A colleague sent me an article written by Dr. Jeffrey Lieberman that was posted on Medscape. It is entitled, “Psychiatric Drug Development: Hope Around the Corner?” Dr. Lieberman is Chairman of Psychiatry at Columbia College of Physicians and Surgeons and one of the most prominent and influential psychiatrists in the United States.
In this article he describes the failed development of several new drugs, one for schizophrenia and two for Alzheimer’s disease. These drugs were pulled from study – fairly late in the process – because they “failed to meet the desired endpoints on interim analyses” or in plain language, they were not effective.
Dr. Lieberman goes on to talk about why “novel drug development for central nervous system disorders is not for the faint of heart.” He discusses the complexity of the brain and the difficulty in finding suitable animal models. He asks, “how can lower species like rodents model the complexity of human behaviors and mental disorders that we are trying to correct pharmacologically?”
In his conclusion, he tries to rally his audience to his cause and this is how he does it:
- He supports the NIMH so-called “fast programs” which are intended “to identify drugs that exist within the pharmaceutical industry and may no longer be under development, but can be repurposed for study for specific disorders(emphasis mine).”
- He points out that “Anyone who works with psychiatric patients knows that there are tremendous unmet clinical needs… With these needs come tremendous market potential, so for those who stay the course and persevere, there will be very lucrative rewards. To me, this seems like a great opportunity, and I think our partners in the private sector should appreciate this” (emphasis mine).
And there you have it. We will once again try to fashion drugs to fit some construct that we have labeled as a disorder in order to target a potentially lucrative market. I am not sure I have ever seen this stated so baldly by an academic psychiatrist.
I wrote most recently about the work done in northern Finland. Some of us have wondered why the rest of Finland, let alone the rest of the world, has not taken more notice of this work. We wonder why we are not studying the people who have recovered. Why aren’t we putting more resources into understanding success and recovery?
I think I have an answer. There is no lucrative market for Open Dialogue. There is no lucrative market for recovery.
I also have an answer to Dr. Lieberman’s title questioning whether hope is “around the corner”. If he is talking about the future of psychiatry and if psychiatry’s leaders are unable or unwilling to disengage from the goal of promoting the financial welfare of the pharmaceutical industry, then my answer is no.