Schwitzer health news blog

Wake up! More sleeping pill drug dirt!

Tufts med school prof Daniel Carlat, in an op-ed piece in the New York Times, says "makers of sleeping pills are now paying doctors to publish bad things about competing drugs."

Carlat claims that industry has colluded to slam the use of trazodone, an antidepressant that psychiatrists prescribe off label to treat insomnia because it works so well. He says trazodone has a long safety record and is cheap, costing as little as 10 cents a pill. He says new highly-advertised sleep drugs Ambien and Lunesta can cost $3 a pill or more.

Carlat continues: "Each time a psychiatrist prescribes trazodone, a potential sale of Lunesta or Ambien is lost. No doubt that is why, in the past few years, several articles have been published in professional journals that can only be described as trazodone-bashing. With titles like 'The Use of Trazodone as a Hypnotic: A Critical Review' (published in The Journal of Clinical Psychiatry), these articles purport to present balanced reviews of the scientific literature on sleeping pills. But the authors, psychiatrists with university affiliations, have been paid by Sepracor, Sanofi-Aventis or Takeda, the companies that stand to gain from trazodone's downfall."

In these articles, Carlat claims, "Trazodone is criticized as lacking high-quality research data on its ability to help people sleep. What is left unmentioned is that because trazodone is no longer patented, no pharmaceutical company stands to profit from doing such research."

Carlat calls for a mandate of "fuller disclosure of links between drug companies and authors. Several states now insist that drug makers report the gifts they give doctors. These same companies should be required to disclose the exact nature of a doctor's involvement in preparing a sponsored article, as well as the dollar amount of his or her fee. I suspect it would be the rare doctor who would want such information to come to light."