Our seminar recently watched the movie “Side Effects” (FINALLY!) I did not see the trailer beforehand nor read a synopsis of it, so I had no idea what to expect. If you have not seen the movie yet, be forewarned that it is a psychological thriller and this post may contain spoilers. Anyways, I enjoyed the movie, but it left me quite scared of three particular things: 1) humans in general, 2) humans especially when they are lying, and 3) being a psychiatrist.
The movie convinced me that psychiatry is not going to be in my future. How or why, you ask? Well, one of the main characters of the movies was diagnosed with depression, and Jude Law’s character was a psychiatrist that prescribed the patient to take an antidepressant. The medication had a “side effect” that resulted in the patient murdering her husband. This roused the question of who to hold responsible for this occurrence: The patient for her faulty biology or the psychiatrist for prescribing the medication that elicited the deadly side effect? This is what scared me, that Jude Law’s character could be to blame because he was the psychiatrist that prescribed the medication. I cannot imagine being in his shoes, being responsible for a side effect.
Then again, what if a psychiatrist was not aware of the risk of a side effect that is as extreme as the one in the movie? Due to publication bias, doctors do not always have the full picture of the effects of the medication they prescribe. Many drugs seem effective because the literature contains an overwhelming representation of articles on the positive findings. For example, Reboxetin is an antidepressant that underwent seven trials of testing to compare it to a placebo. One trial yielded positive results, and it was published. However, the 6 other trials demonstrated negative findings and those did not make it through publication. What does this say about drug safety and integrity? How are doctors expected to perform their duties at an optimal level without the appropriate information? A number of psychiatrists like Jude Law’s character probably prescribe medication on a daily basis that have side effects that they do not know exist because of publication bias. Would these psychiatrists still be considered as being at fault for the result of the side effect?
As of the moment, I find it frightening that knowledge is being withheld from us. Journals, pharmaceutical companies, PR companies, and et cetera need to consider the ethical issues of publication bias. Nevertheless, I am glad that there is an increased awareness of this occurrence and that efforts are being made to fix it. Hopefully the reports on findings from drug trials improve, but don’t expect me to change my mind about psychiatry. I am fairly set on going into experimental psychology instead and making sure that I provide the world with non-misleading data!
If you are interested in hearing more about publication bias, watch the TEDTalk by Ben Goldacre titled What doctors don’t know about the drugs they prescribe