Dr. Carlat received his undergraduate education at University of California, Berkeley and his medical degree at University of California, San Francisco. He completed his residency in psychiatry at Massachusetts General Hospital in Boston, from 1992-1994 and was chief resident of the MGH inpatient psychiatry unit in 1995. Currently he is an associate professor at Tufts Medical School and edits a monthly newsletter called the Carlat Psychiatry Report, which he founded. Carlat wrote a 2007 New York Times Magazine article about how he was paid to push the anti-depressant Effexor, to his colleagues. He indicated that he received cash compensation and stayed in luxurious hotels in exchange for persuading doctors to prescribe Effexor to their patients, using phrases like "drug whore" and "hired gun" to self describe his actions. He estimated he earned roughly $30,000 for his endorsements of the drug. Carlat has argued that psychiatry has been inconclusive about how and why it works: "We don't have any direct evidence that depression or anxiety or any psychiatric disorder is due to a deficiency in serotonin because it's very hard to actually measure serotonin from a living brain. Any efforts that have been made to measure serotonin indirectly — such as measuring it in the spinal fluid or doing post-mortem studies — have been inconclusive. They have not shown conclusively that there is either too little or too much serotonin in the fluids. So that's where we are with psychiatry.... In cardiology, we have a good understanding of how the heart pumps, what electrical signals generate electricity in the heart. And due to that understanding, we can then target specific cardiac medications to treat problems like heart failure or heart attacks.... not perfect, but pretty well worked out." Carlat was recruited by the pharmaceutical companyWyeth to promote the antidepressant Effexor as being more effective than other antidepressants on the market. According to Carlat, he started to question the research about the efficacy of Effexor and other antidepressants, and was soon dropped from the company's hired speakers. He wrote about this experience in an article entitled 'Dr. Drug Rep' for the New YorkTimes magazine. This article went on to be selected for Harper Perennial's Best Science Writing 2008 anthology and became the basis of his book Unhinged.
