Exploiting the Mentally Ill For Fun and Profit
*Anarcissie*
Reinstein received nearly $500,000 from antipsychotic
drug's manufacturer Company paid him to promote Seroquel
despite misgivings about his research
By Christina Jewett, ProPublica and
Sam Roe, Tribune reporter
Chicago Tribune
November 11, 2009
www.chicagotribune.com/health/chi-drugs-seroquel-reinsteinnov11,0,6067737.story
Executives inside pharmaceutical giant AstraZeneca faced
a high-stakes dilemma.
On one hand, Chicago psychiatrist Dr. Michael Reinstein
was bringing the company a small fortune in sales and
was conducting research that made one of its most
promising drugs look spectacular.
On the other, some worried that his research findings
might be too good to be true.
As Reinstein grew irritated with what he perceived as
the company's slights, a top executive outlined the
scenario in an e-mail to colleagues.
"If he is in fact worth half a billion dollars to
(AstraZeneca)," the company's U.S. sales chief wrote in
2001, "we need to put him in a different category." To
avoid scaring Reinstein away, he said, the firm should
answer "his every query and satisfy any of his quirky
behaviors."
Putting aside its concerns, AstraZeneca would continue
its relationship with Reinstein, paying him $490,000
over a decade to travel the nation promoting its best-
selling antipsychotic drug, Seroquel. In return,
Reinstein provided the company a vast customer base:
thousands of mentally ill residents in Chicago-area
nursing homes.
During that period, Reinstein also faced accusations
that he overmedicated and neglected patients who took a
variety of drugs. But his research and promotional work
went on, including studies and presentations examining
many of the antipsychotics he prescribed on his daily
rounds.
The AstraZeneca payments, filed as exhibits in a federal
lawsuit, highlight the extent to which a leading drug
company helped sustain one of the busiest psychiatrists
working in local nursing facilities.
In an interview and in response to written questions,
Reinstein said industry payments he has received for
speeches and other engagements have had no bearing on
his research results or patient care. He said he does
not "accept any money from corporations to study their
medications. This eliminates any possible conflicts of
interest."
But he does receive money from the Uptown Research
Institute, a for-profit business that conducts industry-
and government-funded studies on psychotropic drugs to
help mentally ill patients.
Reinstein's office in Uptown is adjacent to the research
institute, which is owned by John Sonnenberg, a clinical
psychologist who describes Reinstein as "a mentor of
mine" and "brilliant."
Sonnenberg said drugmakers and others pay his institute
to do research, and the group, in turn, pays Reinstein a
consulting fee of "under $2,000 a month" and has for
many years. A decade ago, Sonnenberg said, Reinstein was
an active researcher for the institute but since then
has served only as an adviser.
"My research organization is separate from him,
financially and organizationally," Sonnenberg said.
While payments from drugmakers to researchers are legal,
critics have long argued that they should be publicly
disclosed. Legislation to make Illinois one of a handful
of states to require disclosure died in Springfield this
year but is included in the U.S. House and Senate
versions of health care reform proposals.
"We need to know that we can fully trust the
relationship we have with our doctor and that another,
more lucrative relationship with industry does not
outweigh it," Sen. Herb Kohl, D-Wis., who is pushing for
such reform, said in an interview.
Health professionals who have encountered Reinstein have
had similar concerns. When he gave promotional
presentations about various medications at Grasmere
Place nursing home in Chicago, case manager Staci Burton
recalled that she was pleased to get free lunches. But
she said she wondered why Reinstein put his patients on
twice as many drugs as other psychiatrists who treated
residents.
"I was thinking, 'Why are you using so many
medications?' " Burton, who worked at the facility from
2004 to 2006, said in an interview. "(His patients)
would have symptoms, they'd have all these side effects,
and their doctor was not listening."
Psychotropics to lose weight?Chanile Hayes, a South Side
resident, says she came under Reinstein's care at a
psychiatric hospital after she suffered a nervous
breakdown nearly 10 years ago. She found it odd, she
said, when Reinstein told her that taking Seroquel would
help her lose weight.
"I couldn't understand why he wasn't taking it because
he was a plus-sized man himself," said Hayes, now 37.
She is one of thousands of people nationwide suing
AstraZeneca on allegations it concealed Seroquel's links
to weight gain and diabetes.
