Dr. J. David Jentsch is a professor of psychology at UCLA; his research area is psychopharmacology. I contacted him because Aaron Blaisdell told me that he had decided to stop accepting research money from drug companies. This is unusual; I wondered why.
My own research over the past 12 years has focused on the etiology of mental disorders (how genetic factors influence brain chemistry and behavioral functions) and how psychoactive substances work to normalize behavior through working on those very pathophysiological mechanisms. In particular, I study the brain systems and molecular pathways in control of cognitive functions, with a very specific focus on using that knowledge to generate insights about cognitive enhancement for schizophrenia, addictions and AD/HD. I study rodents and primates.
I have received funds from drug companies for two reasons. 1) The companies appreciated my work and funded efforts to discover new mechanisms that might inform what they ultimately did. 2) The companies provided funds to my laboratory so that I could investigate how novel potential candidate mechanisms that they developed influence cognition in laboratory models.
When one does work like I do, one wants to know that information learned is moving from the bench to the real world. That always requires a connection to a drug company — they make drugs/universities do not. That being said, I’ve always been of the opinion that having the best and most rigorous academic labs undertake these collaborations is in everyone’s best interest (the quality of the work is ensured). In my case, this was always a tiny part of what I did; therefore, the quality was good, my objectivity was unquestionable and the answers were certain.
2. How does one get drug-company money for research?
3. How much easier is it to get drug-company money than to money from other sources (for the same research)?
It’s hard to say. Fewer people receive drug company funds. If a company is interested in your work and approaches you, it’s not that difficult to obtain the funds. But it is difficult to be recognized to do this kind of work.
4. When did you start getting drug-company money for your research? If you’re comfortable saying how much it has been over the years (per year), that would help clarify the implications of your decision.
Because of the negative perception of these sorts of activities, it is not worth continuing to engage in them. I don’t require those funding sources. That being said, I find it a bit unfortunate. Again, it’s in everyone’s best interest if the TOP scientists did those collaborations to ensure their quality and rigor. When I don’t do them, it is possible that a less objective party does. Second, every concept I have about novel treatments that isn’t pursued because of lack of such a relationship is a potential delay in moving basic science to real use.
5. What are some examples of how the animal-rights activists publicized and complained about your use of drug-company money?
After the bombing [his car was bombed in March 2009], statements were made on the web and in the press by animal rights groups saying that people such as me used animals needlessly in a drug-company-fueled manic process of animal killing in order to get rich. As I already mentioned, this is not the case, if only because people like me often have relatively few such grants, and their size is not large (again, usually not larger than a single year of funding on an RO1 grant). Because of this, I simply decided not to take any such grants in the future.
6. The car bombing (on top of other attacks) led to the decision to stop taking drug company money?
Additionally, there is already a good deal of “negative perception” of research funded by drug companies within academic circles, and so I had already batted around the question in my mind about whether I should accept further awards. When the extremist attack on me happened in March of this year (2009), I had not had such an award in some time. That was not because I had taken a decision about the matter – simply that I hadn’t found a situation I wanted to pursue. At that point, the decision solidified.
7. Your decision to not take drug company money — what effect do you think it will have or hope it will have?
I am certain a situation will arise where I will have an idea about a novel therapeutic based upon my research that I will be unable to pursue without such a relationship to a company. What is more, the compounds in development by companies are not being evaluated by me, so they may well be evaluated by someone with a little bit less rigor and objectivity.
I believe strongly that the academic enterprise gives a crucial “objective” check on novel therapeutics when leading scientists who are not “dependent” on drug company money examine them. The alternative is that others who are more dependent, and therefore less objective, will do it.
While Dr. Jentsch sounds like he is approaching the issue with integrity, I think his concerns that he will not be able to pursue a novel treatment strategy due to his stand are dwarfed by the general misallocation of funds toward psychopharmacological interventions generally. The only reason research has been driven in this direction is because of the combination of a patent system and a corporate-driven research sector. If it weren’t for these factors we would be looking for solutions to mental health problems in environmental considerations — but there is no money in these areas, because they can’t be patented. The current system is not supporting public health unfortunately.
The meta-analysis of SSRIs by Irvine Kirsch at Hull showing them largely indistinguishable from placebo is one example of the collossal waste of psychopharmacology, the worse outcomes for schizophrenics in developed countries (drug-intensive) versus developing countries (often drug-free) is another. If society were run on cost-benefit analysis we would have pulled the plug on most psychopharmacological research a couple decades ago. Unfortunately, there are multiple agency and moral hazard problems in public and private institutions that perpetuate this wasteful research. It isn’t 100% bad — maybe 97%.
Consistent with themes from this blog, for instance, consider the Barker Hypothesis regarding the role of in-utero nutrition in health problems. If you could patent healthy fetal development, we would be far closer to solving problems related to health and mental health.
MT, that’s really interesting about better outcomes for schizophrenics in poorer countries. Can you provide a link or something?
From a WHO study entitled “Schizophrenia and public health,” published in 1998 and available here: https://www.who.int/entity/mental_health/media/en/55.pdf
“A substantial body of evidence shows a more benign course and better outcome in developing countries.” “The factors that underlie higher improvement rates in developing countries, however, remain ill-defined…”
I just found this as an example citation — I originally read of the phenomenon in the book “Unsafe at any dose” by Bob Johnson, a UK psychiatrist who worked with imprisoned violent offenders and managed (according to his self-reported data) to dramatically reduce violent incidents and also lower psychopharmaceutical drug use in the most violent prison population in the UK. He claims to be able to get these results using talk therapy, and further that the various psychopharmaceuticals judiciously prescribed do more harm than good.
Johnson attributes the difference in outcomes for schizophrenics between the two regions to be due to the prescribing of drugs studied for acute treatment of psychosis on a chronic basis. As we have such a strong pro-pill culture, and belief in the superiority of Western medicine, I doubt his theory will be tested any time soon. It would threaten too many shibboleths in the psychiatric community.
I wish Gary Taubes would do his next book on psychopharmaceuticals!