Meta tags:

Headings (most frequently used words):

2007, december, november, and, thursday, the, friday, for, psychiatry, monday, psychology, look, 21, wednesday, 12, email, pharma, new, but, why, data, how, on, from, antipsychotics, marketing, clinical, closer, 28, sunday, 23, 20, 14, 13, 07, 06, tuesday, 04, 29, 26, 19, 15, 09, 08, blog, archive, academia, general, organizations, scientific, misconduct, about, me, translate, this, page, subscribe, via, year, changes, zetia, would, we, show, you, scary, social, phobia, common, bipolar, explosion, spot, parody, other, highlights, key, opinion, leader, provides, false, information, in, cme, american, psychological, association, awakens, slumber, long, hooked, help, seroquel, everything, academic, spokespeople, blast, past, suicide, regarding, prozac, buried, dementia, psychiatrist, speaks, effexor, dr, drug, rep, will, antipsychotic, coverup, continue, arkansas, unleashes, razorbacks, risperdal, atypical, elderly, booming, business, sex, psychiatric, drugs, honor, system, upcoming, features, absolutely, smashing, indictment, of, big, latest, abilify, alzheimer, study, is, complete, joke, here, ari, pimp, razole, science, collide, nimh, gets, dunce, journalism, award,

Text of the page (most frequently used words):
the (525), and (236), that (161), for (134), this (83), not (77), study (68), but (65), are (65), was (63), with (61), from (61), have (56), you (47), 2007 (46), drug (45), their (45), data (44), about (41), one (41), has (41), they (39), these (38), patients (36), his (36), more (35), will (34), who (34), which (34), #marketing (33), how (29), out (29), can (29), depression (29), research (28), what (28), there (28), may (26), other (26), psychologists (26), abilify (25), regarding (25), here (25), psych (24), comments (24), well (24), been (24), psychiatry (23), suicide (23), posted (23), just (23), would (22), post (22), such (22), all (22), pharma (21), drugs (21), treatment (21), placebo (21), some (21), academic (20), when (20), bipolar (19), labels (19), read (19), because (19), efficacy (19), clinical (18), also (18), see (18), disorder (18), your (17), antipsychotics (17), dementia (17), new (17), any (17), point (17), were (17), science (16), december (16), much (16), medications (16), off (16), now (16), effect (16), over (16), studies (16), its (16), psychiatric (15), atypical (15), seroquel (15), people (15), than (15), very (15), had (15), effects (15), them (15), companies (15), did (14), use (14), think (14), get (14), good (14), part (14), time (13), nimh (13), antipsychotic (13), american (13), opinion (13), could (13), authors (13), even (13), then (13), should (13), group (13), label (13), work (13), size (13), two (13), apa (13), blog (12), social (12), furious (12), seasons (12), health (12), risperdal (12), article (12), through (12), evidence (12), course (12), benefit (12), company (12), montgomery (12), given (11), november (11), why (11), associated (11), little (11), make (11), yet (11), results (11), effective (11), many (11), following (11), like (11), significant (11), state (11), zyprexa (11), anxiety (11), industry (10), elderly (10), help (10), key (10), look (10), published (10), youth (10), again (10), better (10), prescription (10), based (10), paper (10), small (10), times (10), say (10), every (10), term (10), being (10), risperidone (10), english (9), long (9), big (9), show (9), ssri (9), between (9), increased (9), makes (9), years (9), important (9), across (9), risk (9), patient (9), medication (9), let (9), lot (9), take (9), risks (9), side (9), most (9), fda (9), our (9), mental (9), public (8), sex (8), information (8), journal (8), rate (8), still (8), mentioned (8), rates (8), change (8), only (8), findings (8), perhaps (8), various (8), those (8), know (8), few (8), product (8), points (8), improvement (8), first (8), both (8), become (8), improved (8), said (8), money (8), seems (8), rather (8), lilly (8), negative (8), license (8), sexual (8), author (8), continuing (8), education (8), psychology (7), scientific (7), treatments (7), psychiatrist (7), september (7), effexor (7), psychological (7), association (7), common (7), posts (7), prescriptions (7), story (7), using (7), piece (7), case (7), into (7), thursday (7), recently (7), bristol (7), myers (7), squibb (7), site (7), large (7), claims (7), least (7), great (7), back (7), report (7), best (7), does (7), example (7), nursing (7), trials (7), never (7), figure (7), person (7), linden (7), documents (7), stuart (7), don (6), misconduct (6), interest (6), david (6), latest (6), system (6), leader (6), year (6), home (6), ssris (6), quote (6), earlier (6), writing (6), percent (6), media (6), without (6), states (6), yes (6), sense (6), aripiprazole (6), next (6), already (6), keep (6), treating (6), friday (6), trial (6), psychosis (6), anyone (6), added (6), physicians (6), provide (6), measures (6), mention (6), having (6), symptoms (6), including (6), statistically (6), particularly (6), advantage (6), poor (6), several (6), reading (6), involved (6), janssen (6), problems (6), interesting (6), short (6), shame (6), profession (6), something (6), while (6), comment (6), x065 (6), lead (6), might (6), medicine (6), nemeroff (6), email (5), academics (5), mind (5), world (5), october (5), february (5), journalism (5), alzheimer (5), absolutely (5), arkansas (5), prozac (5), phobia (5), zetia (5), changes (5), increase (5), above (5), 2005 (5), showed (5), note (5), statistical (5), own (5), website (5), link (5), wonderful (5), issue (5), appear (5), doctors (5), according (5), minimal (5), attention (5), couple (5), high (5), right (5), groups (5), under (5), days (5), taking (5), however (5), onto (5), made (5), upon (5), participants (5), day (5), cannot (5), controlled (5), adverse (5), reported (5), during (5), independent (5), maybe (5), used (5), different (5), taken (5), training (5), whether (5), condition (5), global (5), call (5), add (5), sure (5), hiding (5), pharmaceutical (5), aware (5), six (5), after (5), herpes (5), sign (5), astrazeneca (5), months (5), oklahoma (5), cases (5), medical (5), where (5), leaders (5), huge (5), try (5), lawsuit (5), suits (5), consider (5), emslie (5), child (5), functioning (5), via (4), expect (4), multiple (4), certain (4), last (4), giles (4), general (4), january (4), march (4), april (4), gets (4), pimp (4), honor (4), everything (4), hooked (4), parody (4), others (4), please (4), prediction (4), 2004 (4), apparently (4), believe (4), full (4), attempts (4), organization (4), nothing (4), put (4), single (4), peer (4), appears (4), 100 (4), actually (4), seen (4), likely (4), goes (4), recent (4), safe (4), certainly (4), especially (4), present (4), done (4), review (4), give (4), death (4), prescribe (4), agitation (4), means (4), discussion (4), won (4), events (4), nearly (4), funded (4), someone (4), benefits (4), versus (4), scale (4), her (4), impressions (4), mean (4), though (4), suggest (4), medicines (4), blogs (4), check (4), number (4), really (4), written (4), similar (4), feel (4), bad (4), wyeth (4), pfizer (4), schizophrenia (4), conditions (4), greatly (4), success (4), johnson (4), placed (4), participate (4), consent (4), occasions (4), called (4), another (4), suspended (4), three (4), bit (4), indeed (4), virtually (4), despite (4), else (4), attempt (4), force (4), ago (4), start (4), difficult (4), misleading (4), dying (4), hard (4), way (4), graham (4), diabetes (4), wouldn (4), move (4), carlat (4), remarkable (4), press (4), psychologist (4), privileges (4), lifetime (4), page (3), complete (3), profile (3), experience (3), funding (3), things (3), before (3), pharmalot (3), peter (3), rost (3), higher (3), june (3), july (3), august (3), award (3), ari (3), upcoming (3), coverup (3), continue (3), rep (3), speaks (3), past (3), spokespeople (3), false (3), spot (3), scary (3), older (3), today (3), available (3), incorrect (3), generalized (3), remember (3), suicides (3), publish (3), run (3), stories (3), showing (3), kind (3), wonder (3), extent (3), dedicated (3), major (3), university (3), colleagues (3), regulatory (3), version (3), 2003 (3), antidepressants (3), started (3), cited (3), gigantic (3), zero (3), total (3), aged (3), occurred (3), 000 (3), ages (3), differences (3), within (3), slight (3), stop (3), stealth (3), demonstrate (3), robust (3), far (3), briefly (3), measure (3), takes (3), editor (3), wait (3), clearly (3), question (3), significance (3), died (3), related (3), compared (3), doses (3), scores (3), efficacious (3), indicate (3), okay (3), none (3), safety (3), numbers (3), find (3), shown (3), choice (3), researchers (3), must (3), current (3), seven (3), rating (3), closer (3), she (3), changed (3), vary (3), inventory (3), difference (3), monday (3), follows (3), marketed (3), calculation (3), lawsuits (3), thousands (3), behind (3), potentially (3), corporate (3), result (3), responsible (3), thing (3), trying (3), wrong (3), doing (3), talk (3), hid (3), special (3), running (3), humble (3), readers (3), enough (3), strongly (3), need (3), oversight (3), sloppy (3), seem (3), occasionally (3), investigator (3), want (3), examined (3), serious (3), event (3), hospital (3), found (3), known (3), board (3), role (3), promote (3), pete (3), philip (3), clear (3), effort (3), terms (3), hit (3), pimping (3), beyond (3), scientifically (3), uses (3), include (3), adhd (3), always (3), down (3), mudannayake (3), lives (3), manage (3), outrage (3), linked (3), odds (3), fact (3), expert (3), documented (3), allegations (3), weight (3), gain (3), non (3), settle (3), accepting (3), patent (3), same (3), behavior (3), antidepressant (3), thoughtful (3), him (3), quite (3), letter (3), whose (3), children (3), buried (3), reads (3), self (3), gad (3), finding (3), modest (3), set (3), committee (3), says (3), lexapro (3), imperial (3), college (3), school (3), london (3), tolerability (3), pieces (3), task (3), sponsored (3), concerns (3), arise (3), slide (3), neuropsychopharmacology (3), presentation (3), enter (2), subscribe (2), italian (2), view (2), amount (2), drive (2), probably (2), human (2), skepticism (2), center (2), organizations (2), seroxat (2), hacks (2), healy (2), news (2), pharmagossip (2), care (2), renewal (2), dunce (2), razole (2), collide (2), smashing (2), indictment (2), features (2), booming (2), unleashes (2), razorbacks (2), blast (2), awakens (2), provides (2), explosion (2), 2011 (2), newer (2), fewer (2), kids (2), ran (2), turned (2), analysis (2), presented (2), graphs (2), pushing (2), hat (2), tip (2), reader (2), passed (2), along (2), credible (2), allegedly (2), john (2), warnings (2), throw (2), coverage (2), suggests (2), slapped (2), released (2), newspapers (2), relationship (2), decreased (2), decrease (2), pay (2), close (2), figures (2), dose (2), united (2), age (2), notably (2), happens (2), per (2), table (2), lower (2), market (2), indicated (2), hype (2), supporting (2), appeared (2), basic (2), statistics (2), away (2), cut (2), bms (2), policies (2), statements (2), reps (2), internationally (2), sort (2), laugh (2), abstract (2), tell (2), since (2), experts (2), papers (2), sometimes (2), biased (2), guidelines (2), main (2), listed (2), statistic (2), instructions (2), geriatric (2), took (2), realize (2), occurrence (2), hell (2), commentary (2), impacts (2), beneficially (2), miniscule (2), impact (2), relative (2), specific (2), behavioral (2), burden (2), produced (2), secondary (2), outcome (2), psychotic (2), four (2), write (2), deaths (2), emphasis (2), investigators (2), caused (2), test (2), thought (2), chose (2), either (2), laughing (2), pleading (2), ignorance (2), received (2), lesson (2), dozens (2), average (2), minimally (2), moderately (2), deal (2), due (2), entirely (2), cohen (2), helpful (2), knowledge (2), easily (2), indicates (2), less (2), factor (2), sample (2), anything (2), significantly (2), improving (2), impression (2), issues (2), rant (2), mix (2), bury (2), nobody (2), financial (2), lost (2), campaigns (2), hide (2), billion (2), gone (2), tens (2), ignore (2), suffered (2), situation (2), ceos (2), ultimately (2), line (2), sorry (2), paid (2), howard (2), udell (2), true (2), fellow (2), everyone (2), researcher (2), impressive (2), transmitted (2), coming (2), soon (2), tips (2), unfortunately (2), prior (2), links (2), fraudulent (2), idea (2), punchline (2), sorts (2), accept (2), wink (2), free (2), actively (2), directly (2), expertise (2), quotes (2), pharmaceuticals (2), ethical (2), inc (2), hire (2), guy (2), investigation (2), inpatient (2), unless (2), dispensed (2), allowed (2), discontinue (2), informed (2), additional (2), unlicensed (2), dosing (2), action (2), consequences (2), nevada (2), going (2), sooner (2), recall (2), gave (2), geodon (2), indiscriminant (2), brings (2), slick (2), strategies (2), morally (2), bankrupt (2), salespeople (2), misrepresented (2), saw (2), dawdy (2), vulnerable (2), individuals (2), riskiest (2), hired (2), easier (2), sedate (2), supposed (2), phase (2), mania (2), leading (2), pushed (2), atypicals (2), justifiable (2), achieved (2), dangerous (2), sun (2), infants (2), agree (2), required (2), cobble (2), hill (2), almost (2), resources (2), convinced (2), calm (2), room (2), aide (2), predictions (2), decided (2), options (2), writers (2), crazy (2), cost (2), shouldn (2), killing (2), support (2), making (2), helping (2), envelope (2), needs (2), works (2), pill (2), increases (2), until (2), mortality (2), got (2), homes (2), disorders (2), asked (2), order (2), shocking (2), suing (2), alleged (2), settled (2), kickbacks (2), cheaper (2), wednesday (2), excellent (2), wake (2), numerous (2), fascinating (2), dirty (2), sad (2), insider (2), aforementioned (2), currently (2), matters (2), lived (2), pediatric (2), incentive (2), fight (2), too (2), whatever (2), deep (2), internal (2), document (2), daniel (2), job (2), educating (2), slides (2), york (2), internet (2), meds (2), symptom (2), psychiatrists (2), ways (2), stated (2), provided (2), paxil (2), adolescent (2), gsk (2), owned (2), insist (2), exclude (2), emergent (2), adolescents (2), rated (2), clinicians (2), admits (2), overly (2), worry (2), interpret (2), depressed (2), position (2), responded (2), moderate (2), toward (2), worth (2), eat (2), score (2), tracking (2), releases (2), core (2), advice (2), approved (2), prof (2), further (2), referred (2), surprise (2), professor (2), escitalopram (2), agomelatine (2), working (2), sources (2), brody (2), external (2), summarize (2), zimbardo (2), convention (2), recommendations (2), highlights (2), resist (2), passes (2), receive (2), clean (2), names (2), pro (2), stand (2), firm (2), corrupted (2), credits (2), funds (2), name (2), paying (2), sponsoring (2), gifts (2), examples (2), reference (2), citalopram (2), claimed (2), reviewed (2), beneficial (2), augmentation (2), ris (2), particular (2), topic (2), word (2), often (2), epidemiological (2), estimates (2), cultures (2), suppression (2), alex (2), berenson (2), progress (2), exposés (2), 2001 (2), pulitzer (2), articles (2), skip (2), powered, feedblitz, onchange, select, language, spanish, french, german, portuguese, chinese, russian, japanese, arabic, translate, respectable, lack, daily, updates, nuts, pick, pet, peeves, alliance, protection, audit, pharmedout, healthy, online, secrets, psychcentral, psychsplash, macguffin, adventures, blogosphere, jim, edwards, nrx, gooznews, edrugsearch, brandweeknrx, inside, crooked, timber, bitch, academia, 219, 2006, highl, 328, 103, 2008, 2009, 2010, archive, atom, yellow, purported, usa, below, websites, dumbly, descriptions, details, datelined, jules, asher, wrote, mentions, netherlands, contradict, argument, preliminary, contradicts, arguments, reason, ranting, raving, holes, fleet, mack, trucks, publicizing, nope, objective, solely, advancing, doesn, anonymous, nonpartisan, grantees, robert, gibbons, illinois, chicago, mann, columbia, possible, patterns, staff, tidbit, updated, mathematical, models, previous, predicted, idiotic, teen, backfired, preteens, teenagers, sharply, food, administration, black, box, warning, anti, depressants, young, federal, shred, claim, declining, reviewer, drunk, noticed, flaw, analyses, examine, closely, click, enlarge, timeframe, larger, declines, prescribing, comparing, considers, grouping, vast, pilloried, wow, boggled, category, godawful, stay, tuned, suppose, naughty, qualms, pimped, beating, lots, settlement, signs, ounce, bordering, hilarious, coauthors, ability, teeny, notable, deserve, coffers, unneeded, golden, goblet, flouts, overblown, disseminating, nationwide, ruse, office, scan, conclude, whip, pads, slipshod, lazy, incompetent, fashion, skim, manuscript, conformed, violates, principles, liberally, cautions, doubtful, practical, wander, prattle, happened, chance, combine, doubling, choose, treated, credit, extremely, interestingly, improve, cmai, baseline, endpoint, reinforcing, thus, alleviate, reduce, overall, aspects, evident, fixed, institutionalized, suffering, primary, population, exhibit, kill, cerebrovascular, essential, disclaimer, eighteen, determine, fox, policing, henhouse, considered, smaller, plug, labeled, longer, useful, crying, egregious, ooooh, judgment, admission, project, asks, wording, slightly, matter, slice, mansfield, brief, severity, neuropsychiatric, subscale, discuss, neuopsychiatric, standard, deviations, calculate, magnitude, guess, guideline, determining, imply, value, quickie, stats, apripiprazole, joke, pharmagiles, premier, cutting, bar, occasion, steps, vicious, satire, dead, incisive, teaser, slam, dunk, performance, shockingly, accountable, fine, levied, drop, bucket, aggressively, accountants, lawyers, busy, figuring, type, overstate, vioxx, oxycontin, possibly, avandia, launched, unsuspecting, quest, dollar, profits, harm, pretty, inkling, lethal, hazards, selectively, needlessly, complacency, worst, greed, trust, mistrust, environment, tight, harder, launch, constant, cause, whining, ironically, creating, hostile, climate, place, executives, therefore, illegal, actions, underlings, guys, eight, compensation, packages, isn, personalities, looks, pleaded, guilty, boss, personally, pal, buck, stops, execs, weren, damn, employed, capacity, chief, counsel, purdue, skolek, wonks, shareholders, titillate, enrage, documentation, prove, appearance, record, unlikely, sexually, diseases, holding, captive, sites, strange, hopefully, correspondent, send, meantime, ablaze, lately, yourself, favor, essentially, dishonor, nonexistent, contained, throwing, rare, occurrences, leave, lax, standards, imprisoning, playing, misdeeds, disqualify, engaging, understand, occasional, errors, rule, error, mistakes, minus, extensive, prestigious, portfolio, hand, approach, insert, principal, conduct, myself, jokes, recognized, community, member, speakers, bureaus, impeccable, credentials, stump, insomnia, recruiting, rho, quintiles, ppd, development, parexel, contract, contributed, shire, mcneil, novartis, glaxosmithkline, eli, boehringer, ingelheim, collects, foundation, supports, webpage, emergency, detention, participation, extreme, instability, occur, wanted, returned, subjects, 