October 12, 2006

Zyprexa, Seroquel And Risperdal Really Do Suck

Wow. Let me just quote from the lede to the New York Times article on this:

"The drugs most commonly used to soothe agitation and aggression in people with Alzheimer’s disease are no more effective than placebos for most patients, and put them at risk of serious side effects, including confusion, sleepiness and Parkinson’s disease-like symptoms."

Here's a quote from the study's conclusion:

"Adverse effects offset advantages in the efficacy of atypical antipsychotic drugs for the treatment of psychosis, aggression, or agitation in patients with Alzheimer's disease."

The drugs in question were Zyprexa, Risperdal and Seroquel.

I know that I have made myself unpopular in the mental health community for saying harsh things about atypicals over the last year and that some psych researchers are pissed at me over this article in which I lashed out at docs for so aggressively pushing atypicals on bipolars. But, in that same time period, we now have three major studies establishing that atypicals are not nearly as benign as the psych world has been saying for the last decade—they called them the silver bullet for schizophrenia.

First, there was the CATIE study. Then the recent British study showing that the atypicals are no better for schizophrenia, in a clinical sense, than older antipsychotics, same as the CATIE study asserted (I haven't written about this one yet because I have been juggling too many other things, but will get to it soon and especially NAMI's bizarre response to the study). And, now, we have this new study on their inability to perform better than placebo in treating much the same symptoms they are used for in bipolar disorder (agitation and rage) in elderly patients with Alzheimer's—plus they have unacceptable side effects as well. In addition, there are numerous other studies establishing that these newer, very costly antipsychotics aren't very effective at all.

So, it looks like I was right to be banging on these meds.

Nonetheless, the FDA just approved Risperdal for use in children with autism. And it's an open secret that atypicals are being used aggressively in children diagnosed with bipolar disorder. Plenty of teenagers and adults take them as well—even more as a matter of fact.

I wonder how far away are the journal studies establishing that Risperdal has intolerable side effects for autistic kiddos? Then again, why are we waiting?

I made the assertion in my article "The Drugging of the American Mind" (my editor picked that headline) that doctors were side-stepping their ethical responsibilities in so aggressively prescribing these meds to patients. I cringed when I write those words last November because I found it difficult to say such a thing about a profession I respect plus I knew I was way out on a limb, a voice of one in the wilderness if you will. Now, I must call into question the ethics of using these drugs on a long-term basis (ie, every day, forever) in patients of every stripe. They are costly (10 times the price of an older antipsych), have miserable/dangerous side effects and don't perform better than older meds (which are no party themselves when used long term). I can no longer see the justification of prescribing these meds to patients outside of short-term crisis use with the exception of their use in schizophrenia (tragically, there are no other options there except the older antipsychs).

It is time for the medical profession to do some soul searching and grow a pair of balls. Also, it is time for the pharma companies to dramatically slash the price of these meds for the schizophrenics who need them since they work no better than the older, cheaper drugs. Fair is fair.

Too bad patients don't have more market power. But doctors have tons of market power and it's time that the thought leaders in the psych field stood up for their patients, boldly and publicly, and attempted to stem the tide. They did it against the tobacco companies, so why not here?

This is an especially crucial time for such a rethink, since the FDA is on the verge of approving Seroquel for use in bipolar depression, which would allow the company to actively market the drug as a "mood stabilizer" a la Lithium. Zyprexa is already approved that way—and we know just how much that has helped patients.

Our minds and brains and bodies are being fucked with here people. It's time to hold the psych profession and the pharma companies and the FDA and the mental health advocacy groups accountable. And, just to be clear, that statemnt comes from someone who embraces psychiatry as a whole, respects the mental health advocacy groups and knows that the pharma companies are not supposed to be moral actors in any way. I ain't no Scientologist or anti-psychiatry advocate. I just feel like one in light of news like today's.

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

Your voice only added to mine in that wilderness of trying to drive home to docs for 7 years.

