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Journal editor quits in conflict scandal

Neuropsychopharmacology's chief steps down after a paper he co-authored omitted significant financial disclosures

By | August 28, 2006

The editor of a leading psychiatry journal announced last Friday (August 25) that he was stepping down after he published a paper about a treatment for depression without disclosing that eight of nine authors--including himself--had financial ties to the company that makes the device. Charles B. Nemeroff, editor in chief of Neuropsychopharmacology, a publication of the American College of Neuropsychopharmacology (ACNP), will not serve another term as editor, the college told its members in an Email. The decision was made "in part, based on the recent adverse publicity to the journal and the ACNP," the Email said. That publicity arose after the journal's July issue carried a positive review of a vagus nerve stimulation (VNS) device made by Cyberonics, Inc, of Houston, Texas. Nemeroff was the lead author for the paper, which described VNS as a "promising and well-tolerated intervention that is effective in a subset of patients with treatment-resistant depression." The article acknowledged funding from Cyberonics, and listed coauthor Stephen Brannan as an employee of Cyberonics. But it did not reveal that the eight other academic co-authors were all consultants for the firm. The story, one of several recent conflict-of-interest cases, first made news in July, prompting the journal to print a correction stating the authors had submitted disclosures in accordance to journal policy, but that the information simply had not been included in the acknowledgement section of the published paper. This isn't the first time that Nemeroff has hit the headlines for undisclosed financial ties. In 2003, a review he coauthored in Nature Neuroscience neglected to mention significant financial interests in three therapies that were reviewed favorably (including owning the patent on one of the treatments), prompting the Nature Publishing Group to widen its disclosure policies. At the time, Nemeroff and his co-author Michael Owens said: "Going forward, we intend to provide all financial disclosure information, even if it is not requested by the journal editor." Clare Stanford, past president of the British Association for Psychopharmacology and an editor at several journals in the field, said Nemeroff was an influential researcher in his field who was unlikely to have been swayed by the Cyberonics money. "I don't believe for a minute that the fact the paper was funded by a company would have influenced his conclusions," she told The Scientist. "It is unfortunate that he has had to stand down over this incident which is largely a reflection of the scientific community's paranoia rather than any failing of his professional integrity." Not everyone shares her view, however. In a blog entry posted earlier this month on the Health Care Renewal blogspot, Bernard Carroll, scientific director of the Pacific Behavioral Research Foundation, called the incident a "slick, coordinated, public relations-disinformation campaign in which ACNP and its journal were exploited by paid consultants of the corporation." Nemeroff, chairman of psychiatry and behavioral sciences at the Emory University School of Medicine, told The Scientist in an Email that the financial disclosures of all authors were submitted to the journal, but due to an "oversight," were not included in the print version. "There was absolutely no intent to withhold any information concerning financial disclosures." He added that he has served as the journal's chief editor for five years, during which time the journal has "improved in all objective indices including manuscripts submitted, ISI rankings ... I feel that we have accomplished our goals and I have opted not to accept the ACNP Council's invitation to serve another three years." The group Alliance for Human Research Protection, meanwhile, has raised concerns that a professional writer paid by Cyberonics wrote the first draft of the paper. The writer was not listed as an author but was thanked in the acknowledgements. Ronnie Wilkins, executive director of ACNP, told The Scientist that Nemeroff would serve out the rest of his current term as editor in chief, which ends in December. Earlier this year, he had been voted in for another term. Meanwhile, the college wants to ensure the same thing doesn't happen again, Wilkins said. "The council met on August 23 ... and one of the things we asked the publication committee was to look at our policies and procedures to make sure that we have a checklist to avoid this kind of oversight happening again," he said. Stephen Pincock spincock@the-scientist.com Links within this article Charles B. Nemeroff http://www.psychiatry.emory.edu/NeuropsychopharmacologyLaboratory/Charles%20Nemeroff.htm Neuropsychopharmacology http://www.nature.com/npp/index.html American College of Neuropsychopharmacology http://www.acnp.org/default.aspx?Page=Home C. Nemeroff, et al, "VNS Therapy in Treatment-Resistant Depression: Clinical Evidence and Putative Neurobiological Mechanisms," Neuropsychopharmacology (2006) 31, 1345-1355. PM_ID: 16880768 Cyberonics http://www.cyberonics.com/ A. McCook, "Conflicts of interest at Federal agencies," The Scientist, July 24, 2006. http://www.the-scientist.com/news/display/24056/#24128 D. Armstrong, "Medical Reviews Face Criticism Over Lapses," Wall Street Journal, July 19, 2006. http://www.postgazette.com/pg/06200/706933-114.stm B. Carey, "Correcting the errors of disclosure," New York Times, July 25, 2006. http://www.nytimes.com/2006/07/25/health/25news.html?ei=5070&en=794c681583ce7296&ex=1156910400&adxnnl=1&adxnnlx=1156760425-D1Sb+JF5FgICzW9qEslWjQ "Corrigendum: VNS Therapy in Treatment-Resistant Depression: Clinical Evidence and Putative Neurobiological Mechanisms," Neuropsychopharmacology advance online publication, 31 July 2006; doi: 10.1038/sj.npp.1301190 http://www.nature.com/npp/journal/vaop/ncurrent/full/1301190a.html S. Pincock, "Full disclosure?" The Scientist, October 1, 2003. http://www.the-scientist.com/article/display/21640/ Clare Stanford http://www.ucl.ac.uk/Pharmacology/Research/scs.html B. Carroll, "Money and Medical Journals," Health Care Renewal, August 8, 2006. http://hcrenewal.blogspot.com/2006/08/money-and-medical-journals.html "ACNP journal editor quits amid exposure of conflicts of interest," AHRP, August 27, 2006. http://www.ahrp.org/cms/content/view/327/55/
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Comments

August 30, 2006

It is high time that the hand was caught in the cookie jar.\n\nPsychiatry has the greatest conflict of interest possible--they are prescribing drugs and, in this case, mechanical "treatments" for conditions that have no verifiable physical cause.\n\nPsychiatrists are routinely used by the pharmaceutical industry as Public Relations tools in its rampant disease mongering, exemplified by Social Anxiety Disorder created to sell Paxil and the vast "off-label" promotion of Neurontin for psychiatric "disorders."\n\nIt has become the worst kind of incestuous relationship, with public health being the loser, as the 26 FDA health warnings on psychiatric drugs just this year attest.\n\nThe least psychiatrists can do is name who they are receiving money from so that people who read the reports have ALL the data and are not fooled into believing that they are reading a dispassionate review of ALL the pertinent facts when the authors have a clear incentive to "massage" the data.
Avatar of: ken Gillman

ken Gillman

Posts: 1

October 3, 2006

It requires much experience of medicine and business and life to appreciate the many avenues by which conflicts may influence opinions. As an experienced doctor nearing retirement I have to confess I do not feel able to accept the views of many of my erstwhile colleagues, eminent as they may now be. The more stridently they deny being influenced the more sceptical I feel. Nothing short of full disclosure of all monies and favours obtained will now suffice. A brief review of alternative health viewpoints on the web will demonstrate for anyone that they now have so much good ammunition that it is now nearly impossible for me to restore the balance when talking with informed patients. Medical science is now close to irretrevable loss of credibility.

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