I want to add an interesting article I came across relating to another of the vilified doctors on Dawdy’s blog which he’s omitted to share from the standpoint of a balanced perspective. I’m not here defending anyone’s position but what concerns me most from the standpoint of a support person and caregiver is whether or not the research, clinical practices and presentations offered up by these professionals were or are tainted.

“The University’s investigation, to date, has found no evidence that Dr. Nemeroff’s outside speaking activities affected clinical care for patients or persons enrolled in clinical trials, and no evidence that his activities biased scientific research in which he was engaged. Dr. Nemeroff has contended that his lectures were not product-specific but were limited to general medical topics such as depression and bipolar disorder. A review to date, based on his speaker slides and on interviews with attendees at presentations, supports that contention.”

http://www.emory.edu/home/news/releases/2008/12/conflict_of_interest_action.html

It is shameful that individuals are often easily led to judgment lacking facts and/or evidence.

To you and your readers I wish a Happy, Healthy, Peaceful and Prosperous New Year.

Warmly,
Herb
VNSdepression.com

http://carlatpsychiatry.blogspot.com/2008/12/dr-frederick-goodwin-responds-to-carlat.html

And Dr. Carlat responded in kind:

http://carlatpsychiatry.blogspot.com/2008/12/open-letter-to-dr-frederick-goodwin.html

I have spent an average of two months a year, over the past nine years, on a locked-down ward. After my third stay, I agreed to ECT, as the doctors said that was my only hope. I lost three years of memory, but was still cutting open my wrists. After 22 “treatments”, I stopped.

So, I have been on almost every psych med out there, in various cocktails. I build up a tolerance and then crash. It took me until last year to actually be pro-active in fighting. I now call my p-doc asap, when I feel the familiar dread. So, I have been “free” for 18 months, a record!

That said, my p-doc is my hero. Given enough warning, he can make swift and effectual changes in my meds. He also told me that I do have a future without p-meds in the picture. We streamline, but then I slip down.

When I was released from Belmont after three months, in 2006, one of the drugs I was on was 600mgs of Thorazine. (I’d slit my wrists a few days before I was released, with a scalpel blade given to me by another patient). My p-doc said that Thorazine is “barbaric” and took me off it. It took me months to get over the hangover.

Recently, I crashed again. I take Ritalin, which was added last September. I’d read Temple Grandin’s books, and that amphetamine concept struck me. My doc agreed. In the am, Effexor was my routine, but we added Prozac for the terrible suicidal PMS, the ten days before my flow. At nights, Seroquel 200mgs and Mirtazipine 90 mgs are my dose. He is given Pristique, so we added that, as I’m on 300mgs of Effexor, the insurance limit.

So, he has and he does use the free meds to help. I was worried I’d have to go off Effexor. Instead, I just take a free sample that is only two molecules off. I am functioning amazingly well for me.

I also see a CBT once a week. This should never be discounted. It has given me tools to help me handle my life and helped me with my view on myself and my life.

The times have changed drastically over the past year or two, and I’m not certain every researcher and professional has yet gotten the message.

Yes, I don’t think it’s a bad thing for a professional to say to a client or patient, “Hey, I have some free samples of Drug X, but you should know they were given to me by the drug company for free. If you find the side effects of this drug intolerable or aren’t receiving beneficial therapeutic effects from it, we’ll try something else.” That’s how the game has pretty much always worked, though.

In terms of your spouse’s psychologist, depends on the corporations and types of studies run. If a company paid a therapist to learn X therapy and then push it onto their clients, then yes, that’s an appropriate disclosure that should be made (typically, though, it’s the other way, where the therapist pays company or university X to learn about a new therapeutic technique, not the other way around).

It would become unwieldy for me to make a disclosure statement every time I wrote something on this site, so we’ve conveniently provided a link to such a statement at the bottom of every page on our site.

At the end of the day, I think it’s largely well-meaning professionals who have been doing a lot of what has been industry-standard practices (even to the point of not disclosing every dollar earned from outside companies), practices and standards which arguably have changed in the past 2 years with the shine of a Congressional investigation’s spotlight into them. I think this is a good thing, though, as it will ensure greater disclosure in the future.

I would like to briefly comment as to all the hoopla surrounding this issue.

First, my position is simply that there should be full disclosure and transparency from all presenters.

Secondly is to question whether or not these oversights, transgressions and/or lapses of presenting financial information and/or relationships are intentional and are they truly influencing or compromising the judgments, viewpoints or opinions of these various health care professionals.

Thirdly, does this also mean that professionals like your self issue a disclosure statement upon each writing, lecture, media presentation etc, etc? I’ve noted you’ve made no disclosure at the end of your blog posting on this subject.

I know my spouse’s psychologist had been paid by corporations in the past to run some studies. Does this mean his professional judgment and mentoring to my spouse has been compromised and I should question his advice?

Lastly as a very long-time support person does this also mean that each patient being attended to by a health care professional require the same full disclosure and transparency?

As I noticed from a couple of comments to John McNanamy’s blog several of Goodwin’s patients had the highest of regard for their doctor. In my opinion I think the relationship of patient and physician obtaining favorable results is the most significant point of all.

I also have not read of any of Grassley’s exposé leading to any criminal prosecution of these physicians.

Maybe it all simply boils down to inappropriate professional behaviors and the need to institute formal regulations pertaining to disclosure and transparency.

Warmly,
Herb
VNSdepression.com

Disclosure: I am a very, very long-time support person and caregiver and lay-depression expert to my spouse and I receive absolutely no remuneration of any kind from any sources.