Dr. O'Reardon, you had mentioned at the end of our last interview (see TCR, Vol. 1, No. 1) some of the augmentation and combination strategies that you like to use in your clinic but we didn't have time to get into the actual specifics of these. To begin with, how do you decide when to augment? What kinds of drug failures do you try to establish?

The first ECT (electroconvulsive therapy), was performed by an Italian psychiatrist, Ugo Cerletti, who had initially assessed the safety of the treatment with dogs. He performed the first treatment on a human on April 18, 1938.

In case you haven't noticed, antidepressants are under attack. Articles such as "The Emperor's New Drugs" and popular books like "Prozac Backlash" point to a growing public sentiment that psychiatrists need to shed a little hubris.

Throughout every issue of The Carlat Report, you, poor reader, have been subjected to citations of multiple research studies, and to terms such as "controlled," "open-label", "statistically significant." In this article, TCR dives head-first into research methodology, with the aim of helping you to become smarter consumers of statistical trickery.

Index to Volume 1, 2003 of The Carlat Report

Dr. Zimmerman, you and your colleagues have published prolifically on whether the research studies we read are truly relevant to our clinical practices. What's the bottom line of your research?

What a bind we seem to be in. On the one hand, we are short several thousand child psychiatrists in the United States, and parents are beating down our (generalist) doors to get their children medicated. On the other hand, every other piece of news about childhood psychopharmacology seems either bad or lukewarm.

Just when we thought we could finally dismiss the notion that SSRIs cause suicidal ideation, along came the Brits!

Every so often the stars align themselves in such a way that you will be referred an "easy" adolescent. This is a teenager who looks and dresses like you, who is seeking help on his or her own urging, who describes depressive or anxiety symptoms articulately, and who responds well to standard treatment.

Dr. Bostic, what are your clinical and research responsibilities?