July 28, 2006

The Usual Shit

I was interviewing a doctor today on a subject removed from mental illness. A nice change. Towards the end of our chat, we got into a short sidebar about alternative treatments for cancer. He made the point that while he could see the usefulness of medical marijuana that he felt it was inappropriate medicine because it is smoked (not always, but most of the time). His argument was that we should do nothing to encourage smoking of any kind in this country because of what he deemed were unacceptable side effects.

I went into skeptic mode for a minute just to see where it would get me. But we give patients all kinds of medications that have unhealthy side effects every day, in some cases for long periods of time, I pointed out, so what's the problem? He asked me for an example of a med that caused patients all kinds of problems.

Zyprexa, I said. And pointed out what is known about deaths tied to its use, its diabetes-inducing ways and so on. He paused for a moment. Then he said, "On the whole, Zyprexa is therapeutic."

I let that bit of mythology go. He's an important doctor, an internist by training, who was a major muckety-muck at one of America's top 10 medical schools and is, now, head of research at one of the nation's largest HMOs. I am not naming him here, because we really didn't get to flesh out what he meant and because I want the guy to talk to me again. The guy is what's known as a thought leader.

But let's put it this way: If you got 1,000 Zyprexa patients to testify before the FDA about the nasty effects of the drug, their opinions and experiences would be swept away in two minutes by a few sentences from this doctor. He's that big of a big shot.

Why aren't people like him listening to psych patients and being honest with what effectiveness studies are showing about Zyprexa and other pysch meds? Why hasn't the CATIE study sunk into the pronouncements of thought leaders? This isn't a minor question. Until people like him, in a position to truly influence the debate on health care in this country, get honest about what's up with meds, then we are fucked.

Or we are going to have to find another way to change the game without the help of him and his colleagues.

Posted by Philip Dawdy at July 28, 2006 12:01 AM
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Comments

"...we give patients all kinds of medications that have unhealthy side effects every day..."

That's probably one of the most intelligent arguments for the legalization of medical marijuana I've ever heard!

Posted by: Gwen at July 28, 2006 11:25 AM

Then get more than 1000.

Posted by: Stephany at July 28, 2006 06:03 PM

Hi, Philp. First, I'm an anti-smoking Nazi. Second, I would hand out cigarettes free to anyone with schizophrenia. Okay, I exaggerate slightly, but there's very good scientific evidence showing that nicotine action on the cellular level can clear up cognition. To remove a cigarette from someone with schizophrenia could be a breach of the "Do no harm" rule.

So here's the deal: With cigarettes - a few precious moments of cleared up cognition in return for risk of lung cancer. A reasonable choice for some. With Zyprexa - a miracle drug for some in return for risk of diabetes and certainty of a lot of metabolic crap. Again, a reasonable choice for some.

My guess is your internist contact is extremely naive. He works in a specialty where meds typically hit their main target with little or no collateral damge. An antipsychotic, on the other hand, works on a dozen targets at once, 11 which have nothing to do with getting us better. Thus, the high cost of doing business.

Yes, there are meds in other branches of medicine that can cause extreme side effects, but these tend to be the exceptions.

Some individuals may decide that Zyprexa is their best option. It's all about informed choice.