002, 005, 008, 015, 020, determined, woman, wished, facility, agreed, involvement, attorney, fail, comprehend, forms, involve, signed, form, weeks, protocol, licensed, oops, stays, imprisonment, reasonably, grand, physician, suspension, confusing, active, houses, sin, city, wants, subject, disciplinary, transgressions, jurisdiction, doctor, limb, permanently, rescinded, slap, wrist, wet, noodle, alluded, contact, genital, forgot, publicly, norm, update, besides, dole, siblings, candy, professionals, consultants, devise, plans, chemically, easy, amazing, lights, field, stepped, plate, pointed, happily, turns, mostly, rush, minority, instituted, cultural, bring, hospitalizations, dropped, completely, dosage, reduced, initially, stretched, quality, expenditures, diminished, roommate, assignments, dressing, preferences, routine, ignoring, naysayers, doomsday, senior, nurses, together, team, pharmacists, workers, recreational, therapists, brooklyn, louis, thinking, 400, bed, create, occurs, participated, studying, instead, churning, tripe, asleep, wheel, generally, skeptical, claiming, giving, chemical, restraint, slow, class, financially, ratio, offer, headline, incorporate, actual, relief, granted, inaccurate, disputes, bigger, scam, sugar, rid, headlines, bank, doubles, each, careful, problem, extensively, types, testifying, congressional, hearing, prominent, typically, weak, discusses, familiar, missing, increasing, providing, snippet, petersburg, business, leveled, manufacturer, subsidiary, partial, listing, inflammatory, considering, charges, seeing, pattern, emerging, talking, hope, fantastic, thanksgiving, count, exactly, promotion, concealment, designed, encourage, relevant, literature, partially, promoted, offered, medically, necessary, represent, falsely, represented, aggression, extrapyramidal, conducting, bogus, covered, copy, slew, facing, manufacturers, individual, ranging, brought, governments, among, filed, come, shell, fines, taste, serving, engaged, ethically, dubious, practices, enormous, imagine, minutes, panorama, npr, frontline, programs, hitting, complicity, hopes, fleeting, offending, decide, laundry, private, possibility, prognostication, correct, legal, decides, leak, open, insiders, silverman, jack, month, except, extra, indications, protect, generic, cynical, shock, played, patents, wonders, liability, insurance, cover, agreement, admit, fault, invega, monster, instances, demonstrating, covering, detailing, ludicrous, stint, stumped, cool, 30k, account, practice, train, speeches, overplay, downplay, straight, face, buying, fancy, dinners, source, magazine, left, hey, lengthy, merit, second, amen, brother, knee, jerk, reaction, medicate, struggle, compassionate, productive, blame, hijacked, learn, appalled, focus, afforded, unproven, consideration, importantly, focused, immediate, outcomes, steve, plainly, national, institute, vanish, poof, differs, suicidal, ideation, whatsoever, referencing, passing, sharing, words, permission, gives, scientist, sock, puppet, included, publication, theoretically, flatulence, troubling, notice, previously, jonathan, leo, incidence, raises, suspicions, agenda, served, agency, frequently, terrific, crowd, completed, examining, extended, youths, perceptions, secret, sixed, interpretations, guessed, positive, helped, comforted, caliber, ranking, fluoxetine, friends, conclusion, flagship, archives, nice, obfuscation, obfuscated, old, tax, dollars, knows, furthermore, depressive, measurements, wide, variability, initial, reports, relieve, raise, suspicion, squirm, sentences, couldn, proprietary, tuesday, slowly, rolling, 7th, international, forum, mood, frontman, trotted, purportedly, beat, detached, quell, willing, blatantly, putting, butter, bread, psychotherapies, demonstrated, competing, movement, treat, moving, noting, madrs, release, eating, item, bandwagon, headed, heartily, endorse, whole, conflicts, speak, enthusiastic, endorsements, purely, manner, trot, eager, rotten, sitting, deciding, licence, application, memorandum, largest, happy, adviser, declare, csm, once, rival, licensing, process, guardian, finally, decisive, establishing, effectiveness

Text of the page (random words):
