A 2022 study published in Community Mental Health Journal examined nine commonly used psychopharmacology textbooks to identify financial conflicts of interest of their authors and editors. The findings showed that two-thirds of psychopharmacology textbooks authors or editors received personal financial payments from pharmaceutical companies. Unlike most medical journals that require authors to disclose their financial payments, textbook authors and editors are not required to do so.1
Psychopharmacology Textbook Authors/Editors Making Millions of Dollars
The researchers of the conflict of interest study collected a number of psychopharmacology textbooks that are used by psychiatrists, who prescribe psychiatric drugs. Practicing psychiatrists were asked to review the list of textbooks to include and exclude and selected nine textbooks to be evaluated. The researchers used the names of the authors and editors of the textbooks to investigate the conflicts of interest in two databases: ProPublica’s Dollars for Docs (for the years 2013-2018) and Open Payments (for 2019 and 2020).2
The results showed that two-thirds of the textbooks had at least one editor or author who received money from a drug manufacturer. An employee of a pharmaceutical company also authored one textbook. A total of $11,021,409 was received by 11 of the 21 editors/authors from 2013 to 2020. The majority of the money ($10,616,165) was paid to the author of Essential Psychopharmacology: Neuro-scientific Basis and Practical Applications 5th edition (2013). Almost a quarter (5 of 21) of the authors/editors received over $75,000. Almost all these payments (99.8 percent) were for non-education activities such a promotional speaking events.3
Seven of the nine textbooks did have a disclosure statement for conflicts of interest; however, the disclosure was located in a place where the reader is unlikely to see it.4
Commercialization of Medicine is a Public Health Problem
The study researchers concluded that that medical students should be explicitly informed of biases and financial conflicts of interest of authors of educational and training textbooks. The researchers also recommended that textbook publishing should implement a policy that includes a clear and prominent conflict of interest statement so that students are better able to evaluate information and drug use recommendations contained in the textbooks. They stated:
In the same way that the International Committee of Medical Journal Editors (ICMJE) requires transparency, disclosure of Financial Conflicts of Interest (FCOI) should become a standard practice among the authors and editors of psychopharmacology textbooks. It is a positive sign that most (7/9) of the textbooks had a disclosure statement. However, the placements of these statements varied and some were embedded in lengthy prefaces making it unlikely that most readers would see them. Finally, further research should evaluate the possible relationship of FCOIs to the over-estimation of the benefits and under reporting of harms of the drugs discussed in these textbooks.5
Medical textbooks do not include the original clinical trial data upon which statements about efficacy and safety of psychotropic medications are based, which prevents readers from fully evaluating the data. Readers relying on biased recommendations influenced by financial conflicts of interest raises the risk of doctors relying on treatments that potentially harm patients.6
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1 Cosgrove L et al. Conflicts of Interest in Psychopharmacology Textbooks. Community Mental Health Journal 2022; 58:619–623.
2 Sears R. Most Psychopharmacology Textbooks Have Financial Conflicts of Interest. Mad in America Feb. 14, 2023.
3 Cosgrove L et al. Conflicts of Interest in Psychopharmacology Textbooks. Community Mental Health Journal 2022; 58:619–623.
4 Sears R. Most Psychopharmacology Textbooks Have Financial Conflicts of Interest. Mad in America Feb. 14, 2023.
5 Cosgrove L. et al. Conflicts of Interest in Psychopharmacology Textbooks. Community Mental Health Journal 2022; 58:619–623.