Posted by: John McManamy at July 30, 2006 08:04 AM

Per a personal 6 year study of ZyPrexa, and observations of the use of it with my daughter, ZyPrexa is no wonder drug, and possibly the reason she endured a most unfortunate agitated life until it's removal when she then suffered a near year long battle of psychosis, not to mention the 50 pounds she gained on a 5' 3" body frame, and all of this during the most influential years of a young person's life: junior high and high school.
What gave her a start to her life back, is the most recent addition of the old Gold Standard, Clozaril. It comes along with the worst side effects ever read about. But it is working for her, and I have had the pleasure of witnessing a miraculous return of a human being, that I have not had a conversation with, for 11 months.
A note regarding violence ON medication:
My daughter was the most violent while loaded up ON medications. ZyPrexa was one I suspected for years fueling that fire, due to the careful charting of dosages, I would see, and so would she, an increase of aggression per increase of dose.
When she was at a hospital in the Spring, they increased her ZyPrexa over the charts. She would show increased aggression on 10 mg and would have to back down to 7.5mg.
The hospital doc loaded her up to 30 mg and sent her home, where upon arrival, was the most violent she ever was in her life. She was a serious sick young woman ON medications, and I am so grateful she is alive due to the risky behavior while on this as well as other medication (like Haldol, yes, together!)
Regarding smoking and schizophrenic patients:
Give them the smokes and shut up. Unless been in a psych ward recently, don't even talk about 2nd hand smoke, that is completely not a problem compared to the need for a smoke at predictable and unfortunately not too many times during the day for some patients. I say it's part of the medication cocktail, and kudos to the staff and docs who make sure they get the smoke break. Though often times, due to internal events in a ward, the breaks are delayed, and this can cause such mayhem, that it was almost unbearable watching patients have to endure the wait for the smoke break. I actually filled in as a staff (I have some training per my own job to be able to handle any situation)with another staff member one afternoon at one hospital so everyone, including my non smoking daughter could go outside and get the break, this diverted a pretty big crisis in the ward that evening.
What ever doctor is unwilling to truly hear patients, and stories, about what psychiatric medications do to their brain, their bodies, and their spirits, in my opinion are close-minded idiots.
The information brought to doctors by patients is so invaluable, that it blows my mind that there are some docs (and Ive met quite a few myself)that do not believe in withdrawal syndromes or symtoms or mental side effects.
Swollen ankles, the shakes, abdominal pain, wanting to rip my skin off, inability to sleep, those are some extreme side effects to ZyPrexa use endured by me.
It was only the swollen ankles that got the doctor's attention.
It did not appear to alarm the doc, that I was laying across 2 chairs in the waiting room shaking so violently I could not walk into the exam room without assistance, form words, stop drooling. All I could get out was "You have me over drugged."
He saw my ankles and commented that edema was a side effect of ZyPrexa.
Thanks doc, really?
I have found one doctor that loves to have an open minded conversation with me regarding all of my out of box thinking per meds and reactions, but this doc also freaked out when my daughter walked into the office actively psychotic. I challenged him on that. I asked him why he was not interested in seeing a patient that he called his own, when the sickest , for a baseline? How else to find that "baseline" ? what to compare to?
One thing I have learned and encourage everyone to do:
Go see your psych when you feel good.
They have to see you and know you when well, so when you start to unravel or become ill, they can see it.
Make an appointment when you feel the best, it will be worth it if you fall down and need help later.

Posted by: Stephany at July 31, 2006 09:32 AM

I took zyprexa starting in 1996 the year the FDA approved it, which was ineffective for my condition and gave me diabetes.

Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?

Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

I was prescribed Zyprexa from 1996 until 2000.
In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.

All the psychiatrist I've interviewed and the information on line presents zyprexa as a worse offender than the other Atypicals such as seroquel.My doctor has stopped prescribing zyprexa altogether.

The PDR classifies zyprexa as 'severe' for causing weight gain and diabetes and seroquel as 'moderate'.

Of course the 50 year old Thorazine didn't cause diabetes and is many times cheaper but it could cause tardive dyskinesia.

Where Eli Lilly's negligence comes in,is their KNOWING and not informing consumers (black box warning) until the FDA demanded it.

Lilly's incentive not to readily disclose is they had billions coming in from state medicaid scripts.
----
Daniel Haszard http://www.zyprexa-victims.com

Posted by: Daniel Haszard at August 5, 2006 05:57 AM

I'm surviving the suicide of my mom -- and was prescribed Zyprexa to treat my bi-polar. I do believe STRONGLY in the power of anti-depressants to save lives, but atypical anti-psychotics have literally ravaged me.

Within days of increasing my dose of Zyprexa to 5mg, I had severe edema -- well over-the-knee, flu-like symptoms, severe shakes, and extreme urges to hurt myself. I also have 3 new cavities suddenly and wonder if that has anything to do with the 3 weeks I took Zyprexa.

A big symptom of my illness is "pea-soup brain" and the Zyprexa did get rid of that, but at overwhelming costs. It doesn't matter if the pea soup brain is gone if I suddenly start to self-injure, does it??

On the subject -- Seroquel gave me horrific TMJ and a host of other symtoms that have luckily gone away.

I'm still carrying around the 70 pounds I gained with the help of Depakote.

When I look in the mirror at the physical ravages from mental illness and the physical ravages from the anti-psychotic drugs meant to treat some symptoms -- the anti-psychotic drugs win, by far.

If we're looking at lethality issues, both seem to be killing slowly. Mental illness with depression, poor choices and general sense of hopelessness. The anti-psychotic drugs with morbid obesity and damage to all my systems. I almost went blind taking Abilify.

Of course, depression and bi-polar kills quickly, too. And for that, I'm lucky the drugs HAVE saved me. But, that's the anti-depressant class.

Europeans have a better outcome for their psychotic patients and interestingly, their anti-psychotic use is substantially lower.

Posted by: Sunnie at April 17, 2007 01:50 PM

Sunnie,
First, I am sorry about the loss of your mom. I just need to address your thought on increased dental cavities.
YES. My daughter has a dentist who has taken good care of her since she was small[she is 19 now]He made sure to take the time to tell me about how he has seen various patients with added dental problems who are on antipsychotics, and gave her rx of flouride toothpaste. I was impressed a dentist was so on top of this; and he also called her psych and alerted him. [she had a new cavity as well].Shes been on antipsychotics for 8 years.

Posted by: Stephany at April 17, 2007 06:02 PM

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