Gadfly or Watchdog?

Some controversies never die. As Accuracy in Academia recently reported, Dr. Alan Schatzberg and around thirty medical researchers are now under investigation by Senator Chuck Grassley (R-Iowa) for financial conflicts of interest. In Dr. Schatzberg’s case, the conflicts reach as far back as 1998, when he co-founded the company that purchased a patent for mifepristone from Stanford University, his then (and current) employer.

To this day Dr. Schatzberg continues as the principal investigator on Stanford’s National Institutes of Health (NIH) grant to study the anti-depressant effects of mifepristone, an abortion drug. Schatzberg owns $6 million in Corcept Therapeutics stock, according to Senator Grassley.

Surprisingly, my recent article on the subject raised complaints not from Dr. Schatzberg, but from Dr. Bernard Carroll and UCLA Professor Dr. Robert Rubin—two doctors who confronted Dr. Schatzberg for his shoddy science and conflicts-of-interest in 2004.

The two doctors raised much controversy at a Puerto Rico meeting by presenting a poster which compared Dr. Schatzberg’s (and other researchers’) grandiose statements about mifepristone with their financial interest in Corcept Therapeutics. They also criticized several studies’ conclusions about mifepristone’s effectiveness.

Dr. Carroll, speaking also for Dr. Rubin, told this correspondent that Dr. Schatzberg’s “defamatory allegations,” printed by San Jose Mercury news writer Paul Jacobs in 2006, are little more than “smears.” The article written by Jacobs was designed to examine the controversy around Dr. Schatzberg’s scholarship.

Jacobs’ article did refer to the two doctors as “self-appointed guardians of scientific rigor in psychiatric research—gadflies who periodically fire off salvos to journals to complain about papers that don’t measure up to their standards.” However, Jacobs also buried Schatzberg’s claims against the two doctors deep within his story. Jacobs wrote,

“Schatzberg contends that Carroll and Rubin have distorted what he’s said and harbour professional jealousies because their own work on cortisol did not result in new treatments. He also suggests their grievances have nothing to do with his science.”

Among the listed “grievances” given were

–          being underpaid for consulting fees

–          unmarketable (and competing) cortisol research

–          getting “passed over for a committee chairmanship.”

Rather than being unmarketable, Dr. Carroll says his research led to the development of the “dexamethasone suppression test,” which became the testing standard for the medical community for about ten years. The former head of psychiatry at Duke University says that, while routinely encouraged to patent the process, he “believed commercializing the test would work to the detriment of patients” and therefore “left it in the public domain.”

Dr. Carroll wrote in an email to this correspondent,

“There is no truth to the smear that we critiqued Dr. Schatzberg’s work out of personal resentment. Our original criticism of Dr. Schatzberg, initiated in 2002, was harsh but collegial and constructive…Its accuracy was confirmed by independent statistical experts. We had no personal issues with Dr. Schatzberg at that time.”

He continues, “Any bad feeling between Dr. Schatzberg and us arose later through the inappropriate behavior of Dr. Schatzberg and/or his proxies at Corcept Therapeutics…”

According to Dr. Carroll, Dr. Schatzberg:

1.       “derailed the publication” of the Doctors’ critiques,

2.       turned “scientific disagreements into bogus ethics complaints”

3.       threatened legal action against Paul Jacobs for his article,

4.       and “smeared” their reputations when trying to dissuade the reporter from publishing his 2006 article.

Dr. Carroll has also served as faculty at the University of Pennsylvania and the University of Michigan at Ann Arbor. He currently works at the Pacific Behavioral Research Foundation.

“The pattern here is of a concerted ad hominem attack by Dr. Schatzberg on his critics in lieu of a substantive response to our critiques of his weak science,” writes Dr. Carroll. “There is no truth to the smear that we critiqued Dr. Schatzberg’s work out of personal resentment.”

However, the two doctors have a history of conflict with another researcher tied to Corcept Therapeutics. In the summer of 2003, Dr. Carroll and Dr. Rubin condemned Dr. Charles Nemeroff for favorably reviewing a number of depression treatments without first disclosing his financial ties to the industry, something that Nature Neuroscience did not actually require at the time.

“One treatment [Dr. Nemeroff] describes favorably is a patch that delivers lithium through the skin, a method that he says would improve patients’ ability to tolerate the medicine. He did not disclose that he held the patent on that patch,” writes New York Times reporter Melody Peterson that August. Dr. Nemeroff also favorably reviewed two other treatments he had financial ties to, including one owned by Corcept.

Dr. Nemeroff told the NY Times in 2003 that he owned 60,000 shares of Corcept stock.

Interestingly enough, Dr. Nemeroff made the same criticism of the conflict-of-interest dispute as Dr. Schatzberg would later take. “Dr. Nemeroff contended that Dr. Carroll was ‘stirring up things’ because of past differences between the two men,” reports Peterson.

In response to the controversy, Nature Publishing Group changed its conflict-of-interest disclosure policy in September 2003, according to the NY Times.

“We are pleased that we were instrumental in persuading Nature Publishing Group to revise its policy on disclosure. As you could tell reading between the lines, they brushed us off for 6 months until the story hit the New York Times,” writes Dr. Carroll.

Dr. Carroll and Dr. Rubin also take credit for Dr. Nemeroff’s decision to leave his job as editor of Neuropsychopharmacology in 2006 following another disclosure scandal.

“For your background, please know that we also challenged Dr. Nemeroff for another serious instance on nondisclosure in 2006. As a result of that episode, he exited the editorship of a major journal,” writes Dr. Carroll.

“Nemeroff and his co-authors submitted disclosure forms with the manuscript, but a clerical error caused the information to be left off the published paper, Nemeroff says in an email to Businessweek,” reports the business magazine.

Dr. Carroll still disparages Dr. Nemeroff’s professional ethics to this day. As he writes in his own blog this June, “The Expert Interview by Dr. Nemeroff resembles nothing so much as Lindsay Wagner promoting the Select Comfort Sleep Number Bed in television advertisements. Promotional statements are made without scientific backup.” Dr. Nemeroff chairs the Emory University department of psychiatry.

Bethany Stotts is a staff writer at Accuracy in Academia.