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The '''Texas Medication Algorithm Project''' ('''TMAP)''')<ref>[{{cite web|url=http://www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm DSHS.state.tx.us] - |title=Texas Medication Algorithm Project (official site with algorithms etc), |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 decision-tree [[medical algorithm]], the design of which was based on the expert opinions of mental health specialists. It has provided and rolled out a set of [[psychiatry|psychiatric]] management guidelines for doctors treating certain mental disorders within [[Texas|Texas']] publicly- funded [[mental health]] care system, along with manuals relating to each of them. The algorithms commence after diagnosis and cover pharmacological treatment (hence "Medication Algorithm"). TMAP was initiated in the fall of [[1997]] and the initial research covered around 500 patients.
==History==
In [[1994]] MAP was mentioned as an example of a successful project in a paper regarding implementing mental health screening programs throughout the [[United States]], by the President's [[New Freedom Commission on Mental Health]]. 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 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]]. 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 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.
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>
The companies which produce and market the drugs(1) recommended as standard treatments were consulted and assisted in the production of the guidelines.
▲In [[1994]]2004, MAPTMAP was mentioned as an example of a successful project in a 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 ]]''.
Similar algorithms and prescribing advice have been produced elsewhere, for instance at the [[Maudsley Hospital]]<ref>[http://www.mhc.com/Algorithms/AlgoLinks.HTML] Lists of Psychopharmacology Algorithms. Compiled by David N. Osser, M.D. and Robert D. Patterson, M.D. (viewed 17 March 2006)</ref>, London. ▼
▲Similar algorithms andwith 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 . Compiled by |first1=David N. |last1=Osser , M.D. and |first2=Robert D. |last2=Patterson |accessdate=March 17, M2006|website=Maudsley Hospital|url-status=unfit|archive-url=https://web. Darchive. org/web/20010626062649/http://www.mhc.com/Algorithms/AlgoLinks.HTML|date=May 1, (viewed2001|archivedate=June 1726, March 2006)2001}}</ref> , London.
==See also==
* [[Allen Jones (whistleblower)]]
* [[Anti-psychiatry]]
* [[Biological psychiatry]]
* [[Bruce Levine]]
* [[Evidence-based medicine]]
* [[International Center for the Study of Psychiatry and Psychology|ICSPP]]
* [[Sally Satel]]
== References ==
<references/>
==External links==
* [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)
* [http://www.mindfreedom.org/mindfreedom/bushpsychnews.shtml MindFreedom.org] - 'President Bush and the Shrinking of the USA' (press release)
* [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)
== Footnote ==
1. [[Risperdal]], [[Zyprexa]], [[Seroquel]], [[Geodon]], [[Depakote]], [[Paxil]], [[Zoloft]], [[Celexa]], [[Wellbutrin]], [[Zyban]], [[Remeron]], [[Serzone]], [[Effexor]], [[Buspar]], [[Adderall]] and [[Prozac]].
[[Category:HealthcareHealth informatics]]
[[Category:MedicalTreatment informaticsof mental disorders]]
[[Category:psychiatryDrugs in the United States]]
[[Category:ClinicalMental psychologydisorders screening and assessment tools]]
[[Category:Texas]]
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