An Update on Dr. Charles Nemeroff

Dr. Charles Nemeroff, the psychiatry professor that was investigated by the Senate's Finance Committee for conflicts of interest, has moved on from Emory University and been given a position to head the psychiatry department at the University of Miami.

The former Emory University professor, who now works at the University of Miami, came to the committee’s attention because he was accepting sizeable consulting fees from GlaxoSmithKline at the same time he was the primary investigator on an NIH-funded grant for research into a Glaxo drug.

According to Ed Silverman, an update on that investigation should be coming this June. Nemeroff was found to have received millions from pharmaceuticals all while he made favorable reviews of the drugs of these pharmaceutical companies, and he rarely disclosed this conflict. Emory University was also found to have covered up this conflict after the fact.

Emory University and the Unholy Alliance Between Research and Big Pharma

It's often a topic of discussion among professors in the field of psychiatry and related fields. There is a growing influence by the pharmaceutical industry on research provided on it by those in academia. Often, junkets and seminars are paid for University psychiatry professors by the drug companies. In fact, the relationship is so close that it's unclear just how much the research these academics do on the drugs that pharmaceuticals develop. In fact, the relationship has gotten so cozy that their role as watchdog over the industry has likely been totally compromised.

Back in January, I featured an extreme example of just one such relationship. The relationship was between Dr. Charles Nemeroff and several of the drug companies he did research on:Cyberonics, Glaxo Smith Kline, and Pfizer. For years, Dr. Nemeroff received in the neighborhood of $2.6 million from these pharmaceutical companies. In exchange, he wrote favorable articles on drugs these companies were bringing to market. Even worse, he didn't report a very big chunk of this income. News of this corruption hit the media in October of last year. At the time, Dr. Nemeroff was head of the Department of Psychiatry at Emory University. This quid pro quo became the subject of an investigation by Senator Charles Grassley. The investigation found that not only was Dr. Nemeroff compromised by his cozy relationship with the pharmaceuticals, but Emory University was lax in their own supervision of Dr. Nemeroff. Worse yet when presented with evidence, the administration not only close ranks around Dr. Nemeroff, but they even attempted to hide the corruption. Email exchanges show that the cover up by Emory University goes all the way to the top of the medical school and includes the Dean of the Medical School, Claudia Adkison.

In one infamous exchange, Adkison not only admits knowing about the fraud but pronounces relief that a Wall Street Journal reporter wasn't "sophisticated enough to ask the right questions".

thank goodness the reporter wasn't sophisticated enough to ask the right questions

...in working on handling the reporter I tried to make this story go away because Emory's name is in the middle of it

....I am embarrassed and uncomfortable that I write to colleagues around the country to try to defend this when I know all the issues.

Shockingly, Dr. Nemeroff was in fact removed from head of the Psychiatry Department at Emory but remains a tenured professor, earning six figures and in a position to continue to do research on the very pharmaceutical industry he has been so clearly corrupted by. In fact, Dr. Nemeroff would have faced absolutely no disciplinary action had Grassley not done the investigation. Everything that Emory has done in this case has been strictly in response to his investigation. (the staff at Emory University never responded to emails as is their M.O. in any of my exposes of that university) No one involved in the cover up including Adkison was disciplined.

Well, now it's happened again at Emory University. This time it is a Professor Zachary Stowe.

Emory University has disciplined a prominent psychiatrist who was being paid by an antidepressant maker at the same time he was conducting federal research about the use of such drugs in pregnant women.

The university said its medical school dean issued a letter of reprimand on April 30 to psychiatrist Zachary Stowe related to his "external relationships." Dr. Stowe was instructed to immediately eliminate conflicts related to current federal grants and was barred from having any conflicts for the next two years.

Dr. Stowe, the director of the Women's Mental Health Program at Emory, is considered a leading expert on the use of antidepressants in pregnant women. He is listed as the primary investigator on at least three National Institutes of Health grants, beginning in 2003 and continuing through last year, that involve antidepressant use in pregnant women and the effects on children delivered by those women.

