And I naively thought the benign scenario might explain things [“scrutinized”…]. Wrong again. I guess when dealing with the likes of Nemeroff and GSK, taking the high road usually turns out to be a mistake. Danny Carlat actually read the book and here’s what he found:
So I finally got the book, ripped open the manila envelope from an Amazon reseller, and found out exactly what a $120,000 “unrestricted educational grant” will buy: an advertisement for Paxil. Not obvious, not blatant. But artfully crafted, subtle, smooth — more in the style of Nemeroff than Schatzberg. Nemeroff was clearly the mentor in this project.
Much ink has been spilled about whether the book was or wasn’t ghostwritten by a PR firm called STI. This letter from STI to Dr. Nemeroff appears to be a smoking gun of evidence, yet Nemeroff, Schatzberg, and the American Psychiatric Association vehemently deny that this was ghostwritten. Rumor has it that Schatzberg is sicking his attorneys on anyone who dares to suggest what seems to be crystal clear based on the documents. But who cares, really? If it was ghostwritten, that’s unethical. If it wasn’t ghostwritten, it’s actually worse for these academics – because the final result is such a finely crafted piece of promotion that any reputable "author" should be embarrassed and ashamed. This is truly a case of "damned if you do, damned if you don’t."
I’ll leave out Carlat’s close read. Read it in person here. Danny says it well, thorough and to the point. He lays out the situation as it was in 1999, and shows how this book "accentuates the positive and eliminates the negative" about SmithKlineBeecham’s SSRI Paxil. Paxil was a drug I never personally prescribed [and only know about from helping people get off of it – no small task]. But in 1999, SKB obviously thought they could get away with minimizing its many side effects and its withdrawal symptoms. From Danny Carlat’s evidence, it looks like Nemeroff and Schatzberg’s book was an attempt to get Paxil in the hands of Primary Care Physicians. The book wasn’t just "ghost-written," it was haunted through and through by the marketing strategy of the pharmaceutical manufacturer that bought the book, then gave it away to the Primary Care Doctors. Carlat’s conclusion:
To sum up, in 1999, Nemeroff and Schatzberg published a textbook called "Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care." It was funded by SmithKline Beecham with a $120,000 "unrestricted educational grant." Documents posted on the internet hint strongly that the book was ghostwritten by a PR firm hired by the drug company. And an analysis of the book’s content shows that it was crafted to encourage primary care doctors to prescribe Paxil preferentially over its competitors, such as Zoloft.
This is yet another heaping of shame upon psychiatry. Rather than sending bullying lawyer letters to whistleblowers, I suggest that the authors issue the following statement: "We hereby apologize to the medical community and to the public for having published this textbook. In 1999, financial relationships with the pharmaceutical industry of this type were considered acceptable. In retrospect, by having legitimized what was essentially a promotional document for SmithKline Beecham, we realize that we did a disservice to the physicians who read the book, and who falsely assumed that the information was objective. We, in conjunction with the American Psychiatric Association, officially retract this textbook in its entirety."
I had an experience myself that fits in here. Until I read Carlat, I dismissed it. But now I’ll add it to the mix. When I got the alert about the Miami Herald article on Thursday night [Version 1], I left this comment:
Dean Pascal Goldschmidt is too quick to defend, having hired Dr. Nemeroff after he stepped down from the Chairmanship of Psychiatry at Emory University where he was disciplined for failing to report outside income from Pharmaceutical Companies, after he resigned as editor of a journal when he failed to disclose powerful Conflicts of Interest, and after a string of other moral lapses that lead to his being described as "so toxic, he glows in the dark." When he hired Dr. Nemeroff, Dean Goldsmith said "Charlie committed to me that he would never make these mistakes again, and I am scrutinizing his activities to make sure that that remains the case. As far as I can tell, Charlie does not engage in that type of behavior anymore, and I can tell you that if he was, I would know it." Given that remark, Goldschmidt and Nemeroff would both be better advised to acknowledge POGO’s well documented complaint about the past and reaffirm their commitment to the future, instead of reacting with the indefensible "unreliable and unfounded challenge to their reputation" comment. The investigator in this matter, Paul Thacker, formerly Senator Grassley’s investigative assistant doesn’t dabble in "unreliable" or "unfounded." He gets at the truth and proves it.
I was obviously angry that Dean Goldschmidt had retaliated as a Dr. McNasty when he obviously knows Charlie’s history:
"It is unfortunate that two individuals who have contributed so much to the medical discipline of psychiatry, Drs. Charles Nemeroff and Alan Schatzberg, and to the health of so many patients with dreadful psychiatric illnesses here in the U.S. and beyond, are exposed to such an unreliable and unfounded challenge to their reputation.”
I felt the same way about the APA’s response. But back to my comment. Then Friday morning, I got another google alert for the same Miami Herald article. I went to it [Version 2]. It was the same article [with a different URL], but my comment was gone. This second URL was the one that the main site referenced even though the first URL was still there with my comment. I jokingly wrote a friend, "Was it something I said?" implying this was deliberate, but felt I foolish for being so paranoid, thinking it was just part of reformatting their final edition. But now I wonder if the paper didn’t get a phone call. [I later tried to leave a comment and it just didn’t appear – I guess it was something I said]. These guys play dirty, "Rumor has it that Schatzberg is sicking his attorneys on anyone who dares to suggest what seems to be crystal clear based on the documents." If they can’t apologize, they ought to send every recipient a new copy with a different cover:
These people have done way too much to think they can shut up the criticism. Like Dr. Carroll said last year:
"… Dr. Nemeroff is so compromised by now that he has lost effectiveness as a front man for Pharma. Indeed, he is so toxic that he now glows in the dark."
Love that quote of Bernard Carroll’s. Great posts re this topic here. Keep it going, the public deserves the truth.
I hope Senator Grassley gets re-elected in 2012, even if he is a Republican.
Your research and coverage of this is great, Mickey. I would hardly know of it otherwise. I just wish every one of your blogs were splashed all over the front page of the NYT.
Thanks, Mickey. Who got the $120K for the “unrestricted educational grant”???
Maybe this is why your comment to the Miami paper was removed (from Wikipedia):
Narcissistic rage is a reaction to narcissistic injury which is a perceived threat to a narcissist’s self-esteem or self-worth.
When the narcissist’s grandiose sense of self-worth is perceivably being attacked by another person (typically in the form of criticism), the narcissist’s natural reaction is to rage and pull down the self-worth of others (to make the narcissist feel superior to them). It is an attempt by the narcissist to soothe their internal pain and hostility, while at the same time rebuilding their own self-worth. Narcissistic rage should not be confused with anger (although the two are similar), and is not necessarily caused by a situation that would typically provoke anger in an individual.[1] Narcissistic rage also occurs when the narcissist is perceivably being prevented from accomplishing their grandiose fantasies