Social Audit Ltd
P O Box 111 London NW1 8XG
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The Rt. Hon. Frank Dobson PC MP
Secretary of State for Health
Richmond House, Whitehall,
London SW1 12 March 1998

Dear Mr. Dobson

Thank you for your letter of 9th March. Far from keeping me informed of developments, my request to the MCA to provide even a list of the "wide range of expert advisers and other relevant bodies" they claim to have consulted has been refused, and is now the subject of an appeal under the Code. So far as I can see, the appeal is under review by the person who originally refused disclosure, and his reply is now overdue.

I note your guarded response on this question: can the SSRIs cause physical dependence? I respectfully suggest that you may be able to make up your own mind on this question more easily if you ask your advisers two questions:

1. How can there not be physical dependence if newborn babies can experience withdrawal symptoms after maternal ingestion of SSRIs during pregnancy?

2. Is it not absurd to be using a definition which would preclude a diagnosis of "dependence", unless said babes and sucklings also demonstrated, for example, "evidence of tolerance", "progressive difficulties in controlling substance-taking behaviour", "progressive neglect of alternative pleasures or interests", or persistent substance use "despite clear evidence of overtly harmful consequences"?

I am enclosing a copy of some notes I prepared for a debate last week at the Kings Fund Centre, in which the Chairman of the CSM proposed that "The current system of drug licensing adequately represents the patients' interests". Twelve people (19%) voted in favour and 52 (81%) against. I am enclosing also a copy of the letter I have since written to Professor Rawlins, as this may help explain some concerns. Correspondence on a range of matters arising can also be seen at

Yours sincerely,
Charles Medawar


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