ypicals and i agree there are a small minority of patients where you need to use these drugs but not in the numbers we are using them i see so you can do something else besides dole out zyprexa and its siblings like candy but it takes time effort and using one s training in mental health you d think that psychologists and or other mental health professionals could easily be hired as consultants to devise such plans of course it is a lot easier to just attempt to sedate chemically over and over again but are we supposed to do what is easy even if it is not in the best interest of the patient shame shame shame in my humble opinion this phase atypical antipsychotic mania will be associated with gigantic shame on the psychiatric profession just wait a few years the amazing part is how few leading lights within the field have stepped up to the plate and pointed out the problems associated with these medications when they were first released all sorts of key opinion leaders happily pushed them as a huge improvement over older antipsychotics in terms of treating schizophrenia turns out that was mostly hype then the atypicals for bipolar rush hit full force again with the help of key opinion leaders without academics pimping these treatments well beyond what was scientifically justifiable these medications would never have achieved such huge success but now this rather dangerous group of medicines is used for virtually every psychiatric disorder under the sun these uses include bipolar disorder in infants adhd and dementia let s put the most vulnerable individuals on the riskiest treatments despite no clear evidence that they work particularly well there is indeed some evidence for the efficacy of these medications in the short term treatment of schizophrenia and bipolar disorder and in a small number of trials even some long term evidence of efficacy but their indiscriminant use across the board for virtually every condition brings great shame upon psychiatry as a profession on big pharma for its slick marketing strategies 1 2 and most especially upon academic psychiatry for its morally bankrupt role as a group of salespeople who have misrepresented scientific findings to help promote drugs 1 2 3 4 5 6 7 8 update i forgot to publicly tip my hat to furious seasons where i first saw the link to st pete times piece philip dawdy also added some spot on commentary as is the norm at furious seasons posted by cl psych at 11 19 2007 06 32 00 am 4 comments labels abilify antipsychotic dementia geodon marketing off label marketing risperdal seroquel zyprexa sex psychiatric drugs and the honor system i had briefly alluded to dr david linden in an earlier post you may recall that he is the psychiatrist who had his license suspended by the state of oklahoma because through sexual contact he gave genital herpes to two patients i had never known why oklahoma was called the sooner state but now it makes sense if you have sex with and give herpes to your patients you get your license back sooner than anyone would reasonably expect to be specific his license was suspended for a grand total of three months for such misconduct can you say slap on the wrist with a wet noodle so who is this guy let s find out license a link to his oklahoma physician profile can be seen here remember two cases of herpes transmitted to patients three months suspension of oklahoma medical license i find it more than a bit confusing that his nevada license is still active it would appear that in the state which houses sin city one can have all the sex with patients that one wants and not be subject to disciplinary action so give herpes to two patients through sex and the consequences are having a license suspended for three months in one state and no consequences in another state very interesting perhaps his transgressions occurred in oklahoma so nevada figures it is out of their jurisdiction but if a doctor has sex with patients in one state i m going to go out on a limb here and say that his license should be suspended or maybe just maybe permanently rescinded in all states imprisonment of study participants that s what the fda found in their investigation of dr linden one woman wished to participate in a study in linden s inpatient facility she agreed to participate in a study and then changed her mind she was not allowed to discontinue the study for four days and only after the involvement of an attorney what part of you can discontinue the study at any time did linden fail to comprehend patients without consent two patients did not sign informed consent forms to participate in studies this is a gigantic no no participants absolutely must provide consent to participate in studies particularly when they involve taking medications on six additional occasions participants signed the incorrect consent form unlicensed hospital stays in one study patients were placed in an unlicensed hospital for at least two weeks the study protocol called for patients to be placed in a licensed hospital oops drug dosing patients were given incorrect doses of study medication on multiple occasions in one study i ll quote the fda report regarding drug dosing in another study the amount of study drugs dispensed to and returned by subjects 002 005 008 015 and 020 cannot be determined adverse events