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Conflict-of-Interest Charge

To the Editor: In the review by Robert T. Rubin, M.D., Ph.D (1), of Psychoneuroendocrinology: The Scientific Basis of Clinical Practice (2), he charged that I, a coeditor of the book, have an undisclosed conflict of interest: "Also troublesome is Rothschild’s undisclosed financial interest in Corcept Therapeutics, which is attempting to establish mifepristone as an antidepressant." There are only three sentences in this 588-page book regarding studies of mifepristone for the treatment of psychotic depression:

Another interesting strategy is the progesterone receptor antagonist mifepristone (RU 486), which at high concentrations is an effective antagonist of glucocorticoid action in vivo and in vitro (Lamberts et al. 1984; Proux-Ferland et al. 1982). Mifepristone has been observed to be useful in rapidly reversing psychotic depression secondary to Cushing’s syndrome (Nieman et al. 1985; Van Der Lely et al. 1991) and in patients with psychotic major depression (Belanoff et al. 2001; Rothschild and Belanoff 2000). Studies of mifepristone for the treatment of psychotic major depression using a double-blind, placebo-controlled paradigm are currently in progress at our center and several others across the country.

To set the record straight, I do not now and never have owned stock in Corcept Therapeutics. I served briefly as a consultant to Corcept Therapeutics (October 2000 to March 2001) regarding the methodology of a clinical trial of mifepristone for the treatment of psychotic depression. In addition, I was an investigator at the University of Massachusetts Medical School for multisite clinical trials of mifepristone for the treatment of psychotic depression, a fact that is obvious from the relevant paragraph in the book.

References

1. Rubin RT: Book review, OM Wolkowitz, AJ Rothschild (eds): Psychoneuroendocrinology: The Scientific Basis of Clinical Practice. Am J Psychiatry 2003; 160:2073[Free Full Text]
2. Wolkowitz OM, Rothschild AJ (eds): Psychoneuroendocrinology: The Scientific Basis of Clinical Practice. Arlington, Va, American Psychiatric Publishing, 2003[CrossRef][Medline]

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