PROZAC FOR STUDENTS

From Professor Stephen Senn

Sir, I hold no brief for Prozac and would be quite happy to believe Ms
Barbara Butcher's claim (letter, September 1) that St John's wort is
its superior for the treatment of examination nerves, but for her
basing her claim on "non-randomised" clinical trials.

Such an approach to experimentation is not acceptable when developing
pharmaceuticals, and I see no valid reason for adopting lower
standards for herbal remedies. Quite apart from the opportunities for
manipulation which non-randomised trials provide, they do not permit
adequate concealment of the treatment allocated.

We currently employ double standards in dealing with pharmaceutical
and alternative therapies. It is, of course, not in the interests of
those who promote the latter to publicise this fact.

Yours faithfully, STEPHEN SENN, Department of Statistical Science,
University College London, Gower Street, London WC1E 6BT.
stephen@senns.demon.co.uk September 4.

From Professor Ian Hindmarch

Sir, According to Ms Barbara Butcher, the use of Prozac in teenagers
experiencing depression confirms the power of the pharmaceutical companies.

The "power", if such be the appropriate word, is in the hands of drug
regulatory authorities which license a product for a defined clinical
usage and the medical practitioners who decide, given the clinical
characteristics of an individual case, to prescribe a particular
product from the many available alternatives.

A licence to market a medicine is obtained only after strictly
controlled and intensive research programmes have been completed to
the satisfaction of the regulatory body.

Yours etc, IAN HINDMARCH, Human Psychopharmacology Medical Research
Centre, University of Surrey, Egerton Road, Guildford GU2 5XP.
September 1.

Checked-by: Patrick Henry