Dr. Stowe received nearly $200000 in about two years from Glaxo SmithKline all while working on research on their anti depressent drug, Paxil. This time, unbelievably, all Dr. Stowe faced was a "letter of reprimand". Even more shockingly, he was barred from having any more such conflicts for TWO YEARS. In other words, even though it was proven that Dr. Stowe was corrupted by his relationship with a pharmaceutical, he faced no financial or professional demotion, let alone being fired outright.

Then, there is the case of Dr. J. Douglas Bremner. Up until 2005, he thought about the pharmaceutical industry the way most academics in his field did. While he was exposed to the cozy relationship between pharmaceuticals and his colleagues, he'd never written or spoken out much about its consequences. That all changed in 2005. A non profit gave Dr. Bremner a grant to study the side effects of an acne drug named Accutane. Dr. Bremner not only found that Accutane had significant side effects like depression and even suicide, but Dr. Bremner began to conclude that the corrupt relationship between the pharmaceutical industry and those employed with reseaching it had contributed to white washing much of the warning signs of its side effects.

In fact, his book, Before You Take That Pill: Why The Drug Industry May Be Bad For Your Health, published in March 2008. You'll find little in the form of support and public relations about this book at Emory University. That's peculiar since Emory has a well funded and established public relations department. Whenever an Emory University professor publishes a book, the P.R. department at Emory University releases press releases to media contacts. Then, lead by the Atlanta Journal Constitution, local Atlanta media, where Emory University is located, do a series of book reviews of said books. None of that happened in the case of the book by Dr. Bremner. Even though Dr. Bremner brought his book to the AJC himself, they never reviewed it. (it should be noted that at any given time as much as 40% of AJC staff is Emory alumni) In fact, the story gets even more peculiar. Dr. Bremner discovered a press release that Emory had created for his book.

Douglas Bremner, MD an Emory University and Atlanta Veterans Affairs Medical Center researcher, was concerned about the way information was communicated about medications and supplements, so he decided to take action. After two years ofdoing his own research on hundreds of the most popular medications, he has written a book called "Before You Take that Pill," which is scheduled to be released on February 28, 2008.

"You have the right to know the risks and benefits of the pills you take and to form an active partnership with your doctor to make decisions about what is right for you," says Dr. Bremner. "We all want to live as long as possible," he continues. "If this book allows you to use medications safely and convinces you to change your diet and lifestyle to prevent disease, I will consider it a success."

The book covers over 300 of the most commonly prescribed prescription drugs, the fifty top-selling prescription drugs, vitamins, and the best selling herbs and supplements. Also included in the book are drugs that are not used much any more but that are particularly unsafe and haven't been taken off the market yet by the Food and Drug Administration (FDA).

Dr. Bremner says the U.S. is focused on developing newer drugs. But those drugs are more expensive and drive up health care costs and are not necessarily more effective than the older drugs. He says that pharmaceutical companies are not required to prove that new drugs are better and have fewer side effects than the older drugs they are claiming to replace. In addition to that, vitamins and supplements and some medications can be avoided altogether if people are encouraged to stick with a healthy diet, exercise regularly and wash their hands to avoid infection.

"Despite the fact that Americans spend twice as much on health care as any other country in the world, we have some of the worst health care outcomes," says Dr. Bremner. "In a survey of 13 industrialized nations, the United States was found to be the last in many health related measures, and overall was second to the last!"

Dr. Bremner read and analyzed journal articles, editorials, and drug research related to all the medications he describes in this book. Additionally, he reviewed investigative reporting about the safety of the drugs in credible publications such as the New York Times, and he consulted colleagues with specialties related to the medication he was researching.

Says Dr. Bremner "My goal in writing this book is to give patients all the information they need to be aware of the effects of the medications they are taking so that they can have knowledgeable conversations with their physicians, and make informed decisions together."

Dr. Bremner is professor of Psychiatry and Radiology at Emory University School of Medicine, director of the Emory Clinical Neuroscience Research Unit and director of Mental Health Research, Atlanta Veterans Affairs Medical Center. Dr. Bremner performs research using brain imaging to look at the effects of medications on the brain and brain correlates of mental disorders. He is a board-certified psychiatrist and nuclear medicine physician and has authored or co-authored over 200 peer reviewed articles and book chapters and three books, including "Before You Take that Pill".

