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Archive for December, 2016

so long 2016…

( OPINION )

whodunit? theydunit…

( OPINION )

Use the active voice. The active voice is usually more direct and vigorous than the passive:      I shall always remember my first visit to Boston. This is much better than      My first visit to Boston will always be remembered by me. The latter sentence is less direct, less bold, and less concise. If the writer […]

an explanation and a surprise…

( OPINION )

So, picking up from explanation would be welcome… and looking at the enrollments in RAP-MD-01, RAP-MD-02, and RAP-MD-03 that seem so high in those Rapastinel Clinical Trials. The way trialists pick their sample size is to do a Power Analysis. Using the Standard Deviation from a previous similar study, then pick the difference in means […]

season’s greetings…

( OPINION )

explanation would be welcome…

( OPINION )

I’ve been writing about Rapastinel, an NMDA receptor partial blocker touted to have Ketamine’s antidepressant effects without being a psychomimetic [see a touch of paralysis… and a block-buster-in-training…]. It was developed by a Northwestern University neuroscientist who formed a private company [Naurex], later purchased by industry giant Allergan for $560 M. They’ve recently registered four […]

Klerman 1978: schizophrenia…

( OPINION )

Psychiatry was obviously ripe for the the medicalization ushered in by the neoKraepelinians and the DSM-III released two years after this article. Changes in reimbursement schedules, a burst of new psychotropic drugs certified by industry funded clinical trials, and a focus on neuroscience research soon followed. The disappearance of the public mental hospitals was matched […]

Klerman 1978: the critics…

( OPINION )

[continuing from an interesting read…, Schizophrenia: Science and Practice, Chapter 5: The Evolution of a Scientific Nosology, and Klerman 1978: on the medical model…]. In 1978, criticism of psychiatry was in full bloom. At the radical pole were people like R. D. Laing and Thomas Szasz who questioned whether psychiatry should even exist. In 1974, […]

Klerman 1978: on the medical model…

( OPINION )

Some of Gerald Klerman’s comments from 40  years ago [an interesting read…, Schizophrenia: Science and Practice, Chapter 5: The Evolution of a Scientific Nosology] could’ve been written yesterday, and you wouldn’t see any difference. After reviewing the oft told history of diagnosis and treatment of psychotic illness and discussing the neoKraepelinian Credo, he turns to […]

an interesting read…

( OPINION )

I came to psychiatry from practicing Internal Medicine with something specific in mind to learn about – and it wasn’t psychiatric patients. It was the subset of medical patients whose problems were clearly mental – and there were plenty of them. But in a psychiatry residency, that’s not where you start. It’s on the wards […]

blockbuster-in-training addendum…

( OPINION )

We say that the reason that new drugs are given such a generous period of patent-exclusivity is to compensate the pharmaceutical company for its long and expensive research and development process taken at great risk. But ever since the Bayh-Dole Act of 1980, universities and/or their faculty can be granted unencumbered patents even if federal […]