What’s wrong with psychiatry? A conversation with Dr. Daniel Carlat

May 17, 2010

Children treated with powerful drugs for mental disorders that hardly any of them suffered from just decades ago. Eminent psychiatrists investigated by Congress for earning hundreds of thousands of dollars from drug companies without disclosing the income to their patients or the IRS.

For a field trying to help patients work through conflicts, psychiatry is in a “struggle to understand itself,” says Dr. Daniel Carlat, author of Unhinged: The Trouble With Psychiatry – A Doctor’s Revelations About a Profession in Crisis, released this week.

Carlat is a psychiatrist in private practice outside of Boston, and the editor-in-chief of The Carlat Psychiatry Report. He is also a former “hired gun” for Wyeth, a subject about which he has written for The New York Times Magazine.

Carlat’s book takes readers inside a profession whose practice has transformed from endless hours of talk therapy to an endless series of 15-minute checkups adjusting drugs. Psychiatrists can’t even explain how most of those drugs work, says Carlat.

Still, that hasn’t stopped some doctors from becoming drug companies’ hired guns, a lucrative side business that nets psychiatristrs tens or even hundreds of thousands of dollars per year.

Meanwhile, those same drug companies sponsor psychiatric clinical trials whose results can be biased, Carlat contends. And psychiatrists fall more and more in love with diagnostic and treatment technology that shows little evidence of effectiveness.

Can psychiatry be saved? Join us at noon Eastern Thursday for a conversation between Carlat and Reuters Health executive editor Ivan Oransky. We’ll look at the truth behind statistics showing that rates of mental illness have skyrocketed, and at Carlat’s solutions for what ails his profession – at least one of which may surprise you. You’ll have a chance to ask questions.

From the U.S., call 1-888-419-5570. Outside of the U.S., call 1-617-896-9871. The passcode is 29616498.


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Much to my chagrin I’ll be unable to listen in and/or participate in the teleconference.

As a very, very long-time support person and caregiver of more than 4 decades I am very much in agreement that medical practitioners and in particular the field of Psychiatry of which I am more familiar certainly needs to clean up its act in terms of physician and researcher disclosures and relationships with the pharmaceutical and medical device industries as well as questionable diagnosis especially as it relates to youngsters and the administration of drugs not previously investigated for this age group to name but a few areas of serious conflict.

I am also of the opinion that the medical schools have an incumbent moral and social responsibility to the citizens of this country to teach some kind of ethics classes so that future practitioners are not easily swayed by the almighty dollar to prostitute themselves to be spokespersons as was Dr. Carlat early on.

Although I will add from my knowledge of the unique patient population that suffers from recurrent and chronic depression, also known as MDD, that there is a desperate need for newer innovative therapies and approaches for these patients as the conventional therapies simply are ineffective and these patients seriously need encouragement and hope to continue on.


Posted by lifetime | Report as abusive

I’m not sure how things work in the USA, but over here in the UK it is understood that Psychiatrists primarily prescribe medication, and delegate other treatment modalities to professionals such as Psychologists.

In other words, a Psychiatrist’s job IS to prescribe and adjust medication and co-ordinate a patient’s treatment, with other types of therapies provided by professionals with optimal expertise in their respective fields. For many disorders, such as ADHD for example, “powerful drugs” (I’m sorry but what? You can’t define a drug like that. It’s misleading and ignorant) are only a PART of the treatment, with it being well known and proven through rigorous evidence based conclusions that optimal therapy is indeed a combination of medication and other treatment modalities, such as CBT and Neurofeedback.

It’s not fair to say all Psychiatrists are just dishing out drugs because a drug company says so. It’s kind of their job, and it is based mostly on solid evidence provided by sources with no financial motivation, at least in the UK. I don’t see them just dishing out some weird drug to a kid with autism for example because Glaxo-Smithkline says so; there’s no proof that it works and until their is, it won’t happen unless it’s a last resort.

Furthermore, it doesn’t really matter if we don’t know how the drug works, as long as it can be proven that it does and it is of more benefit than harm to a patient. This is a very common approach and is seen in all fields of Medicine.

Maybe it’s just Carlat and his phoney cronies; I doubt the field of Psychiatry as a whole is guilty or in disrepute.

Posted by hahsluhar | Report as abusive

The real problem with American psychiatry is that it’s so phony. It’s a 3-part model where:

1. the patient is given a “diagnosis” that is only a description of his symptoms, just like having pneumonia and being given a diagnosis of “Bad Cough Disorder;”

2. the patient is allowed to talk about his symptoms, year after year after year, at no small cost, and:

3. third, he or she is given expensive, synthetic drugs in an attempt to control those symptoms. In King County (Seattle area) the recovery rate for DSHS clients with a mental illness was audited and found to be .0005%. For emphasis, that’s POINT zero zero zero five percent. If that isn’t a dismal failure, what is?

In the meantime, the leaders of the American Psychiatric Association know very well that there is another model of mental health care that doesn’t just work, it works extremely well. About 90% of acute cases of mental illness are cured – NOT managed for life. This model is called “orthomolecular.” The leaders of the APA have been disparaging this type of care since at least 1962 when scientists Abram Hoffer and Humphrey Osmond discovered kryptopyrroles, a biological marker in the urine showing an adrenal metbolism disorder proven to cause schizophrenia. The only “problem” with this type of treatment is that patients recover and no longer need psychiatrists or their drugs. (Hmmm, methinks BigPharma might not like that.)

Fortunately, orthomolecular treatment lives on. The Orthomolecular Society has had an annual conference for the last 40 years or so, as well as a newsletter and Journal of Orthomolecular Medicine, scientists continue to publish books on how to restore one’s BIOchemistry to cure mental illnesses, etc.

I (finally) learned enough about orthomolecular medicine to cure my family member of “incurable” psychosis. ALL the mainstream psychiatrists, whether in private practice or at the two psychiatric hospitals we used, had claimed he’d be ill for life. Yet, thanks to orthomolecular medicine, he’s been 100% free of welfare, DSHS, psychiatrists and their miserable drugs for over 5 years. The leaders of the APA know full well that a patient cured is a customer lost. It’s no wonder they have chosen to claim that expensive drugs and expensive talk therapy are the only viable treatment. What hogwash.

Feel free to read a little more about orthomolecular treatment at my website, RestoreMyMind.com.

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