Charles Nemeroff, an Atlanta psychiatrist who was the subject of a Senate investigation concerning huge sums he received from drug companies, has been named chairman of the psychiatry department at the University of Miami.

Last year Nemeroff, as the top psychiatrist at Emory University, was the focus of an investigation by Sen. Charles Grassley, R-Iowa, who said he was concerned about the millions the psychiatrist received from drug companies while conducting supposedly unbiased research for the National Institutes of Health on drugs made by the companies he was receiving money from.

On Thursday, Pascal Goldschmidt, dean of UM medical school, called Nemeroff “an exceptional psychiatrist and an exceptional scientist who has one issue in which he recognizes he made a mistake,” in not telling Emory how much he was getting from drug makers.

Goldschmidt said he had read investigative reports from Emory about Nemeroff’s activities and Emory found nothing to indicate that payments the psychiatrist received had in any way influenced his research results.

Elsewhere, opinions are divided.

The former head of psychiatry at Duke University told The Miami Herald Thursday that Nemeroff was “economical with the truth” and his work can’t be trusted, while the leader of the Columbia University psychiatry program said Nemeroff was a top-flight scientist and he had never seen any bias in his work.

For his own part, Nemeroff, 60, said he was excited to be coming to Miami. “I think it’s going to be a top-10 school.”

PAYMENT DISCLOSURE

Nemeroff’s appointment comes at a time when healthcare reform bills in both the House and Senate have sections requiring healthcare providers to publicly reveal their payments to doctors.

In October 2008, the psychiatrist’s activities made the front page of The New York Times after Grassley investigators found that Nemeroff — “one of the nation’s most influential psychiatrists,” according to The Times — had received $2.8 million in consulting deals with drug makers over seven years and failed to report at least $1.2 million of that to Emory.

Based on Grassley’s complaints, Nemeroff’s work on a mayor NIH grant was suspended and Emery asked him to step down as chair of psychiatry while it studied his conduct.

The Atlanta Journal-Constitution reported that the Office of the Inspector General of the Department of Health and Human Services had launched an investigation into Nemeroff’s activities. An OIG spokesman said it never confirms nor denies investigations. Nemeroff said he knew nothing about OIG looking at him.

According to published reports, the psychiatrist received between $800,000 to $1.2 million from GlaxoSmithKline while leading a major study into mood disorder drugs, including ones made by GSK.

Nemeroff said Thursday that the news reports had not made clear that his talks were on GSK drugs now on the market, while his research funded by NIH involved basic lab studies of GSK chemical compounds that were years away from market. That work did not promote GSK products, he told The Herald.

`SCIENCE PIMPING’

But Bernard Carroll, former head of psychiatry at Duke University and once Nemeroff’s boss, said parts of Nemeroff’s work involved Paxil, a GSK antidepressant. “Basically, he was doing basic science pimping for Paxil to produce talking points,” Carroll told The Herald in an e-mail Thursday. “All he ever produced was speculation but that was enough to satisfy Glaxo marketing. . . . I have been exposing his shenanigans for some years.”

Jeffrey Lieberman, head of psychiatry at Columbia University, praised Nemeroff as a leading expert in “basic neuroscience,” studying underlying pathologies and proteins in the brain that cause mental illness. He said he had never detected “any undue influence or bias” in Nemeroff’s research.

However, all the academics interviewed Thursday acknowledged that large payments to researchers were a concern. “Of course, it creates problems,” Carroll said.

At UM, Goldschmidt said it was important for researchers and pharmaceutical companies to work together to develop better drugs. He said limits of how much researchers should be allowed to receive are still being debated.

In June, the Pew Prescription Project gave UM a “B” on a scorecard designed to measure ethical policies on professors’ relationship with the pharmaceutical industry.

REQUIREMENTS

UM is now in the process of strengthening its reporting requirements, said Goldschmidt, so that all outside professional work must be reported — and the results will eventually be posted online for the public to see.

Those requirements will apply to Nemeroff, who starts at UM on Dec. 1, and all other medical school staffers.

In the past, Goldschmidt said, there was debate whether professors needed to report fees from drug makers for giving continuing medical education (CME) talks, which are supposed to be non-promotional. That became an issue in Nemeroff’s case in Atlanta.

In an interview Thursday, Nemeroff said in retrospect he should have declared the CME payments he received from drug makers, but he viewed Emory standards as not requiring such revelations.

LETTER OF SUPPORT

In a letter to Grassley last December, Emory officials wrote: “We do not believe that Dr. Nemeroff’s participation in the compensated speaking arrangements with GSK in any way biased the research conducted under the grant.”

The letter said Nemeroff’s talks on behalf of GSK were “focused on medical education and were not product specific or promotional. . . . As you alleged, Dr. Nemeroff did not disclose substantial speaking fees from pharmaceutical companies to Emory. Under federal regulations and Emory’s policies, we believe he should have done so, although both the regulations and our policies could have been clearer.”

Grassley responded in a letter that his staff’s research found that Nemeroff’s talks were promoting GSK products — not educational — and should have been reported.

Tom Johnson, former president of the CNN network and former publisher of The Los Angeles Times, said Thursday he was part of an Emory advisory board that examined Nemeroff’s behavior and the university’s ethics policies. The policies were “confusing,” Johnson told The Herald. They have since been modified.

`HE’S BRILLIANT’

“He’s brilliant,” Johnson said of Nemeroff. “He was responsible for a significant number of grants and he built up the department. Miami’s getting a truly gifted psychiatrist.”

