Study 329: By the Standards of the Time

Johanna Ryan
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Getting Real about Clinical Research

The controversy over “Study 329” on the effects of Paxil in teen depression has raised questions about the state of ALL medical research.  What looked like a study conducted by leading psychiatrists from top medical schools turned out to have been controlled by the company. Individual patient data was hidden or distorted, statistical tests were massaged, and a company ghostwriter spun a narrative that turned an ineffective, risky drug into a safe and effective treatment.

Study 329 was performed in the 1990’s, and the resulting journal article was published in 2001. To this day no one has retracted that article. Top medical journals continue to publish drug-company directed research. When you search “the literature” for the best way to treat depressed teens, you will  still find that 2001 paper and others like it (about which we know even less).

The Ghost of Research Past

Study 329 was done at 12 research sites: two in Canada and ten in the U.S.  For each site, there was a named author from a major university or teaching hospital actually involved in the research. However, while each of them knew more-or-less what went on at their own site, only the drugmaker knew the whole picture. SK had paid for the study. It ran the analysis, and it produced the draft paper that made the drug look much better than it really was.

The record shows the named authors worried that the results were being distorted, and that SK might leave them to take the blame if the facts came out. In the end, they signed on for whatever reason.

The paper mentions “treating clinicians” made the decisions about raising or lowering doses of paroxetine.  Today GSK reassures us that the subjects’ treating doctors were responsible for following up on any problems they had during the study. The investigators apparently decided that none of the truly serious problems were due to paroxetine. Which means that they couldn’t explain to the Paxil Kids what had happened to them, or how to stay safe in the future.  Neither, of course, could their colleagues – your doctor and mine.

The Ghost of Research Present: Vraylar

The picture painted by Study 329 is scary, but what if there were fifty study sites instead of twelve, or 150 in several different countries? What if the academic “authors” of an article hadn’t laid eyes on any of those sites, much less been a Site Investigator?

What if the real Site Investigators were professional researchers-for-hire?  What if they’d taken part in a hundred studies, but seldom if ever been named as authors? They wouldn’t have to worry if the study design was seen as biased, or the results too good to be true. Their reputations would not be on the line; they’d made their money, and the official “authors” could deal with the fallout.

What if the subjects had no doctors of their own, and were signing up for the study simply to get some medical care? What if their doctor was a professional researcher-for-hire? Either way, the subjects would be dependent on care from a doctor with an economic stake in the success of the study. This could affect their personal welfare, and the reliability of the study results as well.

What happens when a doctor under pressure to recruit subjects with “bipolar depression” is the same one diagnosing you with “bipolar depression”? What if you need, for your health’s sake, to drop out of the study, but “your” doctor needs to maximize the number of subjects who finish?  What if you’re a patient with, say, a thyroid disorder or a drinking problem, who figures this will likely disqualify you from the study but you really need the free medical care, and the travel money will come in handy too.  Will you be tempted to say Yes, when the integrity of the depends on your saying No?

One Drug, Twenty Countries

I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar.  I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials.  Three were still in process, and seventeen were completed.  Not one had shared its results on the government website, a supposedly mandatory step.

I found at least a half-dozen published papers directly based on these studies, although only two were posted on CT.gov. The average number of authors?  Six to eight. The typical paper had a lone academic as “lead” author, the rest being drug company employees. Some had only employee-authors.

The average number of trial sites per study?  Fifty-one.  The “median” Vraylar study would involve 403 subjects at 65 different study sites in four countries!  Together, the twenty studies spanned twenty countries, from Colombia to Bulgaria and from India to Finland. Unlike those U.S. academics on Study 329, I doubted these people would ever get together, in person or via e-mail, to compare notes and debate what the finished paper should say.

Unlike some sponsors, Forest did not share the site names with CT.gov – only locations and ZIP codes.  However, a few of the papers thanked various “investigators” by name. With some patient searching of PubMed, CT.gov and Google, it was possible to identify many of the U.S. sites.

Overwhelmingly they were contract researchers.  Some were freestanding clinical trial businesses.  Others were busy medical practices with a thriving research business “on the side.” The first recruited subjects largely by TV, newspaper and online advertising which emphasized free treatment. The second combined some advertising with recruitment among their own patients.

A Study Like Many Others

I picked one study to focus on:  “Cariprazine in the treatment of acute mania in bipolar I disorder: a double-blind, placebo-controlled, Phase III trial.”  It was published, available for free online, and it had a manageable number of study sites.

