Texas Medication Algorithm Project: Difference between revisions

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The '''Texas [[medical algorithm|Medication Algorithm]] Project''' ('''TMAP)''')<ref>{{cite web|url=http://www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm|title=Texas Medication Algorithm Project|website=Texas Department of State Health Services|url-status=unfit|archiveurl=https://web.archive.org/web/20041013172939/http://www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm|archivedate=October 13, 2004}}</ref> is a controversialdecision-tree [[corporate-sponsoredmedical algorithm]], setthe design of [[psychiatricwhich management]]was guidelinesbased designedon tothe enableexpert doctorsopinions toof systematicallymental screenhealth specialists. It has provided and treatrolled patientsout a set of [[psychiatry|psychiatric]] management guidelines for diagnoseddoctors treating certain mental disorders within [[Texas|Texas']] publicly- funded [[mental health]] care system., along TMAPwith wasmanuals initiatedrelating into the falleach of [[1997]]them to provideThe morealgorithms uniformcommence earlyafter intervention screeningdiagnosis and cover pharmacological treatment for(hence Texas"Medication childrenAlgorithm").

==History==

Opponents of TMAP and similar mental health screening programs view them as [[mind control]] techniques.

TMAP was initiated in the fall of 1997 and the initial research covered around 500 patients.

TMAP arose from a collaboration that began in 1995 between the [[Texas Department of Mental Health and Mental Retardation]] (TDMHMR), [[pharmaceutical]] companies, and the [[University of Texas Southwestern Medical Center at Dallas|University of Texas Southwestern]]. The research was supported by the National Institute of Mental Health, the Robert Wood Johnson Foundation, the Meadows Foundation, the Lightner-Sams Foundation, the Nanny Hogan Boyd Charitable Trust, TDMHMR, the Center for Mental Health Services, the Department of Veterans Affairs, the Health Services Research and Development Research Career Scientist Award, the United States Pharmacopoeia Convention Inc. and Mental Health Connections.

In [[1994]] MAP was recommended as a model for implementing similar mental health screening programs throughout the [[United States]], by the President's [[New Freedom Commission on Mental Health]]. Similar programs have been implemented in about a dozen States, according to a 2004 report in the ''British Medical Journal''.

Numerous companies that invent and develop antipsychotic medications provided use of their medications and furnished funding for the project. Companies did not participate in the production of the guidelines.<ref>{{cite web|url=https://ahrp.org/rutherford-institute-interview-allen-jones-reveals-tmap-drug-scam-linked-to-then-governor-george-w-bush/|title=Rutherford Institute Interview: Allen Jones reveals TMAP drug scam linked to then Governor George W. Bush|date=October 14, 2005|website=Alliance for Human Research Protection|first=Vera|last=Sharav}}</ref> However, in 2012 Dr. Stephen Shon, the medical director of Department of Mental Health and Mental Retardation (MHMR) and author of TMAP, admitted to receiving direct payment from the company [[Janssen Pharmaceuticals|Janssen Phamaceuticals]] while leading the creation of TMAP.<ref>{{Cite web |last=Applbaum |first=Kalman |date=January 15, 2012 |title=The banality of corporate corruption: Janssen's reimbursement department takes the stand. (Risperdal on trial, cont'd.) |url=https://no-more-tears.org/Applbaum-2012.pdf |access-date=May 13, 2025 |website=somatosphere}}</ref> Under such influence, TMAP favored drugs sold by Jansen. For example, the widely used antipsychotic drug Haldol was replaced with the more expensive [[Risperidone|Risperdal]] for every potential Haldol user covered by Texas Medicaid. Resperdal cost 40 times more than Haldol, had worse side effects, and had a similar efficacy to Haldol.<ref>{{Cite journal |last1=Swartz, M.D. |first1=Dr. Marvin S. |last2=Stroup, M.D., M.P.H. |first2=T. Scott |last3=McEvoy, M.D. |first3=Dr. Joseph P. |last4=Davis, Dr.P.H. |first4=Dr. Sonia M. |last5=Rosenheck, M.D. |first5=Dr. Robert A. |last6=Keefe, Ph.D. |first6=Dr. Richard S. E. |last7=Hsiao, M.D. |first7=Dr. John K. |last8=Lieberman, M.D. |first8=Dr. Jeffrey A. |date=May 1, 2008 |title=What CATIE Found: Results From the Schizophrenia Trial |url=https://psychiatryonline.org/doi/10.1176/ps.2008.59.5.500 |journal=Psychiatric Services |volume=59 |issue=5 |pages=500–506 |doi=10.1176/ps.2008.59.5.500 |via=PMC Pubmed Central|pmc=5033643 }}</ref>

TMAP arose from a collaboration that began in [[1995]] between [[pharmaceutical]] companies, the [[University of Texas Southwestern Medical Center at Dallas|University of Texas Southwestern]], and the [[Texas Department of Mental Health and Mental Retardation]] (TDMHMR). According to the ''British Medical Journal'', "the project (TMAP) was funded by a [[Robert Wood Johnson Foundation|Robert Wood Johnson]] grant (along with several drug companies)." The pharmaceutical companies who funded the development of TMAP include [[Janssen Pharmaceutica]], [[Johnson & Johnson]], [[Eli Lilly]], [[AstraZeneca]], [[Pfizer]], [[Novartis]], [[Janssen-Ortho-McNeil]], [[GlaxoSmithKline]], [[Abbott Laboratories]], [[Bristol Myers Squibb]], [[Wyeth-Ayerst]] and [[Forrest Laboratories]].