Johnson said he has suffered from depression for years, and Nemeroff’s treatment of him was outstanding. “I’m not sure if I’d be around today if it weren’t for him.”

In Miami, Goldschmidt said Nemeroff was multidimensional — strong in basic research, treatment of patients and building programs such as suicide prevention.

His biography lists stints as president of the American College of Neuropsychopharmacology and the American College of Psychiatrists. He has published more than 750 research reports and reviews.]

“I know I’m going to take a little smack in the face for this hire,” Goldschmidt said. “But you don’t do anything important without taking some risks. It’s very important that the people of Miami have access to a phenomenal psychiatrist like this.”

URL: http://www.miamiherald.com/103/story/1319569.html

Admitting for the first time what critics have claimed for years, state child-welfare authorities say caregivers for children in state custody frequently use powerful mind-altering drugs to manage unruly kids, rather than treat their anger and sadness.A panel of child-welfare experts, including two top administrators from the state Department of Children & Families, examined the death of a 7-year-old Broward foster child who was on psychotropic medications — without the required consent — when he hanged himself in a Margate home.

The panel’s report, expected to be released publicly later this month, says child welfare authorities too often rely on the potent medications to manage abused and neglected children — but fail to offer psychiatric treatment to help them overcome the trauma they suffered.

“Psychotherapeutic medications are often being used to help parents, teachers and other child workers quiet and manage, rather than treat, children,” the report says. It adds: “We have not clearly articulated the standard of psychiatric care expected for children in state foster care.”

Gabriel Myers hanged himself from a detachable shower hose April 16 at a Broward foster home. He had been in foster care since the previous June, when his mother had been found slumped in her car, surrounded by a stash of narcotics.

After The Miami Herald reported that Gabriel had been given several psychiatric drugs linked by federal regulators to potentially dangerous side effects, including suicide, DCF Secretary George Sheldon appointed a work group to study the care given to the boy, as well as the agency’s overall reliance on mind-altering drugs.

Sheldon said Wednesday that serious questions arose over why so many children in state care are on psychotropic medications — and why so many claim they feel fine once the drugs are discontinued.

“There was a lot of evidence presented to the work group — from kids and from folks in the system — raising a lot of concern over the purpose of these drugs,” Sheldon said.

Sheldon cautioned that the draft of the report is not final and “is subject to a lot of change” after work group members review and tweak it.

An overarching theme of the work group’s discussions, and of the draft report, was the lack of a parent figure — or “champion” — for Gabriel, who the report said had become “overwhelmed” by change and disruption. While the youngster’s life crumbled around him, caseworkers took copious notes and documented each new development.

But the report says, “there was no sense of urgency driving the agencies and individuals responsible for the welfare of Gabriel Myers,” and “no one person stepped forward to act as his parent.”

Though Gabriel was in regular contact with agency-referred therapists and a psychiatrist, the report says, the “intensive therapy” was aimed almost exclusively at preventing the reoccurrence of sexually inappropriate behaviors that may have resulted from his molestation when he was a small child in Ohio.

“Gabriel Myers was not provided specific and upfront therapy to deal with identified trauma, possible post-traumatic stress disorder, and depression,” the report says.

The use of psychiatric drugs among children in state care is widespread.

Records updated by DCF last week show that, among children in state care aged 6-12, more than 22 percent are being given psychiatric drugs.

Almost one-third of the adolescents aged 13 to 17 are on psychiatric drugs, the updated records say.

Among the adolescents, close to four in 10 children in licensed foster care are on such drugs.

The smallest percentage of adolescents taking psychiatric drugs, 12 percent, live with relatives or family friends.

For almost a decade, children’s advocates have maintained that Florida has used potentially dangerous psychiatric drugs as “chemical restraints” on children who endured hellish abuse and neglect — and act out, sometimes violently, as a result.

“It’s heartening that they are admitting what has long been the agency’s dirty little secret,” said Coral Springs attorney and children’s advocate Andrea Moore, who told a DCF Broward administrator in 2001 that doctors were concocting mental health diagnoses for foster kids to justify using unnecessary drugs.

Among the report’s other findings:

• Foster children being administered psychiatric drugs with federal “black box” warnings of potentially dangerous side effects are not “adequately monitored” by foster parents, doctors or caseworkers. The children are not well-informed or involved in decisions about their medication.

• Caregivers for the state’s foster children are not required to report adverse incidents arising from psychotropic medication.

• Psychiatrists and pediatricians “often lack [a] medical history” for the foster children they treat, “yet still prescribe medications.”

• Biographical, medical and educational information contained in the Florida Safe Families Network, DCF’s statewide child-welfare database, is “frequently incomplete and inaccurate.”

• A “significant” number of dependent children have been given psychiatric drugs without the informed consent of a parent or judge, as state law requires. “Too often, parents and/or the court are unaware of critical issues involving medications, procedures are not followed, and documentation requirements are ignored.”

• Mental healthcare for foster children is “fragmented,” poorly funded and often does not include caregivers, who receive little to no training. Disabled children in state care often are excluded from mental healthcare because Medicaid will not pay for therapies specially geared to children with intellectual impairments.

• The state has failed to implement recommendations from prior task forces that studied the deaths of foster children or the use of psychiatric drugs. Indeed, DCF has failed to even assign “responsibility” or “accountability” for implementing such reports.

“Let’s just hope they don’t put this on a shelf and ignore it like all the other reports,” Moore said.

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URL: http://www.miamiherald.com/news/southflorida/story/1183698.html