Ethical perspectives on relations between industry and neuropsychiatric medicine.
Conflicts of interest may influence medical research. In particular, the study on psychotropic treatment of ageing subjects suffering from neurological disorders and comorbid neuropsychiatric phenomena may be hypothetically considered economically non-advantageous, or even of negative impact on drug reputation, because of the high probability of non-response or side effects. Thus, studies on this issue may be disregarded from industry. We aimed to verify whether the global commitment of medical research reflects the actual relevance of depression in the world ageing population, associated or not with neurological conditions. Here, we: 1) have reviewed the literature on this issue, 2) have examined world published data concerning population by age, burden of disease and frequency of depressive disorders and antidepressant therapies, and 3) have reviewed the frequency of published papers on depression and its treatment associated with three neurological conditions. The overall rate of papers about depressive disorders in ageing people reflects adequately the world population and the prevalence of depression in the elderly. However, the rate of papers concerning medical experimentation for antidepressant treatment in Alzheimer's disease, Parkinson's disease and stroke is quite inadequate with respect to the rate of depressive disorders associated to these conditions. Thus, innovative medical experimentation must be encouraged, also in areas apparently of dubious economical advantage but of undoubted clinical relevance and the adoption of strategies to limit the detrimental effect of conflicts of interest in research must be enhanced.
IRCCS Santa Lucia Foundation, Rome, Italy.
Maria Donata
MD
Orfei
Carlo
C
Caltagirone
Gianfranco
G
Spalletta
D000544:Alzheimer Disease / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology*; D016265:Conflict of Interest; D017281:Cost of Illness; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D004345:Drug Industry / Q000941:ethics*; D006801:Humans; D010300:Parkinson Disease / Q000523:psychology; D011570:Psychiatry / Q000941:ethics* / Q000379:methods*; D020521:Stroke / Q000523:psychology; D035703:Therapies, Investigational
D000928:Antidepressive Agents