In [[1994]]2004, MAPTMAP was recommendedmentioned as an example of a modelsuccessful forproject implementingin similara paper regarding implementing mental health screening programs throughout the [[United States]], by the President [[George W. Bush|George W. Bush's]] [[New Freedom Commission on Mental Health]], which looks to expand the program federally. The President had previously been Governor of Texas, in the period when TMAP was implemented. Similar programs have been implemented in about a dozen States, according to a 2004 report in the ''[[British Medical Journal]]''.

TMAP is a decision-tree [[medical algorithm]], the design of which was based on the expert opinions of prescribers. The drugs recommended as "first line treatment", are produced by the sponsors of the guidelines: [[Risperdal]], [[Zyprexa]], [[Seroquel]], [[Geodon]], [[Depakote]], [[Paxil]], [[Zoloft]], [[Celexa]], [[Wellbutrin]], [[Zyban]], [[Remeron]], [[Serzone]], [[Effexor]], [[Buspar]], [[Adderall]] and [[Prozac]].

Similar algorithms with similar prescribing advice have been produced elsewhere, for instance at the [[Maudsley Hospital]], London.<ref>{{cite web|url=http://www.mhc.com/Algorithms/AlgoLinks.HTML|title=Lists of Psychopharmacology Algorithms|first1=David N.|last1=Osser|first2=Robert D.|last2=Patterson|accessdate=March 17, 2006|website=Maudsley Hospital|url-status=unfit|archive-url=https://web.archive.org/web/20010626062649/http://www.mhc.com/Algorithms/AlgoLinks.HTML|date=May 1, 2001|archivedate=June 26, 2001}}</ref>

==See also==

== References ==

* [[Allen Jones (whistleblower)]]

<references/>

* [[Anti-psychiatry]]

* [[Biological psychiatry]]

* [[Bruce Levine]]

* [[Evidence-based medicine]]

* [[International Center for the Study of Psychiatry and Psychology|ICSPP]]

* [[Medical algorithm]]

* [[Sally Satel]]

==External Linkslinks==

* [https://web.archive.org/web/20050413080757/http://www.mentalhealthcommission.gov/reports/reports.htm MentalHealthCommission.gov] - President's New Freedom Commission on Mental Health (official US government website)

[[Category:MedicalHealth informatics]]

* [http://www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm DSHS.state.tx.us] - Texas Medication Algorithm Project (official site), Texas Department of State Health Services

[[Category:Treatment of mental disorders]]

* [http://www.mentalhealthcommission.gov/reports/reports.htm MentalHealthCommission.gov] - President's New Freedom Commission on Mental Health (official US government website)

[[Category:Drugs in the United States]]

* [http://www.mindfreedom.org/mindfreedom/bushpsychnews.shtml MindFreedom.org] - 'President Bush and the Shrinking of the USA' (press release)

[[Category:Mental disorders screening and assessment tools]]

* [http://www.newmediaexplorer.org/sepp/2004/06/23/bush_to_impose_psychiatric_drug_regime.htm NewMediaExplorer.org] - 'Bush To Impose Psychiatric Drug Regime: Plans to screen whole US population for mental illness', Sepp Hasslberger (June 23, 2004)

* [http://www.news-medical.net/?id=3084 News-Medical.net] - 'Texas Medication Algorithm Project guidelines produce improvements in patients with major depressive disorder' (July 5, 2004)

* [http://www.newswithviews.com/Mary/starrett53.htm NewsWithViews.com] - 'Shut Up and Take Your Drugs', Mary Starrett (August 22, 2004)

* [http://www.newswithviews.com/NWVexclusive/exclusive32.htm NewsWithViews.com] - 'New Mental Health Program Alarms Parents in Illinois' (July 28, 2004)

* [http://www.ssricitizen.org/ssrilinkssub6.html SSRICitizen.org] - 'Unholy Alliance: George Bush Jr. And Big Pharma: The Texas Medication Algorithm Project'

* [http://zmagsite.zmag.org/May2004/levine0504.html ZMag.org] - 'Eli Lilly, Zyprexa & the Bush Family: The Diseasing of our Malaise', Bruce Levine (May, 2004)

[[Category:Healthcare]]

[[Category:Medical informatics]]

[[Category:psychiatry]]

[[Category:psychology]]

[[Category:Texas]]