered us. Resolve one of those contradictory signals, and the depression is lifted - most people hand over their cash, even though that is not a long term solution.
Q; Your interaction with the British Medicines Regulator is legendary, Matt. For the benefit of the readers, can you tell me why you, a; first started corresponding with them and b; why you ceased communications with them?
A: Yow, that's a challenge! I think this is how it panned out: I was prescribed fluoxetine (generic Prozac), and I wanted to find out how it was that the MHRA thought that this stuff worked. So, I asked a bunch of questions, which led me inexorably towards their approval process (benefit/risk analysis, and all that). Along the way, I came across any number of horror stories - the Panorama documentary, Keller, personal experiences by patients such as yourself - but I was determined to make my own mind up, which the MHRA did for me, with its evasion, stonewalling and superior attitude. Nobody who is acting in bone fide acts in that way.
And that's how it ended: I refused to go round in circles as they continued to tell me that SSRIs had "benefited millions of people around the world," without offering any evidence to support that claim, and without acknowledging that their claim was not true for me, personally.
Q: Who, in your opinion, should be held responsible when someone dies as an adverse reaction to a prescription drug?
A: Everybody! Everybody knows that it's a lie - at least everybody who's taken these things and either a) had no beneficial reaction; or b) had an adverse reaction AND fails to make this experience public - and I'm not talking about making a crappy AER. It must also be true that the manufacturers and the regulators know. In short, nobody who has ever come into contact with these things can claim to come to the table with clean hands.
Q: Would you like to see the MHRA disbanded, if so, who or what would you put in their place?
A: The MHRA is not fit for purpose - that much is clear. The problem is that in order to regulate, one must understand what it is that one is regulating, or else the industry would run rings around you. That's a double bind, right there! Because the only people who know how the thing works are the industry, which is why the MHRA is well-staffed with people who have worked in the industry, and will probably work there, again.
In answer to your question: one needs people who know how things operate on a detailed level, but who have absolutely no connection with the industry, thereby avoiding the need to do the bidding of the industry that one anticipates will re-employ one. Good luck finding these people!
Q: Would you recommend writing a blog or public diary to people who had suffered severed antidepressant withdrawal events?
A: Absolutely. The level of support out there is truly impressive... Ad hoc support networks have developed on the internet in a way that no public health service can ever hope to emulate. Quite apart from that, as I discovered, there is a therapeutic benefit to be derived from setting one's thoughts down in writing - one clarifies one's position, and begins to move on.
Q: What do you say to people who believe that antidepressants are safe and effective?
A: Have you ever taken them?
Q: If you could ask GSK's Andrew Witty three questions what would they be?
A: I'm not sure I'd want to sully myself, to be honest, but here goes... If you discovered that it had miraculously slipped your attention that one of your Company's drugs was a fraud, what would you do about it? When will GSK appoint a compliance professional to the role of CEO, as opposed to somebody who has a background in marketing? Given that you claim that your products are excellent, why do you find it necessary to pay Key Opinion Leaders to endorse them?
Q: If you could ask the MHRA's Ian Hudson three questions what would they be?
A: Now, here, I'm absolutely sure that I wouldn't sully myself!
Q: Where do you see yourself in 10 years time?
A: Still trying to read minds!
Q: Finally, Matt,, some personal questions...
1. What book are you currently reading?
A: Some GCSE textbook, to assist my daughter's study - I haven't read for recreation in years!
2. What was the last CD you listened to (in full)?
A: Probably Damien Rice's "My Favourite Faded Fantasy".
3. What is the best movie you have seen this year?
A: Miss Peregrine's School for Peculiar Children was quite jolly! Seeing Samuel L Jackson going into contortions, when he clearly wanted to call everybody motherfuckers, was a treat!
4. What country would you most like to visit?
5. If you had the choice of being either a defence or prosecution lawyer, which would you choose and why?
A: I don't think I'd want to do either job - there would always be instances where one simply didn't believe what one's client was saying, and that would be tough, for me.
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