tag:blogger.com,1999:blog-15623877503373117982024-03-17T23:02:51.620-04:00The Carlat Psychiatry BlogKeeping Psychiatry Honest Since 2007Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.comBlogger368125tag:blogger.com,1999:blog-1562387750337311798.post-20107452011007471862017-09-27T10:22:00.001-04:002017-09-27T10:27:26.301-04:00Sign Up for The Carlat Report's Free Quick Tips Newsletter
The Carlat Report Newsletters are launching a bi-monthly email newsletter that will contain concise, practical advice for busy clinicians based on the work we are doing in The Carlat Report, The Carlat Child Report, and The Carlat Addiction Treatment Report.
You don't have to be a paid subscriber to get it, simply fill out this quick webform and you'll start receiving each new issue, Jiveshttp://www.blogger.com/profile/04694386571532253119noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-9837124475070717922017-09-12T17:01:00.000-04:002017-09-13T10:53:02.109-04:00Hating on Antipsychotics: Are We Going Too Far?
Antipsychotics are not perfect. No drugs are. They can cause weight gain and weird movement
side effects and sleepiness. But they have their uses, such as quelling racing thoughts, inner turmoil, and psychosis. There’s nothing inherently good or bad about any class of drugs. It’s up to physicians to understand the data and to prescribe medications judiciously.
With that introduction out of theDaniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-68525768789476847132017-09-06T14:54:00.003-04:002017-09-08T11:53:21.579-04:00We're Diagnosing Like It's 1799
The fact that psychiatry lags far
behind the rest of medicine scientifically is no great news flash. The leaders
of our field have long acknowledged this problem (see, for example, this withering self-critique by then head of NIMH Thomas Insel). None of this should be taken personally. Psychiatrists are
just as smart as other doctors. It’s just that we have the misfortune of having
Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-88774043019933066012017-08-29T18:06:00.001-04:002017-08-30T03:21:49.722-04:00Ecstasy for PTSD: Some Background
You may have heard that the Food and Drug Administration has given the drug ecstasy (MDMA) its "breakthrough designation" for the treatment of PTSD. See this very thoughtful article in the Washington Post for details.
I came out of blog-slumber to post about this because we're in the midst of planning an upcoming issue of TCPR (The Carlat Psychiatry Report) on PTSD, and becauseDaniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-68836194189239075782017-02-17T15:13:00.000-05:002017-02-17T15:13:19.923-05:00Antidepressant News: Just the Right Amount of Opiate?In the early 1950s, opium was considered an effective treatment for depression, but gradually it fell out of favor as its addiction risk became clear. Nonetheless, there's no denying that opioids rapidly elevate the mood of just about anybody, even the very depressed. So that's a pretty tantalizing challenge: Is it possible to harness the elating effects of opiates while avoiding the addictive "Jiveshttp://www.blogger.com/profile/04694386571532253119noreply@blogger.com2tag:blogger.com,1999:blog-1562387750337311798.post-73355307972261404032016-09-07T14:33:00.000-04:002016-09-07T14:33:21.639-04:00Have Companies Stopped Ghostwriting? BMJ Article Says "No" A new article in the British Medical Journal (BMJ) by Alastair Matheson takes a fresh look at ghostwriting in medical research. Apparently, pharmaceutical companies are waging a campaign to convince us that they are now opposed to ghostwriting. But Matheson argues that the practice continues, only under a different name: "editorial assistance."
It comes down to how we define ghostwriting. The Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-41373913919683481452015-10-05T11:17:00.000-04:002015-10-07T10:48:34.106-04:00Boston Globe Article about Genetic Testing in Psychiatry
It would be fantastic to have a lab test to help us decide which drugs to prescribe in psychiatry. See Sunday's great Boston Globe article that picked up on our recent coverage of the GeneSight test.
It's a promising technology, but the marketing has leap-frogged ahead of the science.