what adverse events two participants who were placed under emergency inpatient detention during their participation in studies their extreme mental instability was not reported as a serious adverse event seem to me like it would be rather important to report all serious adverse events that occur in a study unless of course one was either sloppy or wanted to bury negative data and there is more believe it or not the fda investigation only examined two trials all of the above problems and more based on two studies impressive and then he collects data which is the foundation of the science that supports various medications who would hire this guy well let s see according to his research webpage he has done clinical trial research for the following astrazeneca bristol myers squibb boehringer ingelheim eli lilly glaxosmithkline janssen johnson johnson novartis mcneil pfizer shire and to quote his site the following contract research organizations have greatly contributed to our success i 3 research inc research parexel ppd development quintiles rho inc want to sign up for one of his trials it appears that his research organization is recruiting patients with the following conditions alzheimer s dementia depression schizophrenia bipolar disorder insomnia on the stump given his impeccable research and ethical credentials it is no wonder that dr linden is also recognized as a leader in his community and he is a member of several speakers bureaus including wyeth pharmaceuticals pfizer pharmaceuticals bristol myers squibb and others time for bad jokes i can t help myself here are a couple of quotes from his site our p i is actively involved in trials david e linden m d our principal investigator is actively involved in the research we conduct as a result you directly benefit from his years of experience and expertise yes he has a very hand on approach wink wink also feel free to insert your own punchline one more dr linden has an extensive and prestigious portfolio in clinical psychiatry again i ll leave the punchline to you it would appear that drug companies have rather lax standards regarding their investigators would it not it would seem that imprisoning your patients having sex with them playing all sorts of sloppy with data and other misdeeds would disqualify a person from engaging in clinical trial research i understand that there will be occasional data errors in research one can never rule out human error and i accept that but this is well past slight mistakes due to occasionally poor oversight and is this what we would like our science to based on i ve written about a similar situation minus the sex herpes part in an earlier post after reading this post and my prior post as well as the links contained in both posts does it not make one wonder the extent to which psychiatric drug research is based on sloppy and or fraudulent data i m not throwing out a number here i really have no idea perhaps these are rare occurrences but given that fda oversight of research is close to nonexistent much of what happens in research is essentially done on the honor system unfortunately it appears that there is enough dishonor in the current honor system to strongly suggest that we need a lot more oversight posted by cl psych at 11 19 2007 04 55 00 am 2 comments labels misconduct thursday november 15 2007 upcoming features two upcoming stories will both titillate and enrage 1 how a certain company hid risks of a medication and i have the documentation to prove it of course independent academics make a special appearance 2 a researcher with an impressive record it is unlikely that any researcher has given sexually transmitted diseases to more patients than this person holding patients captive yes running clinical trial sites that provide strange data yes and more all coming hopefully soon from your humble correspondent readers please continue to send tips in the meantime several blogs have been absolutely ablaze lately including the following do yourself a favor and check them out scientific misconduct blog health care renewal furious seasons posted by cl psych at 11 15 2007 04 34 00 pm 0 comments absolutely smashing indictment of big pharma okay we all know by now that pharma giles is the premier site for cutting parody on the pharma industry bar none on occasion he steps away from vicious satire and issues a dead on incisive rant one such rant was recently posted and i think everyone should read it teaser follows drugs like vioxx oxycontin and possibly avandia have all recently been launched onto an unsuspecting public in the quest for billion dollar profits and have gone on to harm tens of thousands even though there is evidence to suggest that the companies behind them had a pretty good inkling of the potentially lethal hazards and side effects from data they chose