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Taking the Case to the Profession: London Psychiatric Hospital

November 11, 2004 — Dr. Terry Polevoy and Marvin Ross present the documentary case against Truehope/EMPowerplus to psychiatric residents and staff

Event date
November 11, 2004
Location
London Psychiatric Hospital, London, Ontario
Presenters
Dr. Terry Polevoy, MD, FRCPC, and Marvin Ross, MA
Audience
Psychiatric residents and staff
Related
See David Gilbert & the Pitch at St. Joseph's Hospital for the promotional side of this story

A rebuttal built for a clinical audience

A little over a year after Pig Pills, Inc. was published, Terry and Marvin drove to London, Ontario to present "Alternative Medicine and Your Practice" to the psychiatric residents and staff who would eventually be treating the very patients Truehope's promoters were targeting. Where the recorded pitch at St. Joseph's Hospital in Hamilton captures Truehope's sales pitch from the inside, this presentation is the documentary rebuttal — dense with dates, named researchers, and records obtained through Freedom of Information requests, aimed at equipping the next generation of psychiatrists to recognize the pattern before it reached their own patients.

Approved before it existed

The single sharpest piece of documentation in the talk is a dated sequence showing that EMPowerplus's clinical trials were approved before the product — or the company that made it — existed.

May 1999Adult and children's open-trial IRB approvals granted
June – August 1999Fibromyalgia and bipolar RCT approvals follow
December 19, 1999Evince International — the corporate predecessor in the Synergy/Truehope lineage — is incorporated
April 2000The formulation itself is finalized and named EMPowerplus, by Bonnie Kaplan's own account in her journal article

Institutional review board approval, in other words, was granted before the company that made the drug existed.

The researcher's own data, against her own conclusions

Terry and Marvin walked the room through Dr. Bonnie Kaplan's published data against her own stated conclusions. Her presentation to the Canadian Psychiatric Association in 2000 concluded that the supplement had, in most cases, "entirely replaced psychoactive medications" — yet her own Table 3 showed only one of eight medicated subjects had actually come off medication by the study's end. Her subsequent Journal of Clinical Psychiatry publication showed a similar gap: three of twelve medicated subjects off medication, not "most."

A further inconsistency: that same journal article lists three subjects as having been on EMPowerplus for fifty-eight to eighty-six weeks — despite the product itself, by Kaplan's own account, not existing until April 2000. The maximum possible duration by the time the paper was submitted was roughly forty-eight weeks.

An unpublicized, negative trial

A completed fibromyalgia RCT, presented at the American College of Rheumatology in 2002 and never publicized by Truehope, found no benefit whatsoever from EMPowerplus against placebo in ninety-nine patients — thirty-four of whom dropped out due to side effects. When Marvin asked the university how many of the thirty-four withdrew from the placebo arm versus the active treatment arm, they refused to say.

What was actually in the pills

Independent lab analysis by the Schizophrenia Society of Ontario — conducted in Denver, after a first attempt was rejected because Marvin had opened his undercover-purchased bottle before submitting it, breaking the chain of evidence — found that of thirty-six listed ingredients, only twenty-three could even be measured. Sixteen of those varied by as much as seventy percent from the label. Nine exceeded upper tolerable limits for toxicity, including vitamin A at outright toxic levels in the very bottle presented at the talk.

The original manufacturing lab was not an FDA-approved pharmaceutical facility — its parent company's best-known product was ice cream flavourings.

Dr. Catherine J. Field

"I have never analyzed the content of the product beyond the information on the label" — despite being the researcher credited with evaluating it for the Alberta-approved study.

The Utah admission

The U.S. Office for Human Research Protections found in August 2002 that the Utah phase of the research had been conducted despite a prior ethics board rejection. The recording of the talk adds something sharper: in a direct interview, the Utah-based psychiatrist running that phase of the study told Marvin his research proposal had been rejected by Utah's own ethics board four or five times — before he simply folded his patients into Bonnie Kaplan's Calgary trial instead.

Calling Truehope's own call centre

To close the clinical portion of the talk, Terry and Marvin played recordings of calls made to Truehope's own call centre — volunteers working from ten realistic scenarios, designed by an anonymous GP and vetted by a senior psychiatrist for authenticity, posing as prospective patients.

AIDS/mania scenario: a caller describes a wife with declining CD4 counts and a history of intravenous drug use. The Truehope representative never identifies the caller is describing an AIDS patient, and recommends the product anyway.
ADHD/meningitis scenario: a caller describes a child with fever, neck pain, headache, and chills — textbook meningitis warning signs. The representative says "sounds like the flu" and walks the caller through dosing rather than urging an emergency room visit.
Depression scenario: Marvin calls posing as a clearly depressed, suicidal patient. The representative never identifies the suicidality and, after giving what Marvin describes as dangerously poor advice, tells him to call back again.

"These people are very happily answering phones, dispensing medical advice," Marvin told the room.

The book

This presentation, and the recorded evidence behind it, is part of the documentary record behind Pig Pills, Inc., co-authored by Dr. Terry Polevoy, Marvin Ross, and Ron Reinhold — the definitive exposé of EMPowerplus, the Synergy Group, and the extraordinary claims made for a nutraceutical sold to bipolar patients in Canada and the U.S., over the objections of Health Canada.