The lead author, Gary Sachs, is from Massachusetts General Hospital.  His seven co-authors include four employees of Forest Pharmaceuticals in New Jersey and one medical writer from a Chicago agency hired by Forest.   The last two, Istvan Laszlovszky and Gyorgy Nemeth, work for the drug’s original developer, Gedeon Richter in Hungary.  They also hold patents on Vraylar, and are co-authors on most of the published studies.

The paper confirmed the study was carried out at ten sites in the US and 18 in India between February 2010 and July 2011.  The authors acknowledged just 14 clinical investigators by name: six Americans and eight Indians.  I was able to match all six named Americans with their research sites, whose numbers are listed in bold on the table below, and to figure out the identities of three of the four unnamed investigators using CT.gov.

None of the sites were anywhere near Mass General, or Forest’s Jersey City headquarters either; the closest was in Cleveland, Ohio, some 800 miles from Boston.   It appears safe to conclude that Dr. Sachs did not give Vraylar to manic patients or observe the results himself.

# Location PI & hospital affiliation Organization Funding in 2014
001 Flowood, MS 39232 Joseph Kwentus, M.D.Brentwood Behavioral Precise Research Centers $897,985.70$51,813.42
002 Houston, TX77008 Carlos Herrera, M.D. 7 nursing homes Heights Doctors Clinic $176,032.57$6,498.01
003 Creve Coeur, MO 63141 Franco Sicuro, MDAdvanced Geriatric Mgt Millennium P.A. $1,188,324.92$9,065.84
004 Long Beach, CA  90813 Stephen J. Volk MDDel Amo Hospital Apostle Clinical Trials $393,715.86—
005 Riverside, CA 92506 Sadashiv Rajadhyaksha, MD Clinical Innovations, Inc. None; license revoked 2012
006 Lake Charles, LA 70601 Kashinath Yadalam MDLake Charles Memorial Lake Charles Clinical Trials $1,038,407.13$910.69
007 San Diego, CA 92123 Michael Plopper, MDSharp Behavioral Sharp Behavioral Health Mesa Vista $304,782.89$568.91
008 Cleveland, OH 44109 [Unknown] [Metro Health Medical Center] Unknown
009 Chicago, IL60640 John Sonnenberg PhD[Michael Reinstein MD] Uptown ResearchLakeshore Hospital *SEE BELOW*
010 Oklahoma City, OK 73116 Willis Holloway Jr., MDSt. Anthony Hospital Cutting Edge Research $600,995.75$83,005.44

The funding figures are posted online thanks to the Sunshine Act. The first number is the amount of research funding each doctor received in 2014, while the second tallies “personal” payments for consulting, speaking, and traveling or dining at company expense.

Two physicians had no figures for 2014.  Dr. Rajadhyaksha surrendered his medical license in 2012, a year after our study ended, having been found guilty of sexually molesting two women patients.  Clinical Innovations, Inc. is still in business but has lost its Riverside “campus” for now.  Dr. Reinstein lost his license in August 2014, and is headed for federal prison.  But more about him later.

Our lead author, Dr. Gary Sachs, reported no drug-company research funding in 2014, and a mere $4,713.20 in personal payments!   With over 100 published articles and a seat on the Harvard Med School faculty, he’s clearly a bigger name in his field than Joseph Kwentus or Kashinath Yadalam.  I’m sure there are rewards for such eminence.  However, they don’t come from clinical trials these days, at least not directly.

Start Your Journey to Mental Health Treatment

At Precise Research Centers, just outside Jackson, Mississippi, they don’t make picky distinctions between research and treatment. “Precise is one of the top depression clinics in Mississippi.  Dr. Joseph Kwentus is one of the nation’s leading bipolar doctors,” their website declares. Their ads on local TV help you figure out if you are depressed, and tell you where to go for free help.

At Lake Charles Clinical Trials, “A Place Where Change Is Possible,” Dr. Yadalam will even put you in touch with the local chapter of NAMI, the National Alliance for the Mentally Ill.  He’s been a board member since 2002.  At the Heights Doctors’ Clinic in Houston, a banner outside the clinic in Spanish and English promises “Experimental Medications, Free.”

Dr. Holloway takes another approach. His Oklahoma clinic is actually three facilities in one:  Cutting Edge Clinical Trials; Holloway & Associates, his own psychiatry practice; and Optimal Health Weight & Wellness, which treats obesity, chronic fatigue and sexual dysfunction.  (If you wonder why a psychiatrist is running a weight-loss clinic, consider the number of new drugs recently tested in this area.)   Dr. Herrera at the Heights Doctors’ Clinic also combines a busy internal medicine practice with a clinical-trials business.

Sponsors: Click Here for Our Metrics!