Of course my writing is all throughout this blog re: each one of those APs, especially Zyprexa.

My daughter was never a raging child, up to age 11, until she went on Zyprexa. For years I tried to convince docs to look at zyprexa's own fact sheet per the side effects being exactly the symtoms she was having, and it has been documented in their files, that doses higher than 7.5 mg of zyprexa agitated her.

Sent home from Western State on a whopping 30mg a day. Need not to say more about the events happening on that.

Yes, keep pushing the docs, I am.

I also have pushed since May 2005 to about 9 pdocs, that she may not be able to come off of APs at all, and that thinking outside of the box, the antipsychotics could be creating and did create psychosis, and now her brain can't live without them.

No one wants to talk that talk.

Yes, also, everyone read the fine print of Philip's post here: autistic kids are being medicated with risperdal among other meds, for one sole reason: agitation. Guess what? I have seen it get worse, when they trial these meds, and they are as young as 10 years old.

Posted by: Stephany at October 12, 2006 07:48 AM

Hey Phil- great piece. I was happy to see the atypicals so openly submitted to criticism. Have you noticed how quick journalists and doctors are to discuss the side effects of drugs when they aren't used to treat a mentally ill population? Because the elderly aren't considered the "threat" to society that the mentally ill are, I think PC journalists and docs are more willing to discuss the negative aspects of the drugs used to treat them (not that the elderly aren't terribly mistreated and marginalized in our society). It's part of the whole acceptable discourse: "yeah there are minor side effects to psych drugs but nothing is worse than mental illness."

It makes me sad when people with mental illnesses internalize that rhetoric: "oh I used to be creative or thin or healthy or sexual or energetic but now I'm not but i'm properly medicated and it's a small price to pay." On the one hand it's completely understandable. But nobody deserves to lose their health or personality at the expense of drugs one is to take for life-sustaining "maintenance" forever. I think we should be demanding drugs that don't have life-nullifying side effects along with more holistic approaches to treatment. you know, treatment "plans", not just drugsdrugsdrugs.

i remember sitting in this group therapy session once. about half of us were on seroquel, among other drugs. we were complaining about how we were having a hard time as some of us were sleeping 14 hours a night and having trouble being productive during the day because we were so sedated all of the time. there was a psychiatrist there, a bp expert. he admonished us, "you guys have to think about why you're feeling so 'sedated' all the time. is there a relationship you're trying to avoid by staying in bed? is it homework? what avoidant purpose does it serve for you to blame these meds?" this stuck with me because it's a perfect example of a doctor-an "expert"-advocating for pharma and not for patients. there's a severe disconnect there. that's why i don't venerate medicine like i did before. also because my friends who are in medical school did worse in science classes than i did and struggle with material or flunk the occasional exam the way anybody else in professional school does.

i agree completely with john mcmanamy about knowledge being your best weapon, sometimes even against your own doctor.

Posted by: Lily at October 12, 2006 03:03 PM

Recent studies have found that atypical antipsychotics used to control agitation in aggressive Alzheimer patients (chemical straight-jacket) have unacceptable risk.

At 5 to ten times the cost of the old standby thorazine,recent comparative studies show the diabetes inducing zyprexa class of drugs are only borderline better in controlling symptoms.

WOW zyprexa is a WORSE offender for causing diabetes than risperidone.

My clinical contacts in the mental health field right here in Bangor Maine tell me that they have stopped prescribing zyprexa altogether.

This is interesting,as i thought that all drugs of a certain class had the same molecular makeup (eg asprin) and were just the same drug family marketed to get around patents.

This must be wrong as zyprexa is being reported as more dangerous than than the other atypicals.

WOW

Daniel Haszard Bangor Maine http://www.zyprexa-victims.com ~ zyprexa caused my diabetes

Posted by: Daniel Haszard at October 14, 2006 06:48 AM

Wierd!!! Are any of you bisexual? I just told someone that I was and she's like, "you should come up to my room." I'm not bisexual though.