to selectively ignore during trials people have needlessly suffered or died at best because of complacency and at worst because of corporate greed and as a result public trust in the pharmaceutical industry has never been lower and because of public mistrust the regulatory environment has become so tight that it is now much harder to launch new medicines of any sort a situation which is a constant cause of whining by the pharma ceos who are ironically ultimately responsible for creating the hostile regulatory climate in the first place pharma industry wonks talk about the risk benefit of new drugs and yet it seems that these days it s the public who take the risks and the ceos and shareholders who get the most benefit executives hide behind the line that they cannot be aware of every little thing that goes on their companies and therefore cannot be responsible for any illegal actions of their underlings sorry guys but just what do you get paid six seven or even eight figure compensation packages for by and large it certainly isn t for your personalities or good looks is it howard udell is certainly now trying to suggest that well sure he pleaded guilty but only because he was the boss and not because he was actually personally responsible for any wrong doing sorry pal that may well be true but i think the buck stops with you if you or your fellow execs weren t aware of any wrong doing then you damn well should have been mr udell is still employed in his capacity as chief counsel for purdue ms skolek points out to me slam dunk i d also add the atypical antipsychotics into the mix as well take a look at recent data regarding their performance in dementia for example 1 2 shockingly poor and who is accountable when these medications are marketed to bury risks and make false statements regarding a drug s efficacy apparently nobody sure a fine may be levied but that s just a drop in the bucket you don t think accountants and lawyers are busy figuring out as i type how much money can be lost in lawsuits versus how much can be made from b s marketing campaigns that overstate benefits and hide risks it s all a risk benefit calculation how much financial risk do we take by hiding data versus how much can we benefit from aggressively marketing the product posted by cl psych at 11 15 2007 04 23 00 pm 5 comments labels pharmagiles monday november 12 2007 latest abilify for alzheimer s study is a complete joke here s why a trial has recently appeared in the american journal of geriatric psychiatry this study claims that aripiprazole abilify is safe and effective in treating alzheimer s patients who presented signs of psychosis as i will demonstrate anyone with an ounce of common sense and certainly anyone who passed a basic statistics course can see these claims especially the claims regarding efficacy are bordering on hilarious efficacy here s what the authors said apripiprazole 10 mg day was efficacious and safe for psychosis associated with ad significantly improving psychotic symptoms agitation and clinical global impression quickie stats lesson in determining if there is a statistically significant difference between two groups a large factor is the size of the sample just because a difference is statistically significant does not imply that the difference actually means anything of value with a large sample size as was seen in the present study very small effects can become statistically significant next let s discuss the size of these treatment effects how helpful was abilify mean change on the neuopsychiatric inventory nursing home version was 17 6 points for the 10 mg day abilify group and 13 0 points for the placebo group with the knowledge of the mean change and the standard deviations from both groups one can easily calculate the effect size which indicates the magnitude of the treatment effect i e did people get a little better or a lot better the effect size using cohen s d was 14 the general guideline is that d 20 is a small effect so less than small i guess you could call it miniscule how about other measures used in the study here are a few neuropsychiatric inventory nursing home version psychosis subscale effect size 19 clinical global impressions severity effect size 12 clinical global impressions improvement effect size 10 brief psychiatric rating scale effect size 15 cohen mansfield agitation inventory effect size 17 no matter how you slice it the effects were all very small let s also do a common sense test the clinical global impressions improvement scale asks one question the wording may vary slightly across studies but one example is rate total improvement whether or not in your judgment it is due entirely to drug treatment compared to his her condition at admission to the project how much has he she changed in the current abilify...