These doctors do have reputations to protect.  The sponsors, mainly drug companies, want volume, reliability and speed.  While experience and efficiency count, often the first one to recruit ten patients with Condition X wins the contract. Apostle Clinical Trials, like many sites, posts its recruitment statistics online to impress sponsors.

These centers are located outside the major cities, or in low-income areas. Black and Latino Americans may be more likely than whites to find one in their neighborhoods. Some patients, especially immigrants, may be uninsured. Many are on disability, with low-paying public medical plans that aren’t accepted by many doctors.  Others have insurance that requires large out-of-pocket payments.  For ambitious trialists, a “patient base” like this can be an asset. They get access to lots of people with serious conditions like schizophrenia or multiple sclerosis.  Rates of hypertension and diabetes are well above average.  And as one of my local trial sites explains, “managing retention” can be easier with a “diverse” population and a clinician-trialist who knows how to talk to them.

Clinical Research: An offer You Can’t Refuse?

Most of this was nothing new.  What I didn’t expect was that eight of our ten sites would have close links to (mostly for-profit) inpatient psych units or nursing homes. Dr. Volk is on the staff of Del Amo Hospital, part of the huge Universal Health Services (UHC) chain. Dr. Kwentus is medical director at Brentwood Behavioral Health, the UHC hospital down the road, and his trials are promoted on Brentwood’s website. Lake Charles Memorial does the same for Dr. Yadalam, its former chief of psychiatry and still on its medical staff.

Dr. Plopper is both chief of staff and chief of research at Sharp Mesa Vista, and Dr. Holloway directs the special program for “resistant” youth ages 12-17 at St. Anthony’s in Oklahoma City.  Uptown Research offers sponsors an “affiliated inpatient hospital” – Chicago Lakeshore.  Dr. Herrera is on staff at seven Houston-area nursing home.  Dr. Sicuro, our top doc in research funding, heads a geriatric psych practice which is likely nursing-home based.  (In many states, long-term care and housing for people with serious mental illnesses is left to the private nursing-home industry.)

When you hear “private psych hospital” you may think wealth and privilege. Think again. Today’s successful player in the U.S. market is usually investor-owned, often part of a national chain, and may qualify for federal aid due to its “disproportionate share” of poor patients.  It also has a keen interest in “non-voluntary” patient groups: troubled teens, people with psychotic disorders, elderly folks with dementia.  UHS has opened special units for active-duty soldiers as the military hospitals overflow, and a few companies have won state contracts to treat prison inmates.

In most U.S. states, you can be held involuntarily for brief but renewable periods if you are judged an immediate threat to self or others. Online patient reviews for these hospitals are striking, not for their general negativity (expected), but for the number of people claiming they or their loved ones were kept against their will.  Many allege that “suicidal statements” were coaxed from them or fabricated outright.  In California, they talk of “5150’s,” while in Florida it’s the “Baker Act.”  In Illinois, the good old 72-hour hold seems to have magically grown to five days at Chicago Lakeshore.  In all cases, padding the bill seems the obvious motive.  Could research be another?

From Dan Markingson to Michael Reinstein

All of this has echoes of a recent, infamous human-research scandal: the death of Dan Markingson in a clinical trial of antipsychotic medication at the University of Minnesota. The hospital made Dan an offer he couldn’t refuse: Sign up for the trial, and they’d agree not to have him forcibly committed. How he could be ill enough to warrant commitment, but not too ill to “consent,” was never explained.  In any event, Dan was kept in that trial, despite evidence that he was getting worse on the new medication, until his death by suicide in 2004.  It took another ten years for Dan’s mother and a few tireless faculty activists to defeat the University’s coverup campaign.

Which brings us back to Uptown Research Institute and its founder Dr. Michael Reinstein.  Chicago’s Uptown neighborhood was for years a hub for rescue missions, flophouses and large nursing homes where thousands of people with serious mental illnesses were (and still are) warehoused. Reinstein amassed a small fortune there, providing psychiatric “care” to as many as 4,000 patients in 13 nursing homes, and parlaying his clout as a mass prescriber into a second career as a paid Pharma researcher and lecturer.  Astra-Zeneca, makers of Seroquel, were his first clients, followed by various makers of clozapine, one of the riskiest drugs in psychiatry.

The results, as reported in a 2009 expose by ProPublica, were horrific: Patients “trembled, hallucinated, lost control of their bladders … Staffers said Reinstein had induced some patients to take powerful psychotropic drugs with the promise of passes to leave the home.” Reinstein’s role as the “Clozapine King” of Uptown also resulted in at least three wrongful-death lawsuits.

