Charles Nemeroff Under Scrutiny

For most of its existence, there was no letters section in The New Yorker. A big mistake, which Spy pointed out and made fun of by running Letters to the Editor of The New Yorker. The current version of The New Yorker has letters, of course, but no comments on the web. Another big mistake.

Because those comments can be incredibly good. In its Health Blog, the Wall Street Journal website recently posted news about Charles Nemeroff, the Emory University psychiatry professor who failed to disclose about a million dollars from drug companies. The news itself wasn’t anything special but the comments told me important stuff I hadn’t known:

• What his defenders say. (Not easily summarized.)
• The nature and quality of his research. “Regarding Dr. Nemeroff’s contributions to science, although he has published many papers, a large proportion have dealt with the hypothesis that the adrenal hormone cortisol plays a major role in the etiology of depression. This hypothesis has its proponents, but has not gained widespread support from experimental or clinical data. Drugs designed to inhibit cortisol have been disappointing as treatments for depression. Hence, regardless of any ethical issues surrounding his career, his publications have been numerous, but with low impact on advancing science and on actual clinical outcomes. Actually, it’s a sad commentary on how really difficult it is to understand the biology of mental illness that individuals such as Dr. Nemeroff who conduct rather mediocre scientific work are considered major contributors to the field.” You can read a thousand outraged editorials and blog posts about Nemeroff and not find something this revealing. Without anonymity, it is very hard to say something like this.
• Complete refutation of one of Emory University’s comments. “Emory said its review supports Nemeroff’s contention his lectures weren’t product specific.” WHAT….I worked in pharma sales years ago specifically selling SSRI’s. Nemeroff was WELL known for SPECIFICALLY selling Paxil in his presentations. He was GSK’s Paxil hit man.” So much for Emory’s credibility.
• A surprising suggestion. “Disclosure alone is not going to do that. These are amounts of money that even if Nemeroff had properly disclosed would be unethical -it can’t be right that a Prof is paid 300 K a year for a full time job and get 500 K in addition from drug companies – even IF it was disclosed. Patients will do well in asking their physician to post or tell them about such additional moneys – and should vote with their feet since there are many honest people, though less powerful, in the field as well.”
• A comment on the real cost of people like Nemeroff. “Anon asks, “Who among the bloggers is familiar with his work, conversant with his research, actually read his papers?” I have, and I don’t trust much about what he says in any of his pharma-related articles. Indeed, I have challenged his findings in letters to the editor. The saddest part of this entire scenario (Nemeroff and others) is the wreckage they have strewn throughout our scientific literature in the past 10-15 years.”

Supporting what I said about letters to the editor. The truth about Nemeroff’s research (and by extension a vast swath of psychiatric research) was in the letters to the editor. But a letter to the editor is just one person — and usually these letters can’t be anonymous. This discussion is many people, it’s a discussion, it’s anonymous, and it’s easily available. The emotion expressed — because people can comment quickly and informally — makes the whole thing easy to read.

This is a wonderful age we are living in, that so much nuanced and well-informed comment is available. Never before, not even close. Merry Christmas!