Atypicals Don't Work Much Better than Mood-Stabilizers Alone

As much as I bitch about psych meds on this blog, I would actually like to see them work well for people who take them. Here's more evidence that the Zyprexas and Risperdals of the world aren't nearly as efficacious as the pharma companies would lead us to believe. This journal article is a current study abstract (full-text not available) and it just isn't encouraging news for bipolars.

In the study, researchers found that rehospitalization rates within one year for bipolars were virtually identical, regardless of whether a patient took only a mood stabilizer (23 percent rehospitalized), a mood stabilizer plus an old antipsychotic (eg, Haldol; 27 percent rehospitalized), or a mood stabilizer plus either Zyprexa or Risperdal (both are atypical antipsychotics and 25 percent of patients in this group were rehospitalized). The abstract does not indicate which mood stabilizer was used. I'll update this information when I locate a full-text copy of the study.

Still, the findings are startling. The primary argument for adding costly atypicals atop of mood stabilizers is that the combination is supposed to be effective at controlling manic symptoms of bipolar disorder. I don't think anyone would defend a 25 percent rehospitalization rate as a sign of effective treatment.

This is further confirmation of the CATIE study. It's about time that psych docs, mental health advocates, social workers, policymakers and patients began to openly address the question of whether atypicals really make sense for bipolars, especially given the cost and side effect profile of these drugs.