At the last minute, this press release was pulled and NOT sent out to media. The P.R. department at Emory University told Dr. Bremner, " Because we felt that your publisher was doing a good enough job on that already". Bremner published his book months before either scandal broke openly. It was an open secret among Emory Psychiatry faculty that both Stowe and Nemeroff had a cozy rleationship with the pharmaceuticals though at the time, no one know just how cozy. Ultimately, the timing of Dr. Bremner's book was both ironic and instructive. Both scandals effectively proved the point he made months earlier in the book.

Also last year, Dr. Bremner was brought into the office the aforementioned Claudia Adkison, the head of the Medical School, and grilled about why he was raising so many alarms about the relationship between academics and pharmaceuticals.

Then, not but two weeks ago, Bremner was told by faculty to remove all mention of Emory University from his blog, also titled Before You Take That Pill. In one blog post, Dr. Bremner commented on another blogger, Phillip Dawdy, an individual with bi polar disorder that was being forced to stop smoking in his building. Dr. Bremner referred to this as "eco fascism" and in the post he wrote a satirical letter in defense of Dawdy's right to smoke. Dr. Bremner was told that a complaint came into the university that said that in the blog post Dr. Bremner was effectively giving Dawdy medical advice even though he'd never diagnosed or treated him. (obligatory eye rolls here) As such, the university demanded that Dr. Bremner remove all mention of his affiliation with Emory University on his blog, and Dr. Bremner has complied.

I am fond of the Latin phrase, Res Ipsa Loquitor (the facts speak for themselves) I have hypothesized that the relationship between academia and pharmaceuticals has become so cozy that it has corrupted the role of watchdogs. Instead, Psychiatry professors get into bed so to speak with pharmaceutical companies. As such, universities receive massive grants from pharmaceuticals for research. Meanwhile, professors get paid by drug companies and write favorable reviews rather than honest ones. Let's see what the facts are here. One university has been exposed as having at least two professors as having unethical relationships with pharmaceuticals all while they write papers that are supposed to objectively review their drugs. Both are punished with nothing more than a slap on the wrist when these corrupt relationships are exposed. Another professor writes and speaks about the very corrupt environment that lead to the conflicts in the case of two of his colleagues. His book is buried by their P.R. department. The local media ignores it. Then, he is threatened and ultimately harrassed over his views. Res Ipsa Loquitor.

Some Context on the NIH, Charles Nemeroff, Corruption and My Favorite Latin Phrase

According to this Pharmalot article from November of this year, the National Institute for Health recently removed one of its top deputies.

Shortly before the Senate Finance Committee began its probe into conflicts of interest among academic researchers who simultaneously receive NIH grants and pharma fees, Norka Ruiz Bravo, the NIH deputy director for extramural research, maintained the agency couldn’t simply monitor such things.

To wit, she told The New York Times last March that “for us to try to manage directly the conflict-of-interest of an NIH investigator would be not only inappropriate but pretty much impossible.” She added that “I think (the system) is working to the extent that people are being honest and I think most people are honest.”

Since then, of course, she has been proven incorrect. The Senate Finance Commitee has uncovered several alleged examples of high-profile academics who failed to properly disclose industry payments, which is required by law. In a couple of prominent instances, Emory University’s Charles Nemeroff stepped down as psychiatry department chair and Stanford University’s Alan Schatzberg was replaced as the primary investigator on a grant.

The removal of Norka Ruiz Bravo was in relation to the probe by the Senate Finance Committee of Emory University Professor, Charles Nemeroff. The Senate Finance Committee found that for eight years Nemeroff took money from drug companies like Cyberonics, Glaxo Smith Kline, and Pfizer. In exchange for payments and speaking fees, Nemeroff published favorable articles about drugs that these companies were bringing to market in Psychiatry journals (Nemeroff is of course a Professor in Psychiatry). In other words, Nemeroff was, for eight years, bought and paid for by the drug companies. (as an aside he also didn't disclose most of what he earned)

Ms. Ruiz was removed because the NIH had given Nemeroff millions in grants to run OBJECTIVE studies on many of these issues. By failing to find the conflicts, the money was essentially wasted. Ruiz, as the article illustrates, felt that investigating such conflicts of interest was not her duty or responsibility. The NIH disagreed and she was removed.