While she is a plaintiff in New York state, a federal
suit is playing out in Orlando, Fla. Reinstein is not a
defendant in either case, but Orlando plaintiffs have
cast him as a key figure: an influential promoter of
Seroquel who was financially backed by AstraZeneca. They
allege that Reinstein has claimed that the antipsychotic
drug helps patients lose weight.
Hayes said she went from 140 pounds to nearly 300 within
two years of taking the drug and later developed
diabetes.
Reinstein has done studies, funded by AstraZeneca and
two other drugmakers, that found that various
medications, including Seroquel, carry an unexpected yet
welcome side effect: They help some patients shed
pounds.
That claim runs counter to established research that
links so-called atypical antipsychotic drugs, such as
Seroquel, to considerable weight gain. Drugs in this
class, approved for schizophrenia and bipolar disorder,
can have other serious side effects that include spastic
movement disorders and seizures and can cause premature
death among the elderly.
A Seroquel flier dated 1999 features a photograph of
Reinstein on the cover. Inside, Reinstein describes one
patient losing weight and no longer needing insulin
shots because his diabetes had improved so much.
In a 2001 promotional telecast to 5,000 physicians
nationwide, Reinstein said he had "jokingly kind of
suggested to AstraZeneca" that the drug could be used
for "taking away excessive appetite."
"There's actually some nurses in some of our facilities
who have actually requested (Seroquel) because they
noticed it really did suppress the appetite, and they
wanted to lose weight themselves," Reinstein said,
according to a transcript of the speech, sponsored by
AstraZeneca and broadcast from Somerset Place, a Chicago
nursing home.
Two years after the speech, the Food and Drug
Administration, armed with mounting research, asked
AstraZeneca to warn patients of Seroquel's diabetes
risk. The drug's label now cautions that the medication
is linked to diabetes and weight gain -- with nearly
four times more patients gaining weight on Seroquel than
on a placebo.
In his response to reporters, Reinstein characterized
Seroquel as "generally weight neutral, although some
patients gain weight and others lose weight."
"I would never recommend" that patients take
antipsychotics "to lose weight," he wrote.
AstraZeneca spokesman Tony Jewell said plaintiffs have
not proved that Seroquel was responsible for their
injuries. He said the company, based in London, provided
appropriate safety data about Seroquel to the FDA.
Chanile Hayes, who said she saw Reinstein during visits
to his office, questioned why he prescribed her the
drug: "How could you tell me that it would help me lose
weight if it doesn't help (people) lose weight?"
At AstraZeneca, early doubts
In the corporate halls of
AstraZeneca, the company's scientific staff also
questioned Reinstein's work.
Copies of e-mails filed as part of the Seroquel
litigation in Orlando reveal executives' misgivings
about a Reinstein study involving patients on high doses
of the drug. The results that came back were too rosy
for AstraZeneca's own executives to accept.
One called Reinstein's conclusion that patients
experienced no adverse effects "suspect" and "hard to
believe." Executives "decided that we would ... try to
distance ourselves from this study," according to e-
mails from John Tumas, an AstraZeneca publications
manager.
Reinstein presented his findings in 2001 at the annual
meeting of the American Psychiatric Association, the
profession's most high-profile gathering. At least three
researchers have subsequently cited his study in medical
journals.
During a deposition for the Orlando case, Reinstein said
he was unaware of any criticism from AstraZeneca about
his research.
But he had some criticisms of his own, according to an
internal company e-mail filed in federal court.
Reinstein vented to an AstraZeneca employee in 2001,
saying the firm was giving him the "run around." He also
complained that the company did not help present his
research findings or include him in high-profile
studies.
Within days, Reinstein wrote a letter to AstraZeneca's
CEO in the U.S., identifying him and four doctors he
works with as "the largest prescribers of Seroquel in
the world." He said his travel expenses weren't paid
upfront and called for "new leadership" in Seroquel's
marketing.
Reinstein's complaints caused a stir.
In a strongly worded 2001 e-mail, Georgia Tugend, the
U.S. brand manager for Seroquel, told colleagues that
research conducted by Reinstein and his partners "is
often criticized by their peers in psychiatry."
Some scientists have "significant and numerous issues
... with the quality of research this group has produced
in the past," Tugend wrote, yet Reinstein's group
persists in "demanding research grants from us."
At one point, according to an e-mail from an AstraZeneca
executive, Reinstein and his partners had "blatantly
threatened" to switch patients to a Seroquel competitor.
Reinstein later denied that accusation during a
deposition, testifying that he "cannot imagine" making
such a threat.
