If you who have chosen to spend inordinate amounts of your precious time reading these pages over the last year, you will remember the February 2003 (TCR, 1:2) issue in which TCR slammed Zyprexa for causing diabetes. Well, we're going to slam Zyprexa again this year, but not quite as viciously.

Tired of industry-funded antipsychotic trials? The NIMH comes to the rescue with the "CATIE" project (Clinical Antipsychotic Trials of Intervention Effectiveness). Blissfully un-industry-funded researchers have enrolled 1500 schizophrenic patients at 50 different sites, and have randomly assigned them to Zyprexa, Seroquel, Risperdal, Geodon, or Trilafon (perphenazine).

We have some good news and we have some bad news. First, the good news: Cymbalta (generic name: duloxetine) is an effective dual reuptake antidepressant with a good safety profile. Now, the bad news: it appears to have no advantages over existing antidepressants.

Whether you do ECT (electroconvulsive therapy) or not, and research indicates that less than 8% of you actually perform it (Hermann et al, Am J Psychiatry 1998; 155:889-894), you need to know about it, because you will have to decide when to refer your treatment-resistant patients for it, and you will have to know what to say to them about it as they pepper you with a multitude of questions, as they always do (and should).

Sorry, no earthshaking developments in the antidepressant world in 2003, but here are some developments that you’ll find useful in your practice.

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.

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!