How Do the Meds Actually Work? Posted on November 21, 2007 His questions about a drug's effectiveness led Michael J. Ostacher (bio) to a research career.

I think it’s really honestly somewhat of an accident that I ended up in bipolar disorder research. I was originally in my clinical work mostly treating people with schizophrenia and schizoaffective disorder. And people who have had addictions also. So my main clinical work and administrative work was in severe mental illness and dual diagnosis.

So I worked in a detox. I treated outpatients with schizophrenia and multiple substance use disorders. And so I was primarily interested in studying that population. And it was only because there was a position available at the bipolar clinic working as a clinician in STEP-BD, the Systematic Treatment Enhancement Program for Bipolar Disorders.

They needed somebody to see patients. And I was interested in leaving my clinical position in order to do that. The reason that I wanted to leave originally, and this is something that still drives me in part, a lot of my colleagues were treating patients with medications. And I for the life of me couldn’t find any information out about how they determined that those medications actually worked for the problems they were using them for.

And so I was really concerned frankly that I was in a field where people were just making things up as they went along. And it was really uncomfortable for me. And so there was one drug in particular called Gabapentin that was being used as a treatment for bipolar disorder. And it continued to be used as a treatment in bipolar disorder, even after studies had demonstrated that the drug didn’t work and in fact in some cases made people worse. Yet people were still prescribing it.

And so I had this drive in part to leave my clinical work and go into research, and it was just fortuitous that I was in bipolar disorder.

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