Malcolm May, AstraZeneca's U.S. sales director, reacted
to Reinstein's discontent by saying that the company
should be careful not to alienate a psychiatrist worth
up to a half-billion dollars to the firm.
"I am not suggesting we kowtow to his whims, nor to
support any unethical behavior," May wrote in 2001 in an
e-mail to fellow AstraZeneca executives. "I am
suggesting ... we need to be more responsive to his
opinion and needs."
May continued: "It seems we are annoying possibly our
most important single customer, and that is not
acceptable. ... My concern is that Dr. Reinstein could
be looking for a trigger to leave our fold. That would
be disastrous for our Seroquel business in the short and
long term."
May's message did not cite a basis for the half-billion-
dollar estimate. Reached by phone, May said he did not
recall sending the e-mail.
Court documents show that AstraZeneca continued to pay
Reinstein to promote Seroquel until 2007. A Reinstein
ledger lists hundreds of payments beginning in 1997. The
payments, in increments from $10 to $20,000, totaled
$490,000.
During that period, Reinstein ordered Seroquel for as
many as 1,000 Chicago-area Medicaid patients per year at
a total cost of $7.6 million to taxpayers, records show.
AstraZeneca spokesman Jewell said the company wasn't
paying Reinstein to prescribe its drug but rather to
make promotional speeches. Reinstein and AstraZeneca
mutually declined to renew their ties in 2008, but
Jewell would not say why.
Reinstein said in an interview that some AstraZeneca
officials grew critical of him only after his complaint
to the firm's U.S. chief executive.
Today, Reinstein said, he gets money from the maker of a
dissolvable form of clozapine, another antipsychotic
that he often prescribes. He said he receives less than
$25,000 per year to be in the manufacturer's speakers
bureau, which drug companies commonly set up to promote
their products.
In his deposition last year, Reinstein himself expressed
surprise about some of his research results, saying one
study's findings were "hard for me to believe" -- in
line with concerns expressed at AstraZeneca. When asked
about another study in which patients lost weight on
Seroquel, he said the results could have been affected
by a change in the nursing home's cook or possible
problems with scales.
In all, Reinstein has published at least eight research
articles, mostly about antipsychotic drugs. He has been
cited in at least 20 others. The Uptown Research
Institute is now working on eight studies involving
psychotropics, said Sonnenberg, the owner.
Sonnenberg said studies by his institute "are highly
scrutinized for accuracy and credibility" by the
drugmakers, third-party ethics review boards and,
potentially, the FDA.
Dr. Jerome Kassirer, a professor at Tufts University
School of Medicine and a former editor of the New
England Journal of Medicine, read the AstraZeneca e-
mails at the request of ProPublica and the Tribune. He
concluded that editors of medical journals should
investigate Reinstein's published studies.
"Once you know that he has done a study that has been
discredited," Kassirer said, "you have to ask yourself
about all other studies done."
Sam Roe is a Tribune reporter. Christina Jewett is a
reporter for ProPublica, an independent, nonprofit
investigative newsroom in New York. Funded primarily by
the Sandler Foundation, ProPublica publishes its work at
propublica.org and through partnerships with the Tribune
and other media.
_____________________________________________
RGrannus
> Doctor-drugmaker ties: Psychiatrist Dr. Michael
> Reinstein received nearly $500,000 from antipsychotic
> drug's manufacturer Company paid him to promote Seroquel
> despite misgivings about his research
That's just one of many ways that the establishment exploits the
"mentally ill"
A common tactic is to have persons involuntarily committed and then
charge them or their insurance company tens of thousands of dollars
for the "treatment" they don't want or need. Some of these are
persons with depression who are lured into "community centers" with
the promise of free care. There they see "screeners". But these
psychiatric "screeners" are often bounty hunters for hospitals or at
the least have to justify their jobs.
http://www.antipsychiatry.org/unjustif.htm
"Our investigation has found that thousands of adolescents, children,
and adults have been hospitalized for psychiatric treatment they
didn't need; that hospitals hire bounty hunters to kidnap patients
with mental health insurance; that patients are kept against their
will until their insurance benefits run out; that psychiatrists are
being pressured by the hospitals to increase profit; that hospitals
'infiltrate' schools by paying kickbacks to school counselors who
deliver students; that bonuses are paid to hospital employees,
including psychiatrists, for keeping the hospital beds filled.
