Report: Low To Moderate Evidence For Atyicals Used In Schizophrenia And Bipolar Disorder

I noted recently, a federal government study found, after reviewing the scientific literature, that there was not enough evidence to support the off-label--ie, unapproved use--use of atypical antipsychotics. At the time, I mentioned that another government study had determined that only moderate evidence existed for using atypicals for approved use, primarily schizophrenia and bipolar disorder.

The study--OK, it's a report--by the Drug Effectiveness Review Project at Oregon Health & Science University can be found here. It's a massive document, so go to page 132 for this:

"The evidence is remarkable for its lack of real world effectiveness outcomes important for patients, those relating to social successes and economic independence....Very few of these [studies] studied such outcomes."

Given the hundreds--if not thousands--of trials of atypicals already performed over the last 15 years, it's amusing that no one has studied such questions. But, then, I have long contended that psych researchers have no interest in studying people who do well or in examining the hallmarks of true recovery. Big Pharma won't fund it and researchers aren't exactly asking them to either. After all, what could possibly be interesting about a well patient?

Even more interesting to my mind is that beginning on page 133 of the report, the authors outline the case for effectiveness (long-term) and efficacy (short-term-ish) of the atypicals in schizophrenia and bipolar disorder. Effectiveness for Abilify in schizophnreia? Very Low. Evidence for effectiveness of Seroquel, Risperdal and Zyprexa in schizophrenia? Low to moderate. And so on.

You say you want efficacy? Low to moderate in schizophrenia. Same thing in bipolar disorder.

Whatever evidence there is or isn't comes too late for many patients, including the thousands who've recently had their lawsuits against Eli Lilly settled for injuries suffered while taking Zyprexa. Yesterday, the Eugene Register-Guard, one of the country's best small newspapers, ran this article on one of the plaintiffs. Read it.

And people wonder why I bitch about the wonder drugs.