In 2014 Reinstein lost his license and was charged with felony fraud. Following the 2009 expose, however, control of Uptown Research passed to cofounder John Sonnenberg, a psychologist, who disavowed any further connection to Reinstein. However, Sonnenberg was not a physician. An M.D. was needed to give and monitor medications.   Reinstein was still practicing out of a storefront next door to the Institute.  If he wasn’t the physician, who was?

All indications are that Reinstein was active in the research at Uptown through at least 2012 – including the period of our Vraylar trial. We don’t know how many Dan Markingson-type tragedies Reinstein was responsible for. But a look at this single study is enough to convince me that other Dr. Reinsteins must be out there – and the system has no way to stop them.

What Does it all Mean?

Why was the “Sachs study” of Vraylar for mania limited to three weeks?  Why were the subjects offered so many extra medications to relieve side effects, from benzos and chloral hydrate to Ambien?   If a 4-7 day “medication washout” period was needed at the beginning, what meds were people taking, and how did stopping affect them?

I can’t answer those questions, but I have one of my own:  Given what we know about the study’s structure and the system it took place in, how will we ever arrive at any reliable answers?

First, in many cases it may do no good to put pressure on medical-school faculty (or their schools) to share the data, when they themselves know so little.  Med Schools now have more in common with celebrities lending their names to a new cologne or athletic shoe than with scientists actually testing a new treatment. The drug companies may be the only source of information.

Second, when investigators have an economic stake in both the trial and the patient’s treatment, patients’ rights and safety are up for grabs.   In addition, any diagnoses and treatment records coming out of this system may be valid – or may be fictions created for one billing purpose or another.  In other words, the integrity of the research is also up for grabs.

Third, the popular idea of a patient research boycott may simply not work, at least in countries where healthcare is not a right.  It’s often said that people volunteer for trials for two reasons:  Their conditions haven’t responded well to standard treatments, and they also want to help others by contributing to medical knowledge.  If patients just refused to participate in trials, the reasoning goes, they could force study sponsors to agree to open data sharing.

The assumption is that the boycotters can simply go back to “standard care.”  In the U.S. and  other countries, many don’t have that choice.   When patients are dependent on the researcher for medical care, how many will just say no?  The problems multiply when psych patients are treated against their will – which may be on the rise in national health systems as well as privatized ones.

The Ghost of Research Future

The focus of reform movements so far, including the landmark expose of Study 329, has been on fighting for open data. Conflicts of interest, and even pharma sponsorship of the research, some say, would not be insurmountable problems if we just had access to the raw data.

In the course of this research, however, I bumped into some emerging trends that might lead to a system where raw data no longer exists, at least as we think of it today.  But that’s for the next article.

* * * * * 

This article appeared first on
David Healy’s website, DavidHealy.org

19 COMMENTS

  1. Wow, good expose.

    I was stunned by the amounts of money given to each research center to run the trial. I understand these amounts aren’t money directly paid to researchers, but they still legitimize the researcher as a “draw” who can get money that funds research, gets other lower-level researchers paid for running the study, and helps keep their educational or institutional center open or running. Loads of lower level workers must benefit from these several hundred thousand or million dollar plus payments and the prominent researcher benefits via prestige/status/job security.

    No wonder the head researchers cannot see how minimally effective and frequently harmful neuroleptics are. They see their clients as walking dollar signs. And, even if they didn’t, these psychiatrists/researchers lack the training and motivation to help regressed people through depth psychotherapy (e.g. psychoanalysis, Open Dialogue)

    My broken record statement on seeking psychiatric help bears saying again: Usually, it’s best to avoid psychiatrists and hospitals completely and seek help from non-prescribing therapists, family, friends, support groups, and non-drug holistic options.

    This article only confirms how dangerous the psychiatric system is…. a system where the primary interest is in profit and money, and the treatment makes you unable to feel your feelings, unable to work through your problems, and possibly ruins you with long-term side-effects.

    • How does your broken record statement protect kids ? the elderly? vulnerable people shuttled into emergency rooms to be restrained, contained and rendered helpless ?

      I appreciate how important it is to stress that each of us needs to become an active participant in researching the options available to us for *care* when we need it. But, you seem to think that is all it takes—?

      Really?

      • Kate,
        I like your comments as you are one of the people on here that is as blunt and direct as I am. But, that doesn’t mean it’s realistic for you to project assumptions onto my thinking that aren’t there.

        When I wrote my comment, I didn’t include or exclude any particular group. I was making a general statement about what people can do via educating themselves and choosing to seek or not seek medications and psychiatric “treatment”. It’s correct that this statement would mostly apply to young adults and adults.

