In this episode of Power to the Patients, Brandon Li speaks with Dr. Lara Shirikjian, board-certified psychiatrist and Medical Director at CenExel, about what it truly takes to build effective, ethical, and scalable psychiatric research programs. Drawing on over 20 years of clinical and research experience, Dr. Shirikjian shares how operational rigor, deep protocol understanding, consistent site execution, and proactive communication directly impact study quality, placebo response, and patient retention.
She explains why schizophrenia trials demand thoughtful wraparound support, strong community provider relationships, and clear boundaries between therapeutic care and research participation. The conversation also explores the often-overlooked operational realities sponsors face — from protocol complexity to CRO bottlenecks — and why direct PI-to-sponsor communication can dramatically accelerate problem-solving.
What You'll Learn
- Why operational consistency plays a critical role in minimizing placebo response in psychiatric trials
- How a protocol-first mindset reduces complexity and improves study execution
- Why direct communication between sponsors and principal investigators speeds up issue resolution
- How wraparound services improve retention in schizophrenia research without compromising study integrity
- The importance of planning for post-study patient restabilization before enrollment begins
- How research sites can build trust with community providers and unlock sustainable referral networks
- Why human judgment and site leadership remain essential despite advances in technology and AI
- What sponsors often underestimate about running high-quality psychiatry and CNS trials
Episode Highlights
- [00:48] Intro: From research assistant to principal investigator
- [03:13] Mastering protocols, endpoints, and outcomes
- [04:19] The placebo effect problem in psychiatry trials
- [08:01] Growing from a small site to a large research network
- [10:02] Administrative burden, compliance, and hidden inefficiencies
- [12:12] Recruiting the right patients and avoiding "professional subjects"
- [15:45] Why psychiatry research still needs humans, not automation
- [19:54] Why schizophrenia research still matters most
- [24:10] Supporting patients without crossing ethical lines
- [26:29] The broken relationship between community care and research
- [30:26] Who owns patient care after a trial ends?
- [36:20] Closing thoughts: What needs to change in the next 10 years
