April 7, 2009 The Pump Handle 0Comment

by Alison Bass (cross-posted)

Martin Keller is finally stepping down as the long time chief of psychiatry at Brown University. Brown University officials made the announcement in a Dear Colleagues letter dated today from Edward J. Wing, Brown’s new Dean of Medicine and Biological Sciences.

While Brown officials insist that the decision to step down was Keller’s, my understanding from several sources is that the university has been under pressure to take action ever since Side Effects was published last June and Sen. Charles Grassley began investigating Keller’s undisclosed conflicts of interest in July. Keller is the latest psychiatry kingpin to fall. In recent months, Stanford’s chief of psychiatry Alan Schatzberg and Emory University’s chief Charles Nemeroff were forced to step down after reports that they too failed to disclose years of lucrative financial payments from the pharmaceutical industry.

As I have reported in Side Effects and my blog here and here, Keller not only failed to disclose the millions of dollars he has received over the years from drug companies whose drugs he was studying and promoting in medical journals and at conferences. But there is evidence that Keller and his co-authors misrepresented data in a clinical trial of Paxil to make the antidepressant look safer and more effective than it really was. This trial, known as study 329 and funded by GlaxoSmithKline, was published in 2001 and used by the drug company to heavily market Paxil for off-label use in children and adolescents. Yet as it turns out, the data in this trial do not corroborate the company’s claims that Paxil was more effective than a placebo or sugar pill in treating depression in adolescents. The 2001 study also under-estimated the rate of suicidal thoughts and behaviors among participants taking Paxil in the study (in a 2006 paper, GlaxoSmithKline acknowledged that those taking the drug were five times more likely to be suicidal than those taking the placebo). GlaxoSmithKline is now under investigation by federal Department of Justice officials, and Keller himself has been deposed by attorneys in Boston’s U.S. attorney’s office, according to sources.

I also understand that the NIH recently refused to renew a long-term research grant submitted by Keller, in large part because of the allegations I raised in my book about scientific misconduct. Although Brown officials refused to confirm the NIH action, if you search the federal database for NIH grants (CRISP), you can see that Keller currently has three long-term research grants with National Institute of Mental Health; one of those grants, for a study comparing psychotherapy to drugs in treating depression, runs out this June, Another grant, for a long-term collaborative study of depression, ends in January.

Until recently, Keller was a major rainmaker for Brown, bringing in millions in research funding from the NIH and pharmaceutical companies to the university’s medical school. Indeed, in a 2006 deposition, Keller said his department of psychiatry received $50 million in research funding, a significant hunk of change. Some have speculated that is why Brown has been reluctant to move against him. But now that NIH is no longer renewing Keller’s research grants, one might speculate that his usefulness to Brown has diminished.

In addition, the American Journal of Psychiatry, the pre-eminent journal of the profession, just published a review of Side Effects, in which the reviewer referred to “a favored psychiatrist, whose driving force was profit not treatment.” While the review itself did not name Keller, he was outed by another blog, Clinical Psychology and Psychiatry: A Closer Look last Friday.

All of this may explain why come June, Martin Keller will join Nemeroff and Schatzberg on the growing roster of once-powerful psychiatry chiefs who have toppled from grace.

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