Saturday, January 19, 2008

Can Anyone Explain the Nemeroff Phenomenon?

Please mosey on over to our distinguished neighbor blog, Health Care Renewal:

Scroll down to the January 16 blog entry, "Antipsychotic Drugs for Depression?" by Bernard Carroll. It's a long story, but very carefully documented, about a paper on the use of an antipsychotic medication, risperidone, for the treatment of refractory depression. The paper receives a label that I have not previous encountered in my reading, but is a brilliant neologism--Carroll refers to it as an "experimercial."

The senior author of the paper in question is Charles Nemeroff, MD, PhD, chair of psychiatry at Emory. Dr. Nemeroff's name will be very familiar to most readers of any materials critical of the medicine/Pharma relationship. As Carroll briefly relates, Nemeroff had to resign as editor of Neuropsychopharmacology because the journal published a paper, of which he was the chief author, that was another "experimercial" for a device (an implanted electrical stimulator), but did not reveal that Nemeroff was a paid consultant to the device's manufacturer.

The Wall Street Journal, widely known as a pinko-liberal muckraking scandal sheet, ran an article detailing Nemeroff's questionable activities. They received in reply a letter (Sept. 19, 2006) signed by 45 academic psychiatrists, praising Nemeroff effusively and bemoaning this undeserved calumny heaped on one of the shining stars of the psychiatric firmament. (In previous years, Nemeroff's coziness with industry, and willingness to line his own pockets with industry money, has received notice from other irresponsible scandal sheets such as the New York Times.)

My question is very simple. How can the field of psychiatry hold up its head and act as if its members are professionals, so long as Nemeroff remains an "opinion leader" in good standing? How can Emory University justify allowing such an individual to remain as a department chair? How can 45 other psychiatrists rush to his defense in print without having to put paper bags over their heads? What does this say about all of us in medicine, who claim to have some sort of connection with professionalism and ethics?

I did not set out, in writing HOOKED or in starting up this blog, to engage in personal attacks or character assassination. But there comes a point at which the so-called ethicists, if we are not willing to have the courage of our conviction and name names, are doing as much to obscure the issues as anyone with whom we disagree.

1 comment:

Keeping them honest said...

The answer to Howard Brody's question is suggested by a fawning article about Dr. Nemeroff a few years ago called "Boss of Bosses." The corporations pander to him because they fear he will badmouth their products or undercut their research efforts. Academics pander to him because they fear that, with his extensive cadre of cronies, he is quite capable of causing problems for their grant proposals or journal submissions or their nominations for society memberships. Few are willing to grasp the nettle to expose his shenanigans and his intimidation. As for the image of U.S. psychiatry, every group gets the leadership it deserves.