As for Nemeroff, he recently stepped down as Dean of the Department of Psychiatry and Behavioral Sciences. He does however continue to maintain his professorship and six figure salary at Emory University. In other words, even though a Senate investigation clearly proves that Nemeroff used his position to corrupt, steal tax payer money, and most of create profit for himself at the expense of his craft, this is not enough for Emory to remove him. Furthermore, Nemeroff has an impressive list of awards and organizational memberships. The list is nearly one hundred and here is a snippet.

Current Editorial BoardsEditorial Board, Regulatory Peptides; Editorial Board, Synapse; Editorial Board, LIfe Sciences; Editorial Board, Advances in Neuropsychiatry and Psychopharmacology ; Editorial Board, Journal of Neuropsychiatry and Clinical Neurosciences; Editorial Board, European Archives of Psychiatry and Clinical Neurosciences; Editor-in-Chief, Neuropyschopharmacology; Editorial Board, Harvard Review of Psychiatry; Editorial Board, Psychoneuroendocrinology; Editorial Board, Journal of Psychiatric Research; Associate Editor,

...

Society of the Sigma XI, Society for Neuroscience, American Association for the Advancement of Science, New York Academy of Sciences, International Society for Psychoneuroendocrinology, American Society for Neurochemistry, International Society for Neurochemistry, The Endocrine Society

None of these societies and awards have been made aware of his corruption.

Moreover, according to this chain of emails, Dr. Claudia Adkison, a Dean at Emory's Medical School (as such one of Nemeroff's boss' since the college of Psychiatry is in the Medical school) freely admits to subverting the truth to reporters and attempting to sweep the story under the rug. Here are some of the most relevant quotes.

in working on handling the reporter I tried to make this story go away because Emory's name is in the middle of it

....

I am embarrassed and uncomfortable that I write to colleagues around the country to try to defend this when I know all the issues.

One of the recipients of these chain of emails is Dr. Tom Lawley, another Dean of the Medical school. Furthermore, according to other documents, Emory's higher ups, Lawley included, suspected that Nemeroff was being paid off as far back as 2000 and did ABSOLUTELY NOTHING. Neither Lawley nor Adkison have been disciplined in any WAY SHAPE OR FORM for their behavior. They continue to collect salaries estimated to be deep in the six figures. (Emory's tuition can run up to 40k per year for undergrads)

Finally, in 2004, then medical student Kevin Kuritzky was expelled from medical school at Emory University 41 days prior to his graduation. He had recently prior to that been approached and testified to investigators as part of Department of Health and Human Services investigation into poor medical care by Emory staff at both Grady Hospital and the V.A. Hospital. The stated reason for the expulsion was several tardies. Kuritzky continues to have a civil suit against Emory to this day.

My favorite Latin phrase is Res Ipsa Loquitor, the facts speak for themselves. When analyzing corruption, often that's the best way to look at the situation. In this case, the corruption is obvious. Emory's hands are all over it. The NIH had an incompetent employee and the employee was removed. Emory had a corrupt professor and he was merely asked to step down from his position as Dean. All those that looked the other way while he continued to commit this corruption faced absolutely no sanctions. Kuritzky attempted to shed the light on the very same type of corruption and he was dealt with swiftly. Who is corrupt here and how bad is the corruption? Like I said...Res Ipsa Loquitor.

Epilogue: I have recently attempted to make contact with both Lawley and Adkison and neither responded. Here are each of the two emails. First, here is my email to Dr. Adkison.


