Friday, January 18, 2008

Risperdal for Depression: A Depressing Look

Bernard Carroll, a psychiatrist who is known for laying down the smack on drug industry spin, has a fantastic post at Health Care Renewal that should be read by all. It deals with the marketing and "science" surrounding the use of Risperdal for treatment-resistant depression, a topic I've discussed at length on this site previously.

The campaign aims to shape a favorable climate of opinion for the drug through experimercials (commercially strategic clinical trials) and journal publications that are really infomercials. The stakeholders are some major corporations, “key opinion leaders” (KOLs), leading medical journals, and several million patients who suffer from nonresponsive depression in the US. The winners are the KOLs and the corporations, while the big losers are the patients.
The plot thickens:
You begin to see the picture: we have the appearance of editorial self-dealing, including product placement for a corporate client of the editor; an incompetent or possibly dishonest journal review process; and the appearance that somebody went out of his way in two places to insert a false claim of efficacy into the report of a negative clinical trial.
The depth of reporting is excellent. I can vouch for the Dr. Carroll's analysis of the situation and note that it closely matches my own investigation into the Risperdal for depression studies. When industry, academia, and buckets of money collide, the outcome is predictable.


Anonymous said...

Just came across your blog. There are some fantastic posts here.

I came across the risperidone article in '06 and found that it had been published in abstract form several times:

Rapaport MH, Canuso CM, Loescher A, Lasser R/.Gharabawi G : Preliminary results from the ARISe-RD (Risperidone Augmentation in Resistant Depression) trial 156th Annual Meeting of the American Psychiatric Association, May 17-22, San Francisco CA 2003, NR179

Rapaport MH, Canuso CM, Rouillon F, Leblanc J, Young AH, Loescher A, Bossie C, Turkoz I, Gharabawi G : Results from the augmentation with risperidone in resistant depression trial 157th Annual Meeting of the American Psychiatric Association; 2004 May 1-6; New York, NY 2004, NR799

Canuso C, Gharabawi G, Bouhours P, Leblanc J, Dunbar F, Rapaport MH. Results from open-label phase of ARISe-RD (augmentation with risperidone in resistant depression) [abstract]. Int J Psychopharmacology 2004;7(Suppl 1):S345

Gharabawi G, Canuso C, Greenspan A, Bossie C, Loescher A, Turkoz I, Alexopoulos G : Remission and maintenance effect of risperidone augmentation for older patients with resistant depression. Neuropsychopharmacology 2004, 29 Suppl 1, S87

Nemeroff CB, Canuso CM, Mahmoud R, Loescher A, Turkoz I, Rapaport MH, Gharabawi GM : Augmentation with risperidone in chronic resistant depression:A double-blind placebo-controlled maintenance trial. Neuropsychopharmacology 2004, 29 Suppl 1, S159

Anonymous said...

I am very much impressed by the depth of insight and readability of this web site. My assumption is that the masterminds are academics (meant as a compliment)who may be on the out.

Question for the savvy souls out there -- at which institutions of higher learning can a person with psychopharmacy know how find work without dependence on pharmaceutical company largesse ?

Richard P, Harrisburg