        But this statement would also indirectly relate to children, the elderly, and “vulnerable people”, because those people are often having their fate decided partly by family and friends who are ignorant about the dangers of psychiatry. These support networks are another group that can become more educated and help keep the vulnerable ones away from the psychiatric predators.

        As for kids, the elderly, etc.; if they are all alone or subject to the whims of people who are ignorant about or proponents of psychiatry, then yes they often are f**ked.

        • I guess maybe I should have led with another assumption I have about your thinking regarding Johanna Ryan’s article– based on how I interpreted what you wrote. Don’t want you to assume that I am seeking anything but a better understanding of your thinking. I am especially interested in your take on how dangerous the psychiatric system is, which you say, and I agree, that this article confirms.

          It appears to me that you see this dangerous system as a commodity that is in dire need of *buyer beware* bells and whistles. Fortunately becoming more educated about the hidden dangers in psychiatry’s products and services is now possible. I agree that there are more than a few reasons for propagating a self motivated research approach as a vital first step before seeking psychiatric evaluation and/or treatment. However, the deeper one goes into this vortex, the darker the revelations about this dangerous system. I don’t think public education venues capture the true nature of this beast, though some people will be spared contact with it, duly warned. Loss of a little business is hardly a concern of psychiatry .

          Psychiatric treatment or no psychiatric treatment ? Would or should be the question , if it were just a commodity that can be freely chosen or willfully avoided. This article describes psychiatry as something more like a mythical dragon that acquires eternal life by eating its own tail. It is a self perpetuating, predatory business operating with impunity.

          Here is a peak inside the means by which customers are literally created via a very profitable process– under the guise of innovating treatments and rigorously testing them before they go to market. Educated consumers have as little protection as the most ignorant bystander. In all likelihood, the educated consumer will be subjected to even worse…

          Such is the case when parents protest psych referrals made by school officials who apply leverage that has a double bind– failure to comply with the request for psych eval can mean expulsion from school or loss of custody of the child.

          There are many instances when an educated consumer may find himself in hot water with psychiatry. Even knowing what to expect is unlikely to quell the fear. Not because of what psychiatry is or does, but what it perpetually invents—.

          I just received a “Dear Colleague” letter from McLean Hospital and a full color brochure announcing openings @ McLean Gunderson–“premier borderline personality disorder program for women”. It’s a trolling for referrals advert. As you know, Dr. Gunderson is called “a pioneer in the research and treatment of BPD”. Judging from the looks of this facility, it’s gonna take a lot of clients to sustain it. Funny how the funding for something cutting edge in psychiatry always seems to be awarded before the boon in the diagnosis— . I share this only to say that there is going to come a time when external pressure – political & legal primarily , will be the only way to say “no thank you” to psychiatric treatment–.

          Based on what I have read by you here and on your blog, I have deep respect your self motivated education, your style and your writing– ( and your sense of humor , i.e; how BPD got its name). I wish you would channel your gifts into a wider arena- public education for political activism, for instance. But I don’t assume you would agree– on any of the points I raised– . Your work is a stand alone effort that deserves praise and support. I am not assuming you are a slacker when I suggest you could do so much more– because you have the skills and the polish.

          • Katie,
            Thank you for your thoughtful message. When I read your writing I have the image that you must have been a very kind psych nurse devoted to helping people in difficult situations without diagnosing or labeling them as mentally ill.

            Unfortunately I have decided that I cannot yet advocate publicly under my real name for mental health reform or a different understanding of BPD. This is because I work in a field with children where if my employers or the parents of my students were to find out my controversial views on mental health, I could get into trouble or even lose my job. It’s unlikely, but possible.

            I love my work with kids and need it for financial stability and a sense of identity. I have survived so much abuse and so many desperate times that I simply do not have the willingness to put myself through a job loss if I can avoid it. I’m a survivor and an opportunist, and my self-protective instincts are still very strong. Very few young people with regular jobs and past experience in the mental health system are public commenters on MIA. There are reasons for that.

            Some days I wonder whether I am overestimating the risk of public advocacy. I don’t know but prefer to play it safe in this area. To be bluntly honest, while I want to help people, my first priority is still my own wellbeing and that means protecting my job.

            Furthermore, until recently I had been considering trying to train part-time as a psychotherapist. However, I have become jaded about that idea, partly because all of what I read here on MIA about the mental health system and itnsn distortions around diagnoses/medications is just so bad, that it feels as if I don’t want to try to change the inertia of such a massive and corrupt system.

