Doctor takes “march of shame” to atone for drug company payments

A US psychiatrist has vowed to go on a “march of shame” for payments he received from a drug company in return for medical education talks he gave to other doctors. He now promises to give free “undrug” talks to reverse the effects of the “inappropriate prescribing” he may have caused.

Writing in the New York Times (www.nytimes.com, 25 Nov 2007, “Dr Drug Rep”), Daniel Carlat, assistant clinical professor of psychiatry at Tufts School of Medicine in Boston, has given a candid account of his role promoting the antidepressant venlafaxine (marketed as Effexor XR in the United States by Wyeth Pharmaceuticals). Carlat was flattered when a Wyeth drug representative asked him in 2001 to give talks to doctors about the drug for the treatment of depression. It didn’t hurt that he would be paid $500 (£250; €350) for a one hour talk over a free lunch—and $750 if he had to drive for an hour.

Carlat, who specialises in psychopharmacology, says he didn’t believe at first that he was doing anything wrong when he agreed to give the talks. He was familiar with studies showing that venlafaxine, a dual reuptake inhibitor that increases concentrations of serotonin and noradrenaline (norepinephrine), might be more effective than the selective serotonin reuptake …