{"id":57652,"date":"2015-06-07T15:01:16","date_gmt":"2015-06-07T19:01:16","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=57652"},"modified":"2015-06-07T15:01:16","modified_gmt":"2015-06-07T19:01:16","slug":"not-just-no","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/06\/07\/not-just-no\/","title":{"rendered":"not just “no”…"},"content":{"rendered":"\n

By the beginning of 2011, I was finally catching on to the extent of the the problem with the Psychopharmacology literature. I had written a sarcastic post about inventing a computer to generate Clinical Trials mixing every drug with every condition [NIMH·receptalator<\/font>…<\/a>] and I got a comment<\/a> from someone in Texas pointing out that such a computer program was already proposed. It was a paper by Madhukar Trivedi at UT Southwestern. He had written a computer program to implement an algorithm driven treatment of Major Depressive Disorder on an NIMH grant. The paper was talking about his attempted Clinical Trial [IMPACT<\/font>] to test the algorithm. He’d had to abandon the Trial, because the clinic doctors wouldn’t use the computer unless Dr. Trivedi was there looking at them. In the paper, he was speculating about why they wouldn’t use it [strange bit of psychologizing for a biological psychiatrist, I thought]. Then I looked at his COI declaration [see evidence-based medicine I…<\/a>]  and my jaw fell to the floor. That’s when I started blogging consistently about the pharmaceutical invasion of psychiatry. I’d never seen anything like that before.<\/p>\n

I had found that five year grant for IMPACT<\/font> [MH064062<\/a>] which had been paid out at a total of $3.3 M<\/font><\/strong> [which seemed like a lot for a study that never happened]. Working backwards got me to STAR*D<\/font>. While it had >100 articles, they never published the results of the Primary Outcome Variables – just some secondary rating scales [see a thirty-five million dollar misunderstanding…<\/a>]. Yes, it cost $35 M<\/font><\/strong> in all and essentially told us very little about treatment. Moving further back in time, I ended up at TMAP<\/font>, with Trividi in c harge of nthe Mood Disorder Algorithms. And that opened up learning about the biggest industry\/psychiatry scam of them all, TMAP<\/font><\/strong> – getting in-patent drugs into the State formularies was a gold rush for PHARMA. Somewhere back around 2008, John Rush left UT for the Duke Program in Singapore. At that time, Trivedi inherited all the NIMH Projects at UT. He finished up CO-MED<\/font>, a negative study involving combining antidepressants. Then he got a NIMH Grant for a project of his own [EMBARC<\/font>] to look for biomarkers that discriminated between Zoloft or Wellbutrin responders – a personalized medicine quest of dubious value at best. The NIMH has paid out $9+ M<\/font><\/strong> so far, the grant cycle has elapsed, and yet it’s currently listed as still recruiting on ClinicalTrials.gov<\/a>. Altogether, I’d say the four NIMH studies [STAR*D<\/font>, IMPACT<\/font>, CO-MED<\/font>, and EMBARC<\/font>] came to well over $50 M<\/font><\/strong> total.<\/p>\n

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As you can see, it’s become something of a hobby of mine, following Dr. Trivedi’s projects since that first one in 2011. He’s very adroit at getting NIMH funding, though he’s less adept at finishing the projects. He actually completed CO-MED<\/font> as advertised. Other than that, STAR*D<\/font>, IMPACT<\/font>, and EMBARC<\/font> never got published as the completed research they were funded to be, though there were plenty enough papers generated by STAR*D<\/font> for a small library. <\/font>And TMAP<\/font> just quietly faded away after almost bankrupting the Texas Mental Health budget [bailed out by Governor George Bush prior to leaving for Washington]. In Dr. Trivedi’s defense, the gross corruption and PHARMA collusion exposed had to do with the Atypical Antipsychotics rather than with Dr. Trivedi’s Antidepressant algorithms, though I don’t know that the Antidepressant part of TMAP received a thorough vetting.
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But I never thought my hobby of following Trivedi’s projects would lead to this recent punch line:<\/div>\n
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Psychiatrist Dr. Madhukar Trivedi receives American Psychiatric Association’s top research award<\/a><\/div>\n
UTSouthwestern Medical Center: Newsroom<\/font><\/strong><\/div>\n
May 18, 2015<\/div>\n

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DALLAS – Dr. Madhukar Trivedi, Director of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center and an internationally recognized expert in depression and mood disorders, is receiving the 2015 American Psychiatric Association Award for Research, the Association’s most significant award for research. First awarded in 1949 as The Hofheimer Prize, the award is given in recognition of a single distinguished contribution, body of work, or lifetime contribution that has had a major impact on the field and\/or altered the practice of psychiatry, according to the American Psychiatric Foundation, which identifies the awardees. Dr. Trivedi, Professor of Psychiatry and Chief of the Division of Mood Disorders at UT Southwestern, will present an honorary lecture May 18 at the APA Annual Meeting in Toronto…<\/div>\n<\/blockquote>\n
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click on the graphic for the meeting guide
see page 105<\/sup><\/div>\n
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Dr. Trivedi previously served as one of the Principal Investigators of the Sequenced Treatment Alternatives to Relieve Depression [STAR*D] study, which at the time was the largest and longest study on the treatment of major depressive disorder and is considered a benchmark in the field of depression research. Dr. Trivedi also helped author innovative treatment guidelines called the Texas Medication Algorithm Project [TMAP], a set of comprehensive management tools for doctors treating severely mentally ill patients within Texas’ publicly funded mental health care system.<\/div>\n

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He also served as Principal Investigator for NIMH grants examining treatment for chronic depression, identifying specific signaling proteins found in blood cells that may predict whether a depressive person will respond better to workouts or medications, a computerized decision support system for depression, and one using specific antidepressant combinations to increase remission rates by treating a broader spectrum of depressed patients and by capitalizing on additive pharmacological effects… <\/div>\n<\/blockquote>\n
[Obviously, this narrative differs from my version]. I feel like a tabloid writer this week after the series on Dr. Wagner’s election as AACAP President and now Dr. Trivedi’s award. But there was something that happened in the world of psychopharmacology in the last twenty-five years that was unprecedented in my experience in medicine – maybe anybody’s experience. And while there are moves to set things straight, they’re still in their infancy. So here’s what I encountered on my first exposure to Dr. Trivedi’s work back 5 years ago [see evidence-based medicine I…<\/a>]:<\/div>\n