            With my work, which is mostly with relatively healthy children and families, I can take the easier way out, moving away from my past and from involvement with the mental health system. It’s nice that a large part of my life now involves “normal” people, not my family or other emotionally troubled people. But, I must admit that part of me still wants to train as a therapist, if I could work in some sort of private outpatient setting not involving regular use of medication or diagnosis.

            You’re right; I see the psychiatric system as needing glaring buyer beware warnings all over it. Unfortunately, despite the availability of much good information in the books we know, there appears to be a massive majority proportion of society that still has no awareness of the damage inherent in fraudulent diagnoses and medications.

            If you read the Reddit mental health forums, the Psychforum boards, the PsychCentral boards, and so on, the sheer volume of ignorant people who think medications are effective treatments for mental illness and that diagnoses are the way to understand life problems is…. simply stunning. They massively outnumber the people here on MIA, unfortunately. It’s sad because I’ve spoken to many of these people and they want a more hopeful, human way of looking at emotional problems, but don’t seem to realize that a totally different way of looking at problems in living is there for the taking.

            To fix the system, I think that not only would legal and political pressure somehow have to be applied to vastly curtail use of medications and fake diagnoses, but also, the provision of long-term psychotherapy, peer support, respite centers, job/housing support, family therapy and supports, etc would have to be a prominent and very expensive priority. Particularly important would be healthier childrearing. I am not optimistic about these changes happening especially in an unhealthily profit-focused capitalistic society like the USA. In countries like Norway or Finland, such changes are more likely and are already underway.

            Ironically, Gunderson contributed hardly anything new to the understanding of borderline states. “Borderline” ways of relating were well understood by psychoanalysts like Volkan, Boyer, Giovacchini, Adler, Masterson, and Kernberg long before Gunderson took their ideas as his own. In the brief interaction I had with him, the conversation stopped once I lost my patience with his bullshit about a genetic basis for BPD, and told him, Bane-style (From the Dark Knight Rises) that I was his reckoning, here to end the borrowed time his theories had been living on. For some reason psychiatrists don’t like hearing that from me 🙂

            What about you… Are you still a nurse? How do you advocate?

    • AND dismantled !

      A good place to start is to rip it free of the protection of the medical community.

      When will there be a tipping point reached in terms of the tolerance medical doctors have for their profession being trashed, slashed and burned by a handful of criminals wearing white coats?

      Barring that, we have access to our political leaders–

      • You don’t seem to realize that the historic, and continuing, “dirty little secret” of the medical community is that one of the primary “social control” roles of psychiatry is to cover up easily recognized iatrogenesis for the mainstream doctors. That’s why mainstream medicine is allowing their field to be “trashed, slashed, and burned by a handful of criminals wearing white coats,” they prevent malpractice suits for the rest of the medical community.

        Another one of psychiatry’s primary “social control” roles is to cover up child abuse for the religions, and wealthy. And, of course, the psychiatric industry likes to drug as many blacks, homosexuals, political dissidents, women, and children as they can get their hands on, too, largely because it’s profitable, and our government has unwisely and inappropriately given them this right.

        • I do realize what you are saying here and totally agree that historically these have been the coveted roles of psychiatry — . We finally have new material, damning internal documents are making it into the public domain– .

          I wonder how credible psychiatrists would look, pointing fingers at the medical community when they kick them to the curb?

    • We will tolerate it as long as we continue to keep our heads stuck in the sand in good ostrich-style about all the trauma that exists, both within families and in society at large.

      We refuse to see what our economic system is doing to our country, the world, and the earth at large. We refuse to see our broken educational system that bores and traumatizes students and allows bullying on a huge scale. We refuse to admit that neither the Right nor the Left are friends of the common person and that our government is broken and grid-locked.

      We refuse to educate ourselves about what is going on and most of us rush to the medicine cabinet for a pill when having to deal with the slightest inconvenience or larger problem. We want “experts” to tell us what to do rather than listen to our gut and do what we know deep down needs to be done. We allow psychiatry to pathologize the difficulties of life and turn them into illness.

      As long as we refuse to take a moral and ethical stand about what is going on around us and unless we begin speaking out, even if we are the lone voice crying in the wilderness, all of this will continue. Psychiatry will continue to have its way with all of us if we don’t speak out now.

  2. Evidence-based research, and the perspective presented here in this article destroys the glorious image of medical research. It focuses on key individuals and their tainted intentions in the business of marketing drugs, disguised as a noble endeavor of finding solutions to problems that are too complex to be addressed by any one medical specialization. At the end of the day, it’s people playing with other people’s lives, locked into a way of thinking based on flawed “knowledge” in ever-changing, cleverly contrived books of psychiatry. I wish, everyone could see medical research for what it is, a giant deception. This game should be over!

