How is this website funded?
Short answer: there is none. It doesn’t take much to run a website (hosting, that’s about it).
Slightly longer answer: for about 6 years, until 2008, I used pharmaceutical company money, paid to me for giving talks about bipolar disorders — my talks, not theirs — to help make time available for writing here. There were no strings and you won’t find any sign of that money in here, I’m confident. (I also used their money to fund care of people who couldn’t pay their co-pays, or sometimes their whole bill, and buy things like light boxes and dawn simulators and give them to those who couldn’t afford them. It was a good gig until the companies wanted me give their talk not mine. I then went back to work for my local hospital.)
As you’ll see, pharma’ may have helped me get this site going by giving me some extra hours for it, but they have not influenced the content. Go ahead, test me (here’s the Treatment page, for example; it would show up there, if anywhere?)
That was the short answer? Well, as you probably know, pharmaceutical company money is all over the mental health business, so you should suspect it might be here somehow. If you want the details of how I’ve tried to avoid being corrupted by their $, then read the long answer below. Thanks for your interest. [Note that I have not revised the time frame in the text below; this was my disclaimer when I was taking pharmaceutical money. I am not now, not since about 3/2009.]
(revised 1/2009; updated 11/2014)
Good question (“where’s da money?”) — indeed, this is one of the best questions to determine if a website is really going to give you valid information.
Teaching patients and families about bipolar disorder has been criticized as “disease mongering”. In other words, the entire story about “Depression Plus” on this site (about bipolar variations that don’t have “mania” or look like the “bipolar” you may know) could be a big advertisement funded, indirectly, by the drug companies whose medications are used to treat the symptoms of Depression Plus.” Keep that in mind. I replied to an article about this problem thus: Confessions of a Disease Monger.
However, in this case:
This website was my idea. It was written with no funding at all. After all the site was up and several updates had already been completed, I received a grant from Abbott Laboratories, and that only because I wrote them asking for one. I figured, and they agreed, that they might benefit from people reading all this. They make a costly version of a now-generic medication, divalproex.That Abbott grant was in 2001.
GlaxoSmithKline (GSK) provided a small grant in 2003 which likewise was received years after the site was up and running. They make lamotrigine.
In late 2004, GSK placed me on their national speaker’s list and began paying me very large amounts when I speak for them (update 2009: their product is now generic, and they have just stopped their marketing, so I’m no longer taking any money from them). See below about how this might affect information presented here. However, as evidence of my neutrality, try this. Three different companies have either: not let me on their panel after offering it (Lilly); not had me speak after the standard “training” (Abbott); or taken me off the speakers list after a while (Wyeth). I presume these steps were taken because they discovered I would speak my mind freely; or because I would not use their slide sets, which amount to advertisements, in most cases; and perhaps because sometimes I said bad things about their medications, which are repeated on this website as well.
Update 5/2007: a very revealing article on the methods of the pharmaceutical company representatives, the techniques they used to influence physicians, was just published in a journal which is probably far less influenced by the pharmaceutical industry than many other journals in psychiatry. This is required reading for anyone interested in how pharmaceutical companies sell their medications.
It describes the friendships pharmaceutical company representatives form with doctors as a means of selling their drugs. I am certain that these techniques have been used on me. Indeed, I have formed friendships with several representatives in the process of taking their money, money used as described below. I still think I am maintaining my ability to think independently, and practice accordingly, but as I emphasize throughout this website, you must be cautious about this and take what I say with a grain of salt. You should definitely compare what I say with other opinions, and
form your own.
Update 11/2007: read Dr. Drug Rep by Daniel Carlat, M.D. for a first-hand account of the subtle pressure on a physician speaker to endorse the medication made by the company from which he or she is taking money. I am subject to the same pressure. You would have to ask someone who has attended one of my talks to confirm this, but I still think — after going through the exact same thought process that Dr. Carlat describes — that I am managing to stay neutral. Oh, I still show the company slides where required, and emphasize (for example) “this is what AstraZeneca wants you to know”. But as quickly as possible we move to a discussion of bipolar diagnosis; and when we come around to treatment, I moderate an open-ended discussion in which I try to emphasize treatment approaches with solid, well accepted evidence for their efficacy. I only give talks for companies who allow this approach, so I am not — I don’t think — in Dr. Carlat’s position.