Atypicals For Everything

Apologies for the late posting today. I was working on a long, cranky, experimental post for today last night and it just wasn't quite there yet. But that's OK because CL Psych has run into something in a recent issue of Current Psychiatry that makes me cranky. That's this article concerning the use of atypical antipsychotics in absolutely everything other than schizophrenia. Yep, we're talking dementia, every flavor of bipolar disorder, anxiety, depression and autism. It's a big old atypical party out there!

The article appears to be aimed not at psychiatrists--who already know plenty about using these drugs--but at PCPs, who don't use the drugs as much. Despite Eli Lilly and AstraZeneca's best efforts to get them to treat the Donnas and Marthas of the world with their agents in a PCP setting.

It's exactly this kind of crap that Waxman's Congressional committee and the committee's investigators should be asking questions about. The evidence for use of these drugs short-term isn't especially robust--OK, they calm patients, but then what?--and there isn't much data to support their long-term use at all. Sorry, but I just don't buy the maintenance studies for Zyprexa and Abilify in bipolar disorder, especially with the wacky stats researchers like Lilly's Mauricio Tohen are using.

What's especially troubling about the article is that it barely tips its hat to the evidence that these drugs cause problems in patients. But whatever. Why would that be important?

I'll be back, likely, later today with some things that I think Waxman's committee should be looking into once it receives documents from Lilly and AZ.