  3. As a Chicago medical mob researcher, I remember reading about Reinstein. The FBI came in and made a few arrests in the Chicagoland area in 2012-2013. Here’s his initial arrest warrant:

    https://m.fbi.gov/#https://www.fbi.gov/chicago/press-releases/2012/chicago-psychiatrist-allegedly-submitted-at-least-190-000-false-claims-to-medicaid-lawsuit-alleges-kickbacks-to-prescribe-antipsychotic-medication-for-nursing-home-patients

    I’m glad he was found guilty. Hope the FBI arrested psycho who medically unnecessarily forced hospitalized and had me “snowed,” V R Kuchipudi, meets the same fate, once his trial comes to fruition. He was arrested in 2013, here’s his arrest warrant:

    http://www.justice.gov/sites/default/files/usao-ndil/legacy/2015/06/11/pr0416_01a.pdf

    Lots of “other Reinsteins are out there,” you’re right, and many are still not being arrested, like Kuchipudi’s psychiatric “snowing” partner in crime that I dealt with, Humaira Saiyed.

    Truly, the evil within humanity, have seemingly infiltrated the medical industry and religious institutions, not to mention it seems the research / educational industries, legal industry, judicial system, and government, now. As to why this has happened, one must look into the philosophies behind those that finance these industries and their research – follow the money – and then take away the current bankers’ power. God save the decent.

  4. @bpdtransformation,

    Thank you for clarifying your position re: public/political activism. I completely agree with your thinking and also feel strongly about the importance of reclaiming your true identity and establishing relationships based on trust. For different reasons, I have had to rebuild my professional confidence and reputation. The retaliation from those I had exposed and challenged was brutal–but fortunately, I had a few solid friends, some were professional colleagues, others were parents of kids I met on inpatient units here in the Boston area. The referrals for advocacy came through the latter, which sustained my belief in the need to continue to denounce the MH industrial complex that is still destroying kids. Again, I respect both the work you are doing and the decision you are making to protect it and your hard earned right to do it.

    I have been a nurse for 41 years now. I stumbled inadvertently into adolescent psych in 1988, hired to work as a regular, school nurse variety, RN in a residential center for adolescent boys. I continued on — seeking what other regular nurses I worked with back then were seeking; a reasonable explanation for labeling kids as mentally ill, then brain disordered (officially stamped at first ever White House Conference on Mental Health — just a few months after the terrifying mass murder by *kids* at Columbine); my greatest concern was always the drugs–by 2003, I still had seen no evidence of the benefit, and by then , psychiatrists were drugging them to the gills.

    I definitely get why you start from and focus on the labels, the bogus psych diagnoses. From my perspective, as a nurse, I was first and foremost worried about administering powerful, brain altering drugs to kids. I am no one to criticize any psych clinician who did not insist on scientific evidence for this insane practice, because, I was no more able to get past the authority based rhetoric, passing for medical expertise, that has always been at the root of this horrific scam. The guys in the white coats confidently assured clinicians, parents and patients that the scientific evidence was sound, and so were the studies and RCTs–Yup! Chemical imbalances in the brain… I wish I had kept the script used by nurses to teach kids about their “meds”– why they would need for for the rest of their lives– why they should not feel any more *stigmatized* than a peer who had diabetes or asthma!! In June, 2010, when I was coerced into resigning from Boston Children’s Hospital premier adolescent psych unit, Bader 5, this was the model taught and reinforced. And black box warnings were viewed as a huge problem, in that they may prevent a severely depressed ten from seeking treatment, or their parents from rushing them to a shrink. Don’t believe a word of the- *wasn’t- us* lame response, post being caught in their lies–. “Belief” in biological markers–etc.–? no different than beliefs around the *good intentions* for continuing to propagate this BS. None of this reflects an ounce of respect for anyone below the rank of a Harvard Medical School Professor of Psychiatry, whom Joseph Biederman told us is just one step below “God”.; none of this shows even a hint of concern for the harm it has caused–. And so on.

