MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

Quotations from the doctors’ SSMC Manual
384
This 48 page Manual consists of just 8 content pages, the remainder being nine appendices.
From the Minutes of the joint meeting of the Trial Steering Committee and the Data Monitoring and Ethics
Committee held on 27 th September 2004, it is a matter of record that Professor Peter White expressed concern
that participants receiving only SSMC might interpret it as the ‘go away’ arm of the Trial.
The two “Contents” pages list the following:
“Background to the PACE trial”
“Patient Clinic Leaflet (PCL) – its use in SSMC”
“Timing of visits”
“SSMC – FAQ” (Frequently Asked Questions).
“Appendix 1……Appendix 9”.
Standardised Specialist Medical Care (SSMC) is defined on page 4 of the Manual: “SSMC is the standardised
specialist medical care provided by the CFS/ME clinic doctor for patients who receive a diagnosis of CFS/ME”.
“SSMC includes:
• A positive diagnosis of CFS/ME and an explanation of the condition that is consistent with the Patient Care
Leaflet (see Appendix 2) (emphasis added)
• General advice on managing activity and stress and coping with the illness that is consistent with the Patient
Clinic Leaflet (see Appendix 2) (emphasis added)
• The prescription of medication for specific symptoms (such as simple analgesia, hypnotics, antihistamines
and antidepressants) if indicated and agreed with the patient
• Communication with…the participants (sic) General Practitioner
• Monitoring of the participants (sic) progress
• A copy of the assessment letter will usually be sent to the participant, so long as they wish to receive it”.
Thus the Fatigue Service clinic doctor is permitted to explain “CFS/ME” only according to the Wessely
School beliefs set out in the Patient Clinic Leaflet and to give medical advice only according to the Wessely
School beliefs.
Moreover, there is significant published evidence that antidepressants are ineffective in ME/CFS, for
example, “Randomised, double‐blind, placebo‐controlled study of fluoxetine in chronic fatigue syndrome”;
Jan HMM Vercoulen et al; Lancet 1996:347:858‐861: “Antidepressant therapy is commonly used (in CFS).
However, there has been no randomised, placebo‐controlled double‐blind studies showing the effectiveness of
antidepressant therapy in CFS. We have carried out such a study to assess the effect of fluoxetine (Prozac) in depressed
and non‐depressed CFS patients…There have been anecdotal reports that fluoxetine is poorly tolerated by patients with
CFS. In our trial, 15% of fluoxetine‐treated patients withdrew because of side effects, a higher withdrawal rate than in
fluoxetine trials in depressed patients on the same regime” and the authors concluded: “Fluoxetine in a 20mg daily
dose does not have a beneficial effect on any characteristic of CFS”.
There is also evidence that people suffer adverse reactions to such medication; indeed, intolerance to alcohol
and medication (especially to drugs acting on the central nervous system) is a feature that the renowned
neurologist Professor Charles Poser of Harvard described as pathognomonic of ME/CFS at the 1994 Dublin
International Symposium held under the auspices of the World Federation of Neurology.