A few days ago, psychiatrist and industry gadfly Dan Carlat, who publishes a newsletter about drug research and marketing, wrote a first-person essay in The New York Times magazine about being wooed by Wyeth to pitch the Effexor antidepressant to other docs. His escapades in 2002, which earned him $30,000, ended when he had second thoughts about withdrawal symptoms and high blood pressures caused by the med. This mea culpa was widely read, prompting criticism that Carlat was an unethical hypocrite who should return the money. So today, Carlat writes on his own blog that he’s found a way that he hopes will allow him to compensate for taking the “dirty thirty.” We asked him to explain.

Pharmalot: Your story generated some heat. Were you were surprised?
Carlat: Actually, I expected some of it. I’m surprised more by the amount of comments I’ve gotten. A lot of it has been good. If you go to my site, you’ll see a lot of comments that are mostly congratulations for acknowledging what I did. A few wrote that I’m a hypocrite who passed myself off as an ethical person but then took money to go from function to function to talk about a drug that gave me pause.

Pharmalot: So now you’re going to do counter-detailing. What’s that?
Carlat: Essentially, I’ll be doing the opposite of what I did with Effexor, which was to give drug talks. Instead, I’ll be visiting different doctors, different practitioners in different places in the area (Carlat is based in Massachusetts) and try to educate them about direct-to-consumer advertising, evidence-based medicine and treatment options. It’s basically what Jerry Avorn at Harvard came up with and is trying out (in Philadephia).

Pharmalot: Why not just donate $30,000 plus interest? You think this will clear your conscience?
Carlat: Well, yes. It’s a way of paying back a debt, which is what you do about something you’re not proud of and want to reverse any damage you’ve done. I thought about the whole idea of giving back or paying back. I mean I never thought I’d be asked to do so. And then I wondered, you know, do I donate to a cause? That’s one way, but what’s the best cause? So I thought the most logical thing to do is to take the kind of time I put into getting the money in the first place and put it back by using that time to counteract what was done.

Pharmalot: So you’ll be going to doctors’ offices just like before. Who’s going to pay for the lunches?
Carlat: Well, essentially, I’ll be doing the same kind of thing I was doing before, only trying to bring some balance to the messages of the past. But I won’t be bringing any lunches. I guess we can all bring our own.