    It was a former patient, whom I still had contact with after leaving BCH, via her parents, who engaged me to work on a school project that led to my reading “Anatomy of an Epidemic”– that was February 2011. Watching the video of Bob Whitaker’s ISEPP talk , I am gratified to note that he finally sees a bit of what I told him were the barriers to psychiatry reform being initiated by psychiatrists.\- beginning when I first met Bob, April 2011. Seeing is believing— now, he, too, seeing it. I was kind of glad to hear him admit to *losing his temper* a bit, at the unmitigated gall of one of these *old guard shrinks* in the audience at a grand rounds he was invited to address. 🙂

    I thought psychiatry was BS when I did my clinical rotation through psych as a student nurse. I never would have sought a job on a psych ward– not viewed as *real* medicine in the 70’s when I was in nursing school– for one thing. I offer the excuse for giving psychiatry the benefit of the doubt, because I wanted to continue to work with a population of kids that I found fascinating, unique, and most of all rebellious in all the ways I admire. There was something else though, that compelled me to wade closer to the epicenter of this scourge. I now know that the kids I encountered in 1988 were being inducted into an experiment on false pretenses, then exploited to make billions for pharmaceutical companies-via the slight of hand method psychiatry is known for. I think I ventured as far as I could go on on my gut feelings of distrust of psychiatry.

    Psychiatrists , not pharma execs, proclaimed the scientific breakthroughs that transformed shrinks into medical *brain chemistry*doctors”. I was curious, skeptical and fascinated by this 180 degree turn around in status of shrinks. But, honestly, if I had already lost my heart to these kids, who were now *my patients* I could not have continued working in psych or endured ongoing mocking, and outright disdain from those who knew me as a *real* nurse, I stayed the course— all the way to Harvard affiliated Boston Children’s Hospital.

    My methods and means for both advocacy and activism are predicated on a premise ; like, “necessity is the mother of invention” . I have many underground referral sources and have established some very interesting, influential contacts– many of whom I encountered when I began to work with the Pelletier’s in April 2013.

    The second round of attacks from Harvard Child psychiatry, which initially caused those who were vital to the Pelletiers to marginalize me– accomplished two things :1) Kept me out of the spot light when the Pelletiers appeared in person on mainstream media- news and Dr. Phil, for example; 2) Protected me from being connected to the politically- based campaign, that took the spotlight off of psychiatry all together.

    Timing is everything– If it is not meant to be, it is meant to be better– . And BTW, your blog post on the genetic basis for BPD had me laughing out loud in front of my computer. My grandkids pleaded with me to share the *jokes*– . To your credit, my 9 year old grandson totally *got it*.

    Keep up the excellent work!

    Best,
    Katie

    • Thank you, Katie, for sharing your experience and for your appreciation of the parody article. I’m sure you understood that it was intended as a thinly veiled, vicious attack against the absurdity of psych diagnosis, as well as comedy.

      Do I understand right that you are still a practicing psych nurse? And if so, do you not get in trouble for expressing your opinions so openly now, in 2015?

  5. Johanna,

    I can’t hold a candle to your research prowess, and I am an appreciative audience for your clear, concise writing style. Your arguments are resonating closer to my radicalized viewpoint of the state of the buy out of academic medicine. I think, though, based on your response to my faith in the medical community comment, (above, where there are no more reply buttons) there is a profound difference in our expectations based on the subtle differences in of our position, or proximity to the fiends who are behind this scourge.

    I do not envision medical professionals as a group of like minded professionals. I have seen my fair share of incompetent quacks in medicine over the years, and realize that the temptation to cash in on a medical degree is no less attractive to medical, *real* medical doctors, than it obviously has been for psychiatrists. What I am talking about refers to the subset of integrity possessing, morally guided, members of the medical profession that I know well. There are a few in the field of psychiatry as well. Strictly speaking, I am referring to those who made a serious commitment to the medical profession based on desire to heal, cure and at the very least, help without intentionally harming vulnerable people. It is this group who is struggling with fulfilling their duty and protecting the profession that gained trust and was granted power and authority based on this trust.

    Their silence is complicity– their silence condones the indefensible. If they organize, their voices can tip the scales in our favor– politically, and most definitely in the criminal justice arena, where only their voices will matter.

    I do push the envelope, appealing to the conscience of *good* doctors that I know– but it will take some clever networking by those doctors who already are blogging and writing about this post of yours, and all recent commentaries about documents in the public domain. I believe they can and will step up to the plate–

    Darkest before the dawn??

    Wish you lived closer to Boston–

    Best,
    Katie

  6. To me stepping up to the plate by sincere medical professionals with the highest titles who wish to help the people APA coercive psychiatry oppresses, as well as AMA oppressive medicine and the oppressive ADA (American Dental Assn.) Would require about a hundred or more to stand up and for example say ” we are resigning in mass if funding is not made available for a Soteria House in every community across the USA and the entire population granted emergency health freedom rights due to unprecedented ever growing predatory coercive actions by the major established medical fields of which psychiatry is the most deeply and entirely steeped in pseudo-scientific coercively delivered torture and at a minimum must be stripped of its power over any human being in the USA or anywhere if possible on the planet.