May 10, 2007

My Doctor Is A Pharma 'Ho And Atypicals For Teens

About six weeks ago, a reader tipped me that the New York Times was poking around on a story about Seroquel set in Minnesota. That story is out today--by Gardiner Harris, Ben Carey and Janet Roberts--and it is kick ass.

I won't summarize or quote from it much as I am limiting my writing time, but it's more about Risperdal than Seroquel, it's got all the usual off-label marketing issues afoot, including docs getting paid to pimp for the product and then prescribing it for kids and teens many more time than the average psychiatrist, some establishment psych docs make noises about how this is unacceptable, and there's quite a bit about how Risperdal screwed up the muscles in a teen's back. And even more. Like docs making around $200,000 a year whining about not making much. (Nice touch by the paper!)

I know Risperdal screwed up the muscles in my face for a time and that Seroquel made my back twitch and tighten (and I've begun to wonder what role that wonder drug's hangover may be playing in my current chronic back situation), so I am glad to see the paper treating this as an important injury caused by the drug. My hunch is that the atypicals as a whole do all sorts of things to peoples' bodies that we don't appreciate. Looking back, I swear the muscle tension I got in my body in late-2004 was an advance sign of the tardive dyskinesia later caused by Seroquel in 2005. There is weird shit up with these drugs.

As much as I appreciate the Times' reporting on atypicals and kids and teens and whatnot (and all that Zyprexa stuff as well), I think they are missing the even bigger story. That would be atypicals in adults for mild mood complaints and sleeping problems. The use and off-label marketing of atypicals for such people is just as monstrous as it is elsewhere. And really drove sales in a way that the kids didn't. They should also be taking a look at how Seroquel became a drug of abuse (it's a minor street drug these days) and problems real world patients have run into developing an apparent tolerance to the drug.

Posted by Philip Dawdy at May 10, 2007 12:07 AM
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Comments

I have to totally agree with Phillip's assessment. When I got ill, several of my "friends" who are also psychiatrists, told me to try, Risperidone and/or Seroquel. I asked them if they thought I was psychotic, or had psychotic symptoms. They said NO. I said then WHY prescribe this for ME???? They said, well, we are using it now, for hypomania... I declined and was unhappy with the suggestions.

Since the Cymbalta made me sicker than any medication I had ever taken, I was very wary. Luckily I was able to slide by that one.

I am VERY concerned about the use of the atypicals for off labe reasons. I am praying that serious bloggers like yourself, are noted by the powers that be, and maybe, just maybe, someone will put a stop to this.

Is it any surprise that I was offered these medicines? All the MDs who told me to take them, get funding from PHARMA, and probably would not practice in academia, if they could NOT supplement their incomes giving PHARMA talks and serving on their panels.

I asked each of the MDs if THEY had ever taken Risperdal or Seroquel, and felt the SIDE EFFECTS themselves... of course.. NO.

Your muscle problems had showed up many times in the data that I examine. I think someone should look into this side effect, that is often washed under the table, when these are compared to the typicals.

Posted by: Dr. Black Kitty at May 10, 2007 06:26 AM

I try and tread lightly when prescribing atypicals. They are not to considered casually. I know; I'm a child psychiatrist.

Thanks of the remark that Seroquel is now popular on the street. I didn't believe it when I heard it.

And no, I would NEVER use an atypical just to treat insomnia or mild mood problems.

Posted by: DocMalk at May 10, 2007 07:30 AM

This same article could have been written about adults, my question is why it never is? It seems as if the mainstream media can't wrap their head around the fact that psychiatry does not have safe and effective drug treatments for adults with psychiatric diagnoses. I believe that if they faced that fact it would be too threatening to their belief that the problem lies in us, that we are non-compliant or treatment resistant or just unpredictable, rather than that we are faced with very bad choices when we look to psychiatry for help.

Posted by: Alison at May 10, 2007 08:39 AM

I agree with Alison. I have tried SO hard to find a chemical cure for myself, given that I code drugs all day, and have done numerous PHARMA studies. I can't find one that works. I don't want to be fat, dull or shakey. I don't want my feet to shake by themselves. I don't