The annual meeting of the UK’s Royal College of Psychiatrists is in full swing at the moment in London. The conference will again not be debating important new findings about antipsychotic drug treatment. Two years ago the conference organising committee rejected a suggestion to discuss this issue.

This year I proposed a similar symposium, which would have included Lex Wunderink, who led the Dutch first episode antipsychotic reduction and discontinuation study and Robin Murray who was going to present data from imaging studies (including an ongoing study at the Institute of Psychiatry) on how antipsychotics affect the brain. I was going to speak briefly about the subjective effects of antipsychotics, and about the Radar project, a national research programme funded by the UK’s National Institute of Health Research.

The proposal was rejected again. I am extremely concerned that the Royal College conference organising committee do not appear to be aware of the importance of this issue. Here is my correspondence with committee:

Dear Chair of the Conference Committee,

I was disappointed that my suggested symposium concerning new evidence about the potential drawbacks of long-term antipsychotic treatment was rejected again. There is increasing public and professional concern about the use of antipsychotic drugs, and yet it seems the Royal College is not interested.

To my mind and many others, the long-term results of the Dutch First Episode study (Wunderink et al, 2013) are some of the most important research results ever published in the mental health field. They raise questions about our whole approach to treating schizophrenia and psychosis. In addition to this, the evidence that long-term antipsychotic treatment is associated with brain shrinkage is obviously a hugely significant issue (Robin Murray was going to present data on this in the proposed session).

Other institutions are aware of the importance of this research. There was a session at last year’s APA conference in Torontoon long-term antipsychotic treatment, which was so well attended people had to be turned away. I was recently approached by the Editors of PLoS Medicine to write an article on antipsychotic treatment, because they were concerned about these issues. Moreover, I am part of a group of investigators, including several leading British psychiatrists, who have just been awarded a large grant by the NIHR to study antipsychotic reduction and discontinuation in the light of the concerns about the long-term impact of these drugs.

I have now twice asked the principle investigator from the Dutch First Episode study to present at the Royal College annual meeting, and twice I have had to tell him that the Royal College do not want to hear from him. I strongly believe that British psychiatrists need to hear about this research. I speak frequently all over the country, and I know that many are not aware of it.

If my presence in the proposed session is a problem, I am most happy to withdraw in favour of another speaker. In fact I would be grateful for any suggestions the conference organisers had on improving or expanding the proposed session.

I believe the Royal College’s lack of interest in this topic reflects badly on the College in particular, and on British psychiatry in general. Hence I have copied in the President.

Yours sincerely,

Joanna Moncrieff

This is the reply I received (with names redacted):

Dr Moncrieff

I do not really have anything to add to [the original standard rejection email], other than to reiterate that we had many more suggestions than it is possible to accept (the acceptance rate is well below 1 in 3). We use a system of rating submissions by all committee members to inform our final choices. There were many excellent submissions this year and we have been unable to accommodate them all – not because they are flawed or uninteresting, but simply because they did not compete successfully for the limited spaces available. Your submission was in that category. There is no reason that a future submission may not be successful, but it must be competitive with other submissions for that meeting.

Many thanks for your interest in organising a session for the meeting and I am sorry you were not successful on this occasion.

With best wishes, sincerely

To which I replied:

Dear congress organising committee representative,

Thank you for your reply.

I remain astounded and concerned that the Royal College of Psychiatrists’ International Congress organising committee do not regard the new evidence on long-term antipsychotic treatment as important enough to include in the programme for the annual Congress.

I will indeed keep trying. I believe that British psychiatrists would welcome, and benefit from, the opportunity to consider this challenging research.

Yours sincerely,

Joanna Moncrieff.

I did at least receive a courteous reply, encouraging a future submission:

Dr Moncrieff

Thank you very much for your email – and your intention to submit a future proposal on this interesting topic.

Many thanks, best wishes