THE BURNED OVER DISTRICT

So they have resorted to the simple expedient of repurposing the ones that aren't moving that well. For a long time the medical profession has warned against the use of antidepressants for the bereaved. Not any more.

When, though, should the bereaved be medicated? For years, the official handbook of psychiatry, issued by the American Psychiatric Association, advised against diagnosing major depression when the distress is “better accounted for by bereavement.” Such grief, experts said, was better left to nature.

But that may be changing.

In what some prominent critics have called a bonanza for the drug companies, the American Psychiatric Association this month voted to drop the old warning against diagnosing depression in the bereaved, opening the way for more of them to be diagnosed with major depression — and thus, treated with antidepressants.

The change in the handbook, which could have significant financial implications for the $10 billion U.S. antidepressant market, was developed in large part by people affiliated with the pharmaceutical industry, an examination of financial disclosures shows.

The association itself depends in part on industry funding, and the majority of experts on the committee that drafted the new diagnostic guideline have either received research grants from the drug companies, held stock in them, or served them as speakers or consultants.

Drug companies have shown an interest in treating patients who have recently lost a loved one, having sponsored and published the results of at least three trials in which the bereaved were treated with antidepressants, including the Wellbutrin study.

The financial ties between the creators of the APA handbook and the industry far exceed limits recommended in 2009 by the Institute of Medicine, a branch of the National Academy of Sciences.

Sure, the drug companies had to buy their favorable rulings but if it fattens up the bottom line, it will be money well spent.