Daniel Carlat

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Daniel Carlat, M.D. is a psychiatrist in the United States. He has a private practice in Newburyport, MA and is on the faculty of Tufts Medical School. He is the author of the book Unhinged: The Trouble With Psychiatry, which criticizes the field of psychiatry for abandoning its roots in talk therapy in favor of medication-based treatment. He is the founder and editor of a monthly newsletter called The Carlat Psychiatry Report, "a peer-reviewed, non-industry biased, CME publication."[1]

Background[edit]

Carlat graduated from the University of California, Berkeley in 1983 and received his medical degree at the University of California, San Francisco. He completed his residency in psychiatry at Massachusetts General Hospital from 1992-1995 and went on to serve as chief resident of the MGH inpatient psychiatry unit in 1995.

Carlat has argued that psychiatry has been inconclusive about how and why it works: "We don't have any direct evidence that depression or anxiety or any psychiatric disorder is due to a deficiency in serotonin because it's very hard to actually measure serotonin from a living brain. Any efforts that have been made to measure serotonin indirectly — such as measuring it in the spinal fluid or doing post-mortem studies — have been inconclusive. They have not shown conclusively that there is either too little or too much serotonin in the fluids. So that's where we are with psychiatry. ... In cardiology, we have a good understanding of how the heart pumps, what electrical signals generate electricity in the heart. And due to that understanding, we can then target specific cardiac medications to treat problems like heart failure or heart attacks.... not perfect, but pretty well worked out."[2]

Carlat was recruited by the pharmaceutical company Wyeth to promote the antidepressant Effexor as being more effective than other antidepressants on the market.[3] According to Carlat, he started to question the research about the efficacy of Effexor and other antidepressants, and was soon dropped from the company's hired speakers. He wrote about this experience in an article entitled 'Dr. Drug Rep' for the New York Times magazine. [4] This article went on to be selected for Harper Perennial’s Best Science Writing 2008 anthology and became the basis of his book Unhinged.

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