The supposed experts responsible for these "diagnoses" are
usually biased in favor of commitment because of their personal
economic concerns or their affiliation with the psychiatric "hospital"
where the "patient" is or will be confined. Psychiatric "hospitals",
like all businesses, need customers. In the case of psychiatric
"hospitals", they need patients. They not only want patients, they
need them to stay in business. Similarly, individual psychiatrists
and psychologists need patients to make money and earn a living....
"Keeping all those psychiatric beds filled is critical, and
administrators are aggressively ensuring that they will be. .. Some
facilities even resort to paying employees and others bonuses of $500
to $1,000 per referral.
An administrator at a psychiatric "hospital" told me
competition between psychiatric hospitals is what she called "cut
throat". Combine this intense competition with America's poorly
written involuntary commitment laws and judges who refuse to impose
protection from unwarranted commitment that bona-fide due process
requires, and the result is a lot of people being deprived of liberty
and suffering psychiatric stigma unjustifiably."
Update
"Some psychiatric hospitals made a practice of admitting adolescents
in distress, using the diagnosis of bipolar disorder. The federal
government finally intervened, charging the hospitals with fraud and
assessing fines of millions of dollars. Many of these children did
not have bipolar disorder at all, but were acting inappropriately
because of stresses in their families, with their friends, and at
school." --Edward Drummond, M.D., Associate Medical Director at
Seacoast Mental Health Center in Portsmouth, New Hampshire, in The
Complete Guide to Psychiatric Drugs (John Wiley & Sons, Inc., New
York, 2000), pages 13-14. Dr. Drummond graduated from Tufts
University School of Medicine and was trained in psychiatry at Harvard
University."
See also:
http://www.cchr.org/take_action/report_psychiatric_abuse.html
"Vulnerable people who have sought help from psychiatrists and
psychologists have been falsely diagnosed and forced to undergo
unwanted and often harmful psychiatric methods."
It happened to a relative of mine. He was being treated for
depression by his own doctor but went to a peer support group meeting
at a local center. The head of the center talked him into going to a
local hospital with the promise of free additional psychiatric help.
The hospital had him involuntarily committed. He ended up being
charged about $20,000 (for which he has no insurance). Now you may
think that a court order is needed for commitment. Legally it is, but
here's the rub: It takes up to 20 days to set up a hearing before a
judge. During this time they can and will hold and charge you.
P.S. A person is charged for the payment of his own involuntary
commitment. If you don't have insurance, they can and will seize your
assets or put a lien on your house. So if you go to a hospital or
local mental health clinic for help with depression, you could end up
being hospitalized because you're a threat to yourself. The
"screener" who decides you should be involuntary committed may be a
social worker or "counselor" not a psychiatrist.
http://www.njleg.state.nj.us/2004/Bills/PL05/55_.PDF.
> By Christina Jewett, ProPublica and
> Sam Roe, Tribune reporter
> Chicago Tribune
> November 11, 2009www.chicagotribune.com/health/chi-drugs-seroquel-reinsteinnov11,0,606...
Escape_the_Cult_Now
never see them again.
http://theunfunnytruth.ytmnd.com/
http://www.youtube.com/watch?v=rCGP-0545EU
http://www.youtube.com/watch?v=01rAh6nbbS0
*Anarcissie*
> On Nov 23, 10:40 am, "*Anarcissie*" <anarcis...@gmail.com> wrote:
>
> > Doctor-drugmaker ties: Psychiatrist Dr. Michael
> > Reinstein received nearly $500,000 from antipsychotic
> > drug's manufacturer Company paid him to promote Seroquel
> > despite misgivings about his research
>
> That's just one of many ways that the establishment exploits the
> "mentally ill"
>
> A common tactic is to have persons involuntarily committed and then
> charge them or their insurance company tens of thousands of dollars
> for the "treatment" they don't want or need. Some of these are
> persons with depression who are lured into "community centers" with
> the promise of free care. There they see "screeners". But these
> psychiatric "screeners" are often bounty hunters for hospitals or at
> the least have to justify their jobs.
>
> http://www.antipsychiatry.org/unjustif.htm
The best strategy is to prevent them from getting
money out of the case. Therefore, no numbers
(like Social Security) should be given, and nothing
signed.
> social worker or "counselor" not a psychiatrist.http://www.njleg.state.nj.us/2004/Bills/PL05/55_.PDF.
> ...
>
> read more »