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Feature Recruitment to drug trials

Investigating the fallout of a suicide

BMJ 2013; 347 doi: (Published 08 October 2013) Cite this as: BMJ 2013;347:f6039

This article has a correction. Please see:

  1. Edward Davies, US news and features editor, BMJ
  1. 1New York, USA
  1. edavies{at}

In 2004 Dan Markingson committed suicide while he was taking part in the CAFE psychiatric trial. Edward Davies looks at how his death has been dealt with

Almost a decade has passed since Dan Markingson committed suicide while taking part in the CAFE psychiatric drug trial at the University of Minnesota.

After years of pressure and countless fruitless personal and legal battles, however, campaigners still believe that his story is only half told and earlier this year launched a petition demanding Minnesota governor Mark Dayton independently investigate the case.1

The petition makes some grave allegations: “Evidence of fraud and serious privacy violations in psychiatric studies at the university have emerged,” it claims.

“It is possible that other research subjects have died or suffered serious injuries, or that they have been mistreated in other ways. Bioethicists at the University of Minnesota itself have called for an external investigation, yet the university still refuses.”

Nine years of struggle

To understand the most recent developments it’s important to note that many of the protagonists have been at loggerheads since Markingson first entered the CAFE trial in 2003.

Markingson began to show signs of paranoia and delusions in 2003, believing that he needed to murder his mother. He was committed to Fairview Hospital involuntarily after evaluation and was subsequently enrolled on a clinical trial of antipsychotic drugs. This study was a comparison of atypical antipsychotics for the treatment of first episodes of schizophrenia (the CAFE study). The study’s structure was that of a Phase 4 randomized, double blind trial comparing the effectiveness of three different atypical antipsychotic drugs: Zyprexa (olanzapine), Risperdal (risperidone) and Seroquel (quetiapine), with each patient to be treated for a year.

After about two weeks on study treatment in the hospital, Markingson was discharged to a halfway house. His mother, Mary Weiss, raised repeated …

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