Posted by: Gwen at October 14, 2006 11:24 PM

We DO have market power.

The best way to get in the face of big pharma, is to befriend it/them.

The way you start, is simple. With the drug reps. They are not just found at conventions. They walk into the docs offices on a daily basis, and if you catch one on their way out the door, it's an easy conversation to have while going down the stairs, in an elevator or on the way to the car....

TELL them how YOU feel on X medication.

Trust me, they may be sharks, but what stops the consumer from being one too?

Change cannot happen without movement.

I am one of those people who looks for opportunities, and who better to hear the Seroquel fog stories, than the drug rep handing out samples?

A consumer can take action, or a consumer can sit and wait for someone else to do it for them.

If one chooses to sit on the sidelines, then the wait will be that much longer for a quality of life on medication that we dream about; this stuff is not accomplished by dreaming.

If every person reading this website today, reported every fine print detail to the FDA medwatch site (regarding side effects large and trivial sounding)that gives the people doing the studies more detailed information to start.

Then, if every person reading this website took some sort of real action:
Such as:
Write a letter to your Governor. Write a letter to your psychiatrist. Tell friends what it takes to get up every day and exist on these meds. Meet a pharma rep (they aren't hard to miss, they were suits and carry free notepads and pens! get some! then you can take notes and get something for free, gotta make it win/win)..

and speak up. Speak up to anyone who will listen.


Posted by: Stephany at October 15, 2006 12:58 PM

I am just wondering if you have ever been lying in bed completely unstable, and your beautiful 3 year old child climbs in bed, lays down, snuggles into the crook of your neck and whispers "Mommy, please make the voices go away"?
We all need to work together. None of the meds are perfect. But the alternative certainly is not either. - S

Posted by: Sadie at October 16, 2006 11:41 AM

Sadie,

My daughter was 11 when she said that to me.
Hang in there. Your daughter will be one that I think of now when I fight the fight.
Take care,

Stephany

Patient/Consumer
Mother/Advocate

Posted by: Stephany at October 17, 2006 08:33 AM

I acutally really like having schizophrenia. If I didn't have it, I wouldn't be friends with Philip, I woulnd't see my doctor, I wouldn't have met some really nice people throughout the years, and I wouldn't be the writer that I am. I know not everyone likes having schizophrenia, but for me, it has really made my life a lot better.

Posted by: Gwen at October 17, 2006 11:31 AM

My nephew is autistic and the idea of him taking Risperdal makes my skin crawl. It is on my list of "I will not take this" drugs. When I get a new doctor they always get upset with me because I come prepared with a list of drugs I have taken and why I stopped and a list of side-effects I refuse to put up with.

Drugs like Zyprexa and Seroquel turned me into a zombie - I was either asleep or on the edge of sleep 24 hours a day. I was in the mindset of "the cure is worse than the disease" because I had no life.

Thanks for a very frank and informative post.

Posted by: Crazy Fat Chick at October 17, 2006 02:23 PM

I am a professional who works with autistic kids. Hang in there 'chick', and thank you for watching out for your nephew.

It is very hard to see children I teach change, and become agitated, and find out that 'change' also went hand -in-hand with a risperdal addition.

Risperdal especially, is becoming a 'favorite' to 'settle down' autistic kids, who are basically just growing up.

Best,
Stephany

Posted by: Stephany at October 17, 2006 09:06 PM

I have taken Zyprexa since 1997. Unfortunately, it is the only atypical antipsychotic that works for me (stops agitation and psychosis.) Also unfortunately my weight zoomed from 93 lbs to 180 lbs in record time. I now have high cholesterol and high blood pressure and my pdoc says the cholesterol level will not come down (even with modified diet and exercise) as long as I take Zyprexa. He will not try typical antipsychotics.

Posted by: Donna at October 29, 2006 09:30 PM

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