strike two…

Posted on Friday 12 June 2009


Emory Psychiatrist Cited in Conflicts of Interest
WSJ
By DAVID ARMSTRONG
June 10, 2009

Emory University has disciplined a prominent psychiatrist who was being paid by an antidepressant maker at the same time he was conducting federal research about the use of such drugs in pregnant women. The university said its medical school dean issued a letter of reprimand on April 30 to psychiatrist Zachary Stowe related to his "external relationships." Dr. Stowe was instructed to immediately eliminate conflicts related to current federal grants and was barred from having any conflicts for the next two years.

Dr. Stowe, the director of the Women’s Mental Health Program at Emory, is considered a leading expert on the use of antidepressants in pregnant women. He is listed as the primary investigator on at least three National Institutes of Health grants, beginning in 2003 and continuing through last year, that involve antidepressant use in pregnant women and the effects on children delivered by those women…

In a letter earlier this month to Emory, Sen. Charles Grassley (R., Iowa) said he learned the school had informed the NIH last summer that Dr. Stowe had financial conflicts of interest. The senator said records he obtained from GlaxoSmithKline PLC, the maker of the antidepressant Paxil, indicated Dr. Stowe was paid $154,400 by the drug company in 2007 and $99,300 during the first 10 months of 2008. The totals included payments for at least 95 promotional talks on behalf of the company. A Glaxo spokesman was unavailable for immediate comment.

Dr. Stowe is the second Emory psychiatrist to run into problems related to his work with the drug industry. Charles Nemeroff stepped down as chairman of the psychiatry department last year after an Emory investigation concluded that he failed to report more than $800,000 he received from Glaxo from 2000 to 2006. That matter is now being probed by the inspector general for the U.S. Department of Health and Human Services.

Dr. Nemeroff remains on the Emory faculty. Last December, he said in a statement that he acted "in good faith to comply with the rules as I understood them to be in effect at the time."
As a former full time member of the Emory Departrment of Psychiatry, this report is pretty painful to read. It’s actually worse than this article explains. Senator Grassley’s letter has some attachments, emails between Dr. Stowe and GlaxoSmithKline. There’s a contentious exchange when GSK cancelled a couple of Dr. Stowe’s scheduled promo talks for lack of attendees. He demands payment because they interfered with his schedule [he could’ve scheduled some other lucritive talks]. But the worst part is in this email:
 
In the second part, he’s demanding his money for the cancelled appearances. But what the first part says has to do with studies he was doing about using antidepressants in pregnancy. He’d already published a study saying that Paxil was safe for nursing mothers [wasn’t found in breast milk]. Apparently, in this study, he was trying to see if he could say it was safe for pregnant women [ergo, didn’t make it into the amniotic fluid]. He says, "DAMN IT" meaning he wasn’t able to give them what they wanted. Apparently he’d already planned to write "paroxetine [Paxil] undetectable in amniotic fluid." That’s hardly the way a researcher talks. It’s the way a "co-conspirator" or an "employee" talks. Notice he says, "I’ll have the manuscript for you to review right after I finish the Grant stuff." This study was funded by a grant from the National Institute of Health, not GSK! Yet the drug company is going to review the manuscript? If that’s actually the case, this is a pitiful excuse for academic medicine.

To Emory’s credit, they’ve issued a new set of guidelines:

… Emory’s School of Medicine last week issued another updated policy on financial conflicts of interest. The new policy bans Emory faculty and staff members, students, and trainees from receiving any industry compensation for speaking engagements; prohibits any receipt of gifts; allows industry representatives to enter Emory facilities for “necessary interactions” only; and further restricts the involvement of Emory faculty members in start-up companies.
I know that this report is particularly disquieting to me, as a faculty member who used to be there full time. And I’d love to find some way to see this as an exception, but this is the second time in one year [Dr. Nemeroff in October 2008]. I sure hope this is the bottom of the barrel. And both of these men apparently remain on the faculty?…
  1.  
    Sammye
    June 13, 2009 | 5:33 PM
     

    As a woman on faculty, I have been offended by this pos since he arrived years ago. He has always given new meaning to MSP in the way he addressed his patients and female residents/colleagues. For him to be allowed to do research on Pregnant Women was unthinkable. Emory once again shows good judgment and consideration in their choices… I frankly can not think of a better person to get slapped, sorry it is only a couple of years.

  2.  
    February 21, 2010 | 12:16 AM
     

    […] that I mentioned two Psychiatrists investigated by the Senate from my former Department at Emory, Dr. Zach Stowe and Dr. Charles Nemeroff for being in the pocket of drug companies. Guess which company? […]

  3.  
    June 14, 2010 | 1:19 PM
     

    […] off I go to the Internet where I learn that Dr. Nemeroff and Dr. Stowe, in their promoting PAXIL for pay, not only gave numerous talks about the drug, but also published […]

  4.  
    June 14, 2010 | 1:23 PM
     

    […] They published and presented that Paxil was a safe drug during pregnancy, and they were wrong. [see strike two…] Furthermore, they had no basis to make that recommendation [other than GSK’s drive to make Paxil […]

  5.  
    June 14, 2010 | 1:31 PM
     

    […] [Senate Finance Committee] Update: From a a previous post about Nemeroff’s protege, Dr. Zach Stowe. As a former full time member of the Emory Departrment of Psychiatry, this report is pretty […]

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