Dr. Adkison,

My name is Michael Volpe and I am a blogger at http://www.theeprovocateur.blogspot.com/. Recently, I was given the heads up about the on going investigation in the Finance committee of one of your professors, Charles Nemeroff. I wrote this piece last night. http://theeprovocateur.blogspot.com/2008/12/broken-corrupt-record-of-emory.html

In documents found on the web site related to this investigation in the finance committee is a chain of emails in which you are going back and forth between Dr. Nemeroff and your own superiors. In it, you stipulate that you have been attempting to quash the investigation. You admit that it is difficult to speak to colleagues from other schools knowing what you know. You are even once thankful that a reporter wasn't "sophisticated enough to ask the right questions". Do you believe that the sort of behavior you admit in this email is appropriate of a high level dean of your stature?

Furthermore, what are the "right questions"? I am curious given the obscene level of corruption discovered against Dr. Nemeroff why he continues to be employed. Is it really appropriate for your school to continue to give him a six figure salary? Furthermore, according to records on the site, you have had suspicions of this as far back as 2000. Yet, according to the Emory Wheel, your investigation continues to be ongoing. How long will your investigation last?

Also, in 2004, Kevin Kuritzky was expelled from Emory Medical school 41 days prior to graduation. I believe you had first hand knowledge of that situation. He was expelled for a few tardies. Why is Kuritzky expelled for a few tardies, while Nemeroff continues to be employed despite engaging in million Dollar corruption?

Given your admission that you were in fact attempting to subvert the truth from the media, is it really appropriate for you to stay on as Dean? Is a Dean that admits to running interference against the truth in an investigation involving millions of Dollars, corruption,fraud, and conflicts of interest? How can those that report to you have any confidence in your own leadership when it has been so clearly compromised by your role in this corruption.

Finally, I checked the website for the Emory Wheel and I notice that this story has been written about four times, and one of the pieces compliments that administration's response to this scandal. I was personally shocked when I found out the details. This, in my estimation, should be a story that is seriously investigated. Isn't the Emory Wheel the newspaper of record for all things Emory University? Why does this get so little coverage in a newspaper dedicated to keeping the students abreast of things that are happening on campus?

I would like to schedule a time for us to speak so you can clarify the issues I have raised in this email. Please let me know when you are available.

...

Here is the one to Dr. Lawley

Dr. Lawley, my name is Michael Volpe and I am a blogger. I was recently made aware of the corruption perpetrated by one of the professors under your command, Dr. Charles Nemeroff. I was tipped off to the story and wrote this about it. http://theeprovocateur.blogspot.com/2008/12/broken-corrupt-record-of-emory.html

On the website of the Senate Finance committee, I found a startling chain of emails in which Dr. Adkison is corresponding back and forth with yourself and Dr. Nemeroff. In this chain, she freely admits that she is engaging in subverting the truth of the matter from the media. She freely admits that Nemeroff did a lot more wrong than she is disclosing to the media. You received all of these emails. Why didn't you remove her immediately? Do you believe that it is proper professionalism for a Dean to engage in covering up the truth in a matter in which millions of Dollars have been corrupted?

Furthermore, the investigation makes clear that Nemeroff took money from drug companies, didn't disclose it, and didn't even report the full extent of it. While he has been removed from being the Dean of your psychiatry department, he continues to be a professor and collect a paycheck in excess of six figures. Is this what the massive tuition your institution charges should go to? Given what you know about Dr. Nemeroff's behavior why hasn't you and your entire university not informed the proper authorities so that an investigation can be started so that could eventually lead to his PHD status being removed? Do you think it is appropriate for a PHD to be bought and paid for by drug companies?

Furthermore, I know that in 2004 you were intimately involved in expelling Kevin Kuritzky from yur medical school. Your reasoning for this was that he was tardy to a number of classes. Are you then saying that Nemeroff should continue to be employed despite being involved in corruption worth millions of Dollars while Kuritzky should have been expelled because he was late to class a few times? Dr. Lawley, you are included in emails in which there is admission of a conspiracy to withhold the truth of crimes being committed. Doesn't this fact alone mean you are no longer fit to lead?

How can those underneath you possibly trust your leadership given how badly it has been compromised because of your involvement in this scandal?

Dr. Lawley's email is tlawley@emory.edu

and Dr. Adkison's email is cadkison@emory.edu

Always be respectful, but let them know how you feel about the corruption they are party to.