Jay D. Amsterdam: The Paroxetine 352 Bipolar Study Ethical Conduct
Mark Kramer’s comment on Samuel Gershon’s comment
My truly good friend, Jay Amsterdam ("Prof. Jay" – my affectionate nickname for him) informed me that Dr. Gershon had commented on Jay's post. That was encouraging to Professor Jay. I get it! He's given all of us an embarrassment: incontrovertibly factual data which grandly documents the actual words and methods by which high level professionals from industry and academia – connected grandly to our ranks – have colluded to pollute the integrity of our field.
Of course, Jay is disappointed that responses to his disclosures have not been met with more interest and even activism from members of this devoted body. After all, I understand it's bulletins reach into organizations such as ACNP. I think P.J. must feel that the silence has been deafening in our ranks. Why isn't there an outcry from every quarter? Why aren't those who perpetrated these crimes against academia, industry and big publishing, outcast – made to pay in some way?
I felt Jay's email to me had a quality of shaming me. But I'm tired. I previously told him I was moving on from our field: that his fight was no longer my fight.
Besides, I said almost everything I wanted to about corruption (academic, corporate, anti- pharmacology cottage industries) in a long paper that I authored in response to honorable pioneer Dr. Barry Blackwell (Kramer 2016). I don't know that Barry liked it too much. The paper was really to set my mind as straight as possible on the issues. It's a shame that Don Klein expected more from me. I politely agreed with him that it could have been better. But then again that brilliant man was annoyed with a lot of things (may he rest in peace]. In the end, I really could not devise a strategy that would fix our fallen Humpty Dumpty – the one I once so loved dearly on the shaky wall.
And frankly, I told Jay as a friend that he would be so much better off, after he documented what he did, to try to advance the field further scientifically. I was concerned that his salutary efforts would be used against the field, such that really sick patients who might have benefited from a TCA for example, would be turned towards only those practicing in competing non-medical mental health industries.
To me, my friend Jay, despite the incredible efforts he's made (keep in mind with drastically failing, vision) coupled with the suffering he's endured in academia (despite being an impressively capable and productive clinical researcher), sounds at times like a looped jazz phrase: it's great the first time your hear it, it gets clarified second time, the third time it might be taken as a polyrhythmic variation, but the fourth time you just want to hear something else. I love David Healy for his ability to write clearly, his history telling, but I'm sick of his phrases too. f*** it!
Medicines trend to work better than placebo in clinical practice and in clinical trials. I learned this (a little more than anecdotally) from serial systematic placebo-controlled N of 1 experiments as a resident and I don't see why some guys don't understand that, if you don’t. Withholding psychopharmaceutical drugs routinely for certain patients is immoral. Medicine is art as well as science; there likely will always be harms.
And it's true that jazz players, like some psychopharmacologists, do loop their phrases because they don't yet know what else to do. LOL – perhaps micro-dosed mushrooms will help.
I just can't, and don't want to, do anymore in this field. I've been with Jay from the very beginning of his current efforts. I respect him very much. I tried at times to help, but the wind is out of my sails for this kind of thing. It's actually out of my sails for psychopharmacology. I will die happily knowing that we documented what we know in the Journal of Affective Disorders about substance P (neurokinin type 1 receptor) antagonist antidepressants (multiple huge clinical replications, means by which Merck and Co. likely dropped the ball/ why they were not commercialized) (Rupniak and Kramer 2017) and that's all I can do.
My disappointment is so heavy with our field, that it's painful to think of it, especially its lack of etiological science, not to mention it's now clear underlayment of corruption. Some etiological mechanisms eluding us might be in relationship to regional BBB endothelial dysfunction (involving gilia and inflammatory protein dynamics). I don't think much of psychopharmacology has much to do with neuronal circuitry at all (Auld and Robitaille 2003). But that's just what’s left of my reeling analytical mind going a bit off axis
Playing advanced jazz piano is what brings me and others peace, discovery, and great enjoyment. This has always been my first love anyway. It is so now – especially in these last years of life.
So, when P.J. let me know about Sam's response I just dictated a sloppy response into my phone which revealed my cocky position. I inadvertently copied Tom Ban on it about where I stand so I was encouraged just to submit what I dictated. Okay here goes nothing. Maybe this will stir the pot a little for Jay's efforts, maybe it won't. By way of this, I allow my response requested to be bundled in with other responses to Jay. I think what I say is crude and freely associative ... but real.
professor j, thanks for copying me on this.
a few sayings
1] No good deed goes unpunished.
2] He who pays the piper calls the tune.
So, P.J. what's the plan?
Meanwhile my own crusade is getting rid of privatized water in my State. The suckers want to raise water rates 18%. The company's gross profit margin before taxes is 35% which equals highly profitable. They only pay a million dollars in taxes in most years, and yet their net profits were ~$1.3 billion. So, out of every water bill a household pays in Pennsylvania now the company receives 1/3 of it in profit for shareholders and executives – who, by the way, make up to $24 million a year. The hourly rate of their average employee is $20 per hour. So, forget trickle down.
Wherever you turn Jay there's injustice and there's corruption. You can't tell me that AQUA water company did not get into Pennsylvania by greasing the wheels of Governors and the State Senates?
Problem: it's humanity Jay – that’s the problem. It's really worse now because of huge income disparity. What drives people like Nemeroff, Evans, Keller, Montgomery et al. to do what they do (did) as KOLs shills? What happened to them? They undertook useful science early on, but why did they morph into something so unethical and so immoral? Is it fear? Need for control? It's not just money because they have enough, but apparently, they don't think so. So, then, it's power. But to what end?
You've done your work, Jay. I don't think that there's any more to be done unless you have a plan. Maybe I would join a plan, but I don't have one and will not invest the time to draw one up. It's not like we have a cohesive set of principles in our governing bodies in the US. We're a polarized mess.
Case in point: If people can't see that they ought to be vaccinated they're nuts (clinical diagnosis: "Mark Kramer’s personal DSM version-1"). Also denying that there was an insurrection on Jan. 6th and that Trump and those Republican b****** who support his brand is a f****** freak show (code that for the DSM!).
The thing to be more worried about than old pharmacologists reading all these documents you've provided, is a knock on your door asking if you're Jewish. Smell the gas boychick!
There's nothing to be done, Jay – enjoy your life, love the lovable ones, drink wine, listen to good music... (www.mark-kramer.com).
I think most people realize there's nothing to be done, that's why you're hearing silence. Or maybe they don't want to hurt their relationships with KOLs, no matter the cost to their integrity.
Also, understand, as I'm sure you do, that most people, as they get older, have bandwidth limited to taking care of their own health and the health of their loved ones. My own Don Quixote seems to have left town – not entirely, but at least he'll try to get the water bills down.
Auld DS, Robitaille R. Glial Cells and Neurotransmission: An inclusive view of synaptic function. Neuron 2003;40(2):389-400.
Kramer MS. Commentary. Innovation, propaganda, and jail time. Barry Blackwell: Corporate Corruption in the Psychopharmaceutical Industry. inhn.org.controversies. October 13, 2016.
Rupniak NMJ, Kramer MS. NK1 receptor antagonists for depression: Why a validated concept was abandoned. J Affect Disord 2017;223:121-5.
November 11, 2021