seroquel as a mood stabilizer??? i'm disgusted, furious and saddened.

their sales reached 2.8 billion in 2005. enough already.

5-10 years from now i wonder how many patients taking seroquel will suddenly find themselves suffering from diabetes...

But if Seroquel does work for some people with bipolar disorder—as it does for me and for others in the study or even anecdotally—is it wrong for the company to get approval to use it thusly? (I love saying "thusly.") I don't trust AZ either; who trusts any big pharma? They're all pigs. But what's the worst that could happen from this? Patients ask their docs for it; docs prescribe it; patients say they don't like it/it doesn't work; end of Seroquel treatment for that patient. Seroquel was the only thing that ultimately worked for my psychotic depression, so I know I'm biased. But even if it only works half the time (for me, not for you), that makes it a valid treatment. It saved my life. I'd hate to forclose on that possibility for everyone else.

liz, can you tell me how criticizing how az will market the drug is foreclosing access to anyone? i have nowhere on this site called for seroquel not to be approved for anything. i think it's decent stuff for short term use. i think it is damn good for mania, psychosis and short-term treatment of depression ( i use it for the latter purpose for a day or two perhaps once or twice a year). i believe that its use long term is overkill in most cases, given its side effect profile, one that is right up there with zyprexa in some respects. my opposition to it being marketed as a mood stabilizer is that will open the door to its becoming the 'go-to med' much as lithium and depakote have been in the past. but again, i am trying to make a distinction between short-term and long-term use of seroquel. it's a distinction i have been making for a year and i don't necessarily make that distinction each time i post on the topic.

other than the med's effects in long-term use, i don't think there is any evidence about this drug's effectiveness in long-term use other than the catie study. and we all know what the catie study showed. we have a huge problem with docs, families, adovcates and american society in general pushing patients to use very aggressive medication for the long-term based upon 8 to 12 week studies. that's a completely unacceptable situation, and not just in the academic dorky sense, and it makes me skeptical as hell of how seroquel will work as a long-term maintenance med. i will remain skeptical until i see long-term studies of its use in bipolar disorder.

i would be a bit more comfortable with docs' enthusiasm for this med if patients had a lot more power and free choice. patients are not empowered to push docs and their families on what meds they take and what the evidence is for their use long-term. as things stand now, when a patient pushes back or claims that they dislike their meds, they are often pushed by their docs to consider that they are off-base and their families become wildly upset at their beloveds' motives.

i don't think it is too damaging on my part to nit-pick every bit of marketing and evidence used to advance the 'seroquel as mood stabilizer' hoopla. that's my job as a journalist. i am tired of pharma companies and researchers on their payroll completely flooding the playing field with their rhetoric and 'expertise' while the media swallows it wholesale and skeptical patients have no effective way to push back and are doubted when they do.

Okay, I see what you're saying about the short-term vs. long-term issue. I didn't fully grasp that aspect of what you were saying.

I suppose the reason I am tempted to support its approval for bipolar—and marketing it as such—is because there are some pdocs who won't prescribe it off-label. And if it's more broadly marketed, patients will be more aware of it, which isn't necessarily a bad thing.

I have confidence that most consumers are savvy enough to understand that big pharma markets all kinds of crap in an advertising-savvy way. I don't think many people see TV commercials about meds and believe them, especially after so many pop culture spoofs.

But maybe I'm being naive. I mean, of course AZ's primary motivation is to make money, which is why they've been reluctant to label Seroquel in the U.S. with appropriate advisories about the diabetes risk.

I didn't mean to imply you were trying to limit access. I guess I'm just trying to tease out my own assumptions and continue the dialogue.

i too am trying to tease out my own thoughts on all of this so i appreciate yours. i am not silly enough to say that people believe phamra ads, at least not the tv ones, but my point isn't so much the possible tv and web ads for seroquel. when i say marketing, i mean that their sales reps will be able to march up a very busy doc and say 'hey seroquel is the new lithium.' legally, they cannot do that right now. what's more the more these studies become spun out as being highly positive when their results are mixed, the easier it is for media outlets like ap and reuters to write a 'seroquel rocks and it's just like lithium' article, which will then be reprinted in papers around the country, and will also find its way onto those little 'health shorts' that local tv news favors.

that's why the marketing is important.

Seroquel will always be available for off-label use. Studies are not at all convincing that it will work for mood-stabilizing purposes. In fact, studies show that most people go off of ALL psych meds and onto something else eventually because NONE of them work beautifully or consistently over the long-term. Marketing it as a mood stabilizer will give people false hope. Also, Seroquel tends to be more sedating and numbing than most of the atypicals. How many patients in extreme depression or extreme mania can make an informed decision about whether they should try a drug many times known to have side-effects worse than the illness when they aren't in the best decision making place of their lives to begin with? The marketing of it as a mood stabilizer will influence people to try it. I'd sure like to tell people about the memory loss, the 80 pounds I gained in a year's time, the nightmares, and hand tremors I experienced when a doc tried to use it in mood stabilizing dosages as opposed to adjunct doses to help me sleep. As we all know, doctors can still prescribe this in an off-label context to their hearts content. Marketing and approval for something that, at best, will work TEMPORARILY, and then only 50% of the time seems like a prescription for false hope. When you're down and out and looking for an answer, you'll cling to anything -- even if it is marketing by a big pharmaceutical company that you otherwise know has an agenda. Is that the kind of options we want?

P.S. Here's an article that should be mandatory reading, and maybe most of you already have, before taking any atypical in large doses.

The Drugging of the American Mind
http://www.seattleweekly.com/news/0548/051130_news_psych.php

I thought I'd try Seroquel as an alternative to lithium this summer when I had to go off my lithium for a time. A friend swore by it and when I saw the big box in her house I wondered if it might be right for me. I was off my lithium for a time - tooth thing requiring meds that don't mix.

At first I liked Seroquel. It was very calming. But when I reached the theraputic dose I might as well be singing The Ramones, "I wanna be sedated". Even that was ok with me, bad as I am - though over the months it may have become old. Or maybe I would have learned to cope with it.

But then my pdoc wanted me to combine it with my lithium. Seasick city, swimming through jello, unacceptable. I'm just back to my lithium, which my pdoc says has antidepressent qualities. I don't know. Lithium works for me and it's cheap.

However, my London friend swears by Seroquel. And she is a tremendously active woman! For some people, it must work. I think it is good to have choice, just to be certain long term effects are not undesirable.