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Moving from left to right, first there was TMAP [1998], the PHARMA scheme originating in Texas that had seventeen States paying top dollar for psychotropic drugs instead of using the equivalent generics – finally busted by Allen Jones blowing the whistle. It was followed by STAR*D [2001], the $35 M sequencing study of antidepressants that produced hundreds of papers – none of which were the actual results of the study. IMPACTS [2003] followed, a study using computer generated algorithms for doctors in the State of Texas to follow treating depressed patients. It never got off the ground because the doctors wouldn’t follow instructions. CO-MED [2008] was something of a quickie, trying various combinations of antidepressants. Drs. Rush and Trivedi actually finished and reported that one [it was a bust]. <\/p>\n
If you’re following this, there’s a theme here – getting more out of antidepressants by following some kind of rules in the way they’re given. Except for TMAP, they’ve all been financed by the NIMH and have taken a bite out of the public money going for research. In 2008, when Senator Grassley added his name to the list being investigated, John Rush who was the leader left it to his assistant, Madhukar Trivedi, to finish things up and took off for China to head the Duke program there. <\/p>\n
But the legacy lives on. Dr. Trivedi received an NIMH grant for yet another shot at improving the outcome of antidepressants. One might have thought that since CO-MED said that even in combination, the results aren’t better, the notion of some kind of discriminatory administration might improve things would finally die out – but hope springs eternal. And so to EMBARC<\/a> [2010], an attempt to predict who will respond to which antidepressant by measuring all possible things neuro-something and locating predictors. It’s called "personalized medicine" and it was all the rage there for a while, but it’s died off in recent years. Though it may be gone from the stage, it’s not forgotten [about to go over the $10 M mark]: <\/p>\n <\/span><\/ol>\n<\/li>\n<\/ul>\n <\/p>\n Moving from left to right, first there was TMAP [1998], the PHARMA scheme originating in Texas that had seventeen States paying top dollar for psychotropic drugs instead of using the equivalent generics – finally busted by Allen Jones blowing the whistle. It was followed by STAR*D [2001], the $35 M sequencing study of antidepressants that […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-42516","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/42516","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=42516"}],"version-history":[{"count":17,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/42516\/revisions"}],"predecessor-version":[{"id":49164,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/42516\/revisions\/49164"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=42516"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=42516"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=42516"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![](\"http:\/\/1boringoldman.com\/images\/tri-nimh.jpg\")
<\/p>\nIt started life comparing Citalopram®, Wellbutrin®, and Placebo, but for unclear reasons it was switched to Zoloft®, Wellbutrin®, and Placebo. It is listed as still recruiting on ClinicalTrials.gov<\/a>. So far, three papers have been reported as resulting from the grant: <\/div>\n\n
Based on the following parameters:<\/div>\n\n
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I predict yet another sure failure. The only viable questions are "Will the study be completed?<\/em>" and "Will the NIMH ever stop funding this kind of no-possible-yield project?<\/em>" If you go to the EMBARC<\/a> site, you can watch a video of Dr. Trivedi explaining that there are 35 antidepressants and the study will find a way to select among them and pick the treatment thereby speeding up success [not mentioning that there are only two in the study itself, neither a heavy hitter]. <\/div>\nWhat brought this to mind? It was that "new focus" article in the New York Times<\/a> [inertia…<\/a>] that follows this now very tired idea that there’s some future drug strategy that’s going to pick off the remaining cases of Major Depressive Disorder if we can just keep throwing money at the problem – skipping the step of refining what we’re treating in the first place…<\/div>\n","protected":false},"excerpt":{"rendered":"