March 01, 2007

Interesting CATIE Finding, And Another Example Of Analyst Cognitive Deficit Disorder

Some of you remember the landmark CATIE study which has established, to date, that atypical antipsychotics are little better than older antipsychotics at treating schizophrenia--an epic hype-busting finding that was--and offer no cost-benefit boost versus the older drugs. In the new issue of the American Journal of Psychiatry comes a fresh CATIE sub-study. It examined time to discontinuation for study subjects who stopped taking--and this was with a doc's consent--the old antipsychotic perphenazine and were randomized to either Zyprexa, Risperdal or Seroquel.

Oddly enough, Seroquel won (patients stayed on it for 10 months, discontinuation approved by docs), Zyprexa was second (7 months) and Risperdal trailed the pack at less than 4 months. I haven't obtained the entire paper, so I cannot say why specific patients went off specific drugs.

Beyond all its other findings, CATIE has established just how much antipsychotics, and especially the "wonder drugs," profoundly suck for the patients who take them. Not that that's a news flash to anyone outside of academia and Big Pharma. I am looking forward to the day when the AJP gets really honest and publishes my forthcoming double-blind, peer-reviewed, randomized, gold standard paper entitled "Antipsychotics Totally Blow For Schizophrenics, So Why Push Them On Bipolars Too?"

Speaking of "gold standard," yet another market analyst consortium is showing signs of analyst cognitive deficit disorder. The same day the above paper came out, Decision Resources announced its exciting new analysis: "Eli Lilly's Zyprexa Will Remain the Clinical Gold Standard for the Treatment of Schizophrenia Through 2015." And the CATIE study just said what?

"Analyst Cognitive Deficit Disorder is a crippling illness and carries profound social stigma," said Dr. Brutus Pumpaloaf, chair of the department of psychiatry at Blowjobium University Medical School. "ACDD can only be effectively treated with Zyprexa at 30 mgs. twice a day. We call that the 'clinical sledgehammer standard,'" said Pumpaloaf.

Posted by Philip Dawdy at March 1, 2007 12:01 AM
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Comments

For the love of god and all that is holy!!!

Given that (a) the FDA is toothless at best and (b) doctors exhibit a mindless uncritical groupthink that rivals the Heaven's Gate cult, I am beginning to wonder if the Securities and Exchange Commission (SEC) might be the best route to stop some of this idiocy.

This "analysis" is technically from an independent consortium and therefore the disclosure requirements would not necessarily apply, but if I were a Lilly shareholder I would have to be a bit perturbed by the disconnect between the "science" and the "market science."

I'd probably need some Cymbalta for my depression-pain . . . [sigh] . . .

Posted by: Morris Berg at March 1, 2007 07:00 AM

The only time I have ever heard the word "gold standard" was in regard to Lithium and Clozaril.

I've spoken to quite a few psychiatrists (in the last year inpatient house docs in psych wards as well as long-term residential care facilities) on behalf of a family member.As a matter of fact, the long-term residential facility psych doc told me (July 2006)that 60% of his patients are on Clozaril(and free of a state hospital as a result.)

Not one psychiatrist referred to Zyprexa as a "gold standard". As a matter of fact (Lilly readers)Zyprexa was replaced with Clozaril and Lithium.

I have a nearly 8 year home-study (my kid)that is proof Zyprexa is no wonder-drug or gold standard.

Posted by: Stephany at March 1, 2007 08:29 AM

An observation I made:

DR when comparing atypicals for schizophrenia, left Seroquel out and hailed Zyprexa as the "gold standard" for the illness. On the flip side, when DR compared atypicals for bipolar disorder, they left Zyprexa out and hailed Seroquel as the second coming to surpass Lamictal.

Hmm... Those thought-leading psychiatrists must have been swayed by a generic drug name dinerovox.

Posted by: Marissa Miller at March 1, 2007 08:55 PM

Actually, "gold-standard" was another term that was revealed in patent literature regarding insulin. As scientists sought to "prove" the value and need of rDNA genetically-engineered insulin, the patent literature stated that "Beef Ultralente Insulin" was the gold-standard for basal insulins"--the only insulin that provided 24-36 hour basal coverage without a peak.

Need I tell you which--of all the natural insulins Lilly has removed from the market--was the first to be pulled from the American marketplace? Beef Ultralente. For more than a decade, now, Type 1 diabetics have had the "choice" of using pump technology (both expensive and problematic) or try to cover basal insulin needs with peaky insulins.

As I've mentioned before in Philip's columns, Lilly's marketing technology was defined and refined using their rDNA insulin promotion! Zyprexa is only their latest and greatest "success."

Posted by: Melody at March 4, 2007 05:04 AM

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