This Wednesday afternoon I will be participating in a webcast with journalists and Adminhttp://www.blogger.com/profile/04122757311649368319noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-24091610751990025962015-09-16T16:54:00.002-04:002015-09-16T16:54:53.808-04:00The TMS Wars: Psychiatry Goes High Tech
In the pages of The Carlat Psychiatry Report, we’ve covered transcranial magnetic stimulation (TMS) numerous times—most recently in the current issue. For those who haven’t heard of these devices, they work by pulsing magnetic fields into the brain. The magnetic fields stimulate neurons—far more gently than electroconvulsive therapy. The theory is that this gentle brain stimulation, focused on Adminhttp://www.blogger.com/profile/04122757311649368319noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-41707442290031977732015-08-20T21:24:00.002-04:002015-08-20T21:24:59.167-04:00Flibanserin: 5 Things to Consider Before Passing Judgment on the “Female Viagra”
Flibanserin (brand name Addyi) has just received a controversial and complicated FDA approval for the treatment of low sex drive in women. There’s a lot of outrage in the blogosphere, much of it centered on the lobbying of the FDA by disease advocacy groups. I agree that this politicization of what should be a scientific process is embarrassing to both Sprout and its supporters. Adminhttp://www.blogger.com/profile/04122757311649368319noreply@blogger.com2tag:blogger.com,1999:blog-1562387750337311798.post-47414933243772011942015-08-05T12:50:00.000-04:002015-08-05T12:57:45.831-04:00Vyvanse: Is History Repeating Itself?One of the benefits of having the Carlat World Headquarters here in beautiful Newburyport, Massachusetts is that we get to work next door to an iconic antiques barn called Oldies. It's a wonderful stockpile of odds and ends that range from decommissioned lobster traps to faded movie posters.
The other day I came across an old issue of LIFE Magazine with a cover story on “The Dangerous Diet Adminhttp://www.blogger.com/profile/04122757311649368319noreply@blogger.com3tag:blogger.com,1999:blog-1562387750337311798.post-54141474128588938882015-07-01T14:20:00.001-04:002015-07-01T17:28:27.382-04:00Hospitality and Pharma: Relationship on the Rocks?Decades of mutually beneficial economic ties have bound the fortunes of hotels, restaurants, and drug companies. But in an era of Sunshine Act disclosure, renewed calls for professional ethics, and ballooning healthcare costs, that relationship may be souring.
It used to be a veritable love-fest. As recently as 2011, I was writing about a restaurant's attempt to rebrand itself as a "Adminhttp://www.blogger.com/profile/04122757311649368319noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-19431654862165544842015-06-26T17:52:00.000-04:002015-06-26T17:52:11.398-04:00Hotel Workers Against Industry-Funded CME?
In a fascinating new chapter in the battle over industry funding of CME, a huge hotel workers' union has started a campaign to end the practice. Unite Here represents 270,000 workers, and the organization claims that industry funding of CME drives up their health care costs, which is undoubtedly true. So they have created a website, No More Drug Money, to advocate their cause, and they areDaniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com1tag:blogger.com,1999:blog-1562387750337311798.post-22686157047924164852015-05-17T09:07:00.001-04:002015-05-17T09:09:57.060-04:00The GeneSight Test: A Wing, a Prayer and 13 Patients
We just published the May issue of The Carlat Psychiatry Report, and the topic is "Biomarkers in Psychiatry."
I contributed an article reviewing the evidence for the GeneSight genetic test, which is being quite heavily marketed as a way to choose the right medications for patients. According to company's website:
"Multiple clinical studies have shown that when clinicians used GeneSight to Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com9tag:blogger.com,1999:blog-1562387750337311798.post-40588165558687660232015-04-30T09:30:00.000-04:002015-04-30T11:22:15.201-04:00How Drugs Collide: What Every Psychiatric Prescriber Should KnowPlease file this blog post under "Shameless Self-Promotion."
I just published a new edition of my book, Drug Metabolism in Psychiatry: A Clinical Guide. You can buy it here, and you can read a free preview of the first two chapters here.
It's mostly a book for psychiatrists and psychiatric nurse practitioners. It's pretty short at 145 pages, but it's very concise and in my opinion fun to Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-43137661538214181182015-04-16T15:17:00.000-04:002015-04-16T16:14:01.636-04:00How a New Blood Test for Depression is like Apple Recognition
Four years ago I wrote a blog post about the MDDScore blood test for depression. That was before there were any peer-reviewed publications describing it. Now there are at least two. The latest came out a couple of months ago in the Journal of Clinical Psychiatry, and you can access the article, along with two interesting commentaries, for free.
While I won't go into the article in any detail, Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com8tag:blogger.com,1999:blog-1562387750337311798.post-67961213259791970232015-04-15T12:15:00.000-04:002015-04-15T16:50:25.856-04:00Medscape Presents: The Brintellix Show
As I wrote in part one of my Medscape review, the website gets high marks for up-to-the-minute coverage of psychiatric
news, and it deserves kudos for posting a ton of textbook-like content on
disorders and drugs. I wasn’t so thrilled with its "un-privacy" policy, which
results in your personal info and browsing history being sold to third parties.
Today we get into the dark side of Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-51790643146360673632015-04-08T09:49:00.000-04:002015-04-08T09:49:33.619-04:00Medscape Psychiatry Review, Part One: The Good...Medscape is the number one website for American physicians--a 2010 survey found that 57% of doctors read the site. I'll wager that proportion is higher in 2015.
I have not always been Medscape's number one fan. I've called the site out for pushing Cymbalta in a Lilly-funded "Pain TV" program and for touting Invega in a CME-accredited infomercial that was so blatant that Business Week ran a Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-40605952259461687162015-04-01T14:12:00.001-04:002015-04-08T17:06:07.860-04:00Psychiatry Website Review: Rajnish Mago's "Simple and Practical Mental Health"
Lately I've been browsing for good psychiatry websites to harvest ideas for an upcoming redesign of The Carlat Psychiatry Report. Everything's fair game in my search, whether industry-funded or not. I'm not going to try to pretend that industry funding inevitably leads to tainted information. Clearly, sometimes it does, but sometimes it doesn't.
I've been finding a lot of quality Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-29392826545778841472015-03-24T17:10:00.002-04:002015-03-25T10:57:03.455-04:00The Atlantic Slams Alcoholics Anonymous--The Carlat Take
The current issue of The Atlantic magazine has a fascinating article entitled "The Irrationality of Alcoholics Anonymous." In a wide-ranging and well-researched article, the author Gabrielle Glaser, begins with the story of a lawyer identified as "J.G."
"J.G." began drinking at age 15 and his habit ramped up through college and law school. Ironically, much of J.G.'s law practice is Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-24282899669111297692015-03-21T10:55:00.000-04:002015-03-21T10:55:53.800-04:00On Combining Antipsychotics, Top-Performing Therapists, and Procrastination
I woke up this morning and realized that I've allowed myself to become a victim of BPS--Blog Procrastination Syndrome. It happens to the best of us. We write a post, and days and weeks and months go by. "My next post has to be really, really good," we think.
Forget that. I'm just going to dive back in beginning today. "Done is better than perfect," someone once told me.
At The Carlat Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com2tag:blogger.com,1999:blog-1562387750337311798.post-74488139259059469582014-11-06T16:57:00.002-05:002014-11-06T16:57:52.278-05:00Exploring the link between industry payments to doctors and prescribing habits
This article was originally published in The BMJ on November 5, 2014.
Orthopedic surgeons receive the biggest payments from industry in the US
according to the Open Payments database. The next step, writes
transparency pioneer Danny Carlat, is for researchers to compare payment data with disclosures of physicians’ prescribing patterns
After substantial delays, the Open Payments Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-20820446426585299872014-10-08T13:04:00.000-04:002014-10-08T13:15:50.307-04:00Payments to Doctors: The Bottom Line
There's a scene in Ghostbusters in which the characters are discussing gun safety.
"Don't cross the streams."
"Why?"
"It would be bad."
"I'm fuzzy on the whole good/bad thing. What do you mean, 'bad'?"
"Try to imagine all life as you know it stopping instantaneously and every molecule in your body exploding at the speed of light. Total protonic Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com0tag:blogger.com,1999:blog-1562387750337311798.post-55795069088804306552014-10-01T15:23:00.000-04:002014-10-03T09:54:08.801-04:00I'm Back! Now Let's Talk Sunshine.
Hi readers. Yesterday was my last day at The Pew Charitable Trusts--timed to coincide with the launch of the Open Payments website.
Before commenting on the website, here are some quick impressions about my last 2 1/2 years in Washington: fascinating, sometimes frustrating, often exhilerating, and overall just a great introduction to the arena of politics. Pew is amazing--work there if you Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com2tag:blogger.com,1999:blog-1562387750337311798.post-22112891100289016872012-03-19T05:55:00.001-04:002012-03-21T15:26:43.443-04:00Dr. Carlat Goes to Washington To Head Pew Prescription ProjectThis will be my last Carlat Psychiatry Blog post for a while, as I have recently accepted a new job as the director of the Pew Prescription Project in Washington DC. My main job there will be to pull together a group of experts to review conflict of interest recommendations, and to work with various partner organizations (AMSA, Community Catalyst, and the National Physician's Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com15tag:blogger.com,1999:blog-1562387750337311798.post-54641075275737580852012-01-06T14:15:00.000-05:002012-01-06T14:15:19.904-05:00BMJ's Ten Commandments for the Ideal PhysicianThe British Medical Journal's great blogger Richard Lehman has published the following Ten Commandments for excellent clinical practice. These are great rules of thumb for any savvy health care practitioner--but they do require that wee bit of extra work to truly understand the statistics behind the medical literature. (Hat tip to Steve Balt, MD, for sending me the link).
The New Daniel Carlathttp://www.blogger.com/profile/11317615613596329209noreply@blogger.com6