Saturday, August 20, 2011

Prof. McGorry and the cancelled NEURAPRO-Q Study - worst news in a bad week for former Australian of the Year

Professor Patrick McGorry just can't stay out of the news, for all of the wrong reasons. On Thursday night McGorry was being grilled on Lateline by Tony Jones, and today The Sunday Age and the ABC's news channel are reporting that a trial which was to be conducted by Prof. McGorry, given the title of the NEURAPRO-Q study, of the controversial psychiatric drug Seroquel with children and youths as subjects has been aborted as the result of ethical complaints from 13 "psychiatrists, psychologists and researchers from Australia, Britain and the US". AstraZeneca, the manufacturers of the drug used in the trial have reportedly last month been forced to pay hundreds of millions of dollars in a lawsuit over the drug and diabetes. AstraZeneca is one of the many pharmaceutical companies from which Prof. McGorry "has received unrestricted research grant support". Is this peer review in action? I think it's a pity there wasn't much more of it a few years ago.

As is often the case with articles that I read about the professor, an opinion attributed to Prof. McGorry in this article has provoked my concern "Professor McGorry acknowledged the evidence suggested antipsychotics were not effective as a first-line treatment for the at-risk group. But he said the risks had been exaggerated and he would consider a similar trial on patients for whom other treatments had failed." One might consider that patients who still have symptoms after being given the "first-line" treatments might be suitable candidates for drugs, but consider that the professor is talking about a group of youths who don't meet the full criteria for a psychiatric diagnosis such as schizophrenia. I would think these patients are of doubtful status - not fully psychotic and individually possibly not in any pre-psychotic state. So I think it is a reasonable question to ask, of this group, what distinguishes a minority who do not respond to non-drug treatments that are supposed to be effective in treating those who are on the cusp of psychotic illness? Are these non-responding patients more psychotic, or are they non-psychotic patients whose identification as pre-psychotic was a complete mistake? If the latter is the case, they should never be put anywhere near a drug like Quetiapine/Seroquel.

Another quote from McGorry I found amusing: "A recently released literature review by The Cochrane Collaboration found there was insufficient evidence that early intervention could prevent psychosis and that any benefits were not long term. Professor McGorry said it used flawed methodology." Oh yes, those people over at the Cochrane Collaboration have a reputation for playing fast and loose with methodology!

Drug trial scrapped amid outcry
by Jill Stark
The Age.

August 21, 2011.

Links to images of the complaint letter:

in HTML at The Age:

PDF of document from the Sydney Morning Herald:

Journal paper with listing of Prof. McGorry's competing interests:

McGorry, Patrick (2008) Is early intervention in the major psychiatric disorders justified? Yes. British Medical Journal. August 4th 2008. 337:a695.

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