A state mental health plan naming the preferred psychiatric drugs for children has been quietly put on hold over fears drugmakers may have given researchers consulting contracts, speakers fees or other perks to help get their products on the list, The Dallas Morning News reports.

The Children’s Medication Algorithm Project, or CMAP, was supposed to determine which psychiatric drugs were most effective for children and in what order they should be tried at state-funded mental health centers, the paper writes. In April, state health officials gave researchers the go-ahead to roll out the guidelines, but a month later, they delayed the protocol after objections from Texas Attorney General Greg Abbott’s office.

At most, the suspension indicates that state investigators fear fraud has occurred, according to the paper. At the least, the change reflects nationwide unease with potential conflicts of interest between leading medical researchers and drugmakers that fund much of their work. Publicly, officials say it’s because the state is suing Johnson & Johnson’s Jannsen unit for allegedly using false advertising and improper influence to get its drugs on Texas’ now-mandatory adult protocol, the Texas Medication Algorithm Project.

The focus of the investigation is unclear, but the probe into the adult protocol turned up allegations that drugmakers paid speaking fees to researchers who worked on the adult protocol speaking fees, and foot the bill for trips to market the Texas program. The researchers who designed the children’s protocol, who are not parties to the lawsuit over the adult drug program, insist they are motivated only by children’s health, according to the News, which adds no evidence has emerged to disprove that point and many have dedicated their careers to advancing child psychiatry.

At least four of CMAP’s key developers – all affiliated with the University of Texas system, and all of them published child psychiatry experts – have received research funding from drugmakers, or have been consultants and speakers for several different drugmakers, according to their own published papers and financial disclosure forms filed with the university, the paper writes. Drugs made by some of these manufacturers appear in the children’s drug protocol.

Graham Emslie, a UT-Southwestern psychiatry expert, tells the News that he never once witnessed improper influence from drug companies while he helped conduct CMAP research. “There’s much more influence relative to day-to-day prescribing” of drugs than there is doing university research or designing a protocol, he says.

The paper reports that these researchers developed the Children’s Medication Algorithm Project and received income or grants from drugmakers, according to their published papers and university financial disclosure forms:

DR. M. LYNN CRISMON: The CMAP project director who heads UT-Austin’s College of Pharmacy has received research funding or consulting dollars from at least 10 different drug companies, according to his published studies, including Eli Lilly, Janssen, and Pfizer. He said he could not comment on CMAP or the lawsuit.

DR. GRAHAM EMSLIE: The UT-Southwestern Department of Psychiatry researcher has consulted for several different drug companies, including GlaxoSmithKline and Pfizer. He has received research grants from at least three drug companies, including Eli Lilly and Forest Laboratories. University financial disclosure forms, where these drug companies are listed, report income in broad ranges. They indicate he may have made up to $125,000 from drug companies since 2004. He said the CMAP protocol was about evidence-based medicine, “not the [drug] the most recent representative told me about.”

DR. STEVEN PLISZKA: The UT Health Science Center in San Antonio scientist has received research funding from Cephalon and AstraZeneca and has served as a consultant and speaker for McNeil and Shire. University financial disclosure forms, where these drug companies are listed, indicate he has made at least $130,000 in drug company speakers fees and consulting contracts since 2002. Dr. Pliszka said he didn’t know CMAP had been delayed until a reporter asked about it. “For any physician, the bottom line is, does their patient get better,” he said.

DR. CARROLL HUGHES: The UT-Southwestern’s Department of Psychiatry doctor has received research funding from GlaxoSmithKline. University financial disclosure forms also indicate he was once an ad-hoc consultant for BioBehavioral Diagnostics, which designs equipment to test for behavioral disorders, and was awarded shares of company stock. He declined to comment.

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