*Note* This scheduling program was not designed by folks who do a lot with APA Style and unfortunately it defaults to listing authors in alphabetical order. We cannot fix this for this online schedule, but the author orders are posted in the order submitted in the printed program available via pdf here.

Sunday, March 8 • 8:30am - 9:45am
Risks of Commercialized Science: Antidepressants, PMDD, and Big Pharma

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The American Psychiatric Association (2013) officially added Premenstrual Dysphoric Disorder (PMDD) as a mood disorder in the DSM-5, despite controversy over its validity, the lack of research in marginalized populations (Pilver et al., 2011), and concerns that PMDD pathologizes normal experience and disregards contextual factors of emotional distress (Ussher, 2012). However, the pharmaceutical industry has much to gain by legitimizing PMDD as a disorder and promoting the need for antidepressant medication (ADM) to treat it. The repackaging of Prozac/fluoxetine as Sarafem as a “new and effective” treatment was certainly helped by the financial relationships among industry, the APA, DSM, and FDA; the majority of DSM-IV PMDD panel members had industry ties, and the expert opinion given to the FDA by a DSM panel member that PMDD was a ‘real and distinct’ disorder was instrumental in getting Sarafem/Prozac approved (Cosgrove & Wheeler, 2013). There are currently three ADMs approved to treat PMDD and the industry-facilitated approval of these drugs was used to justify PMDD’s inclusion in the DSM-5. In a previous investigation, we found two meta-analyses of randomized clinical trials (RCTs) of ADM for PMDD that came to different conclusions about efficacy—even though they reviewed the same evidence. The meta-analysis authored by researchers with commercial ties concluded that ADMs are effective (Shah et al, 2008). The authors of the other meta-analysis who did not have industry ties concluded that current evidence about efficacy is unsatisfactory (Kleinstäuber, 2012). In this presentation, we will provide data on the extent and type of industry support of RCTs of ADM for PMDD, discuss the relationship between industry funding and the conclusions drawn about the efficacy and safety of ADM for the treatment of PMDD, and examine how marginalized populations are represented in RCTs. Prescriptions for reform and implications for stakeholders will also be addressed. References American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing. Cosgrove, L., & Wheeler, E. E. (2013). Industry’s colonization of psychiatry: Ethical and practical implications of financial conflicts of interest in the DSM-5. Feminism & Psychology, 23(1), 93-106. Kleinstäuber M., Witthöft M., & Hiller W. (2012) Cognitive-Behavioral and pharmacological interventions for premenstrual syndrome or premenstrual dysphoric disorder: A meta-analysis. Journal of Clinical Psychology in Medical Settings, 19, 308-319. Pilver C. E., Desai, R., Kasi, S., & Levy, B. R. (2011). Lifetime discrimination associated with greater likelihood of premenstrual dysphoric disorder. Journal of Women’s Health, 20(6), 923-931. Shah, N. R., Jones, J. B., Aperi, J., Shemtov, R., Karne, A., Borenstein, J. (2008). Selective serotonin reuptake inhibitors for premenstrual dysphoric disorder: A meta-analysis. Obstetrics & Gynecology, 111(5), 1175-1182. Ussher, J. M. (2012). Diagnosing difficult women and pathologising femininity: Gender bias in psychiatric nosology. Feminism & Psychology, 23(1), 63-69.


Madeline Brodt

University of Massachusetts Boston

Lisa Cosgrove

University of Massachusetts Boston

Shannon Peters

University of Massachusetts Boston

Sunday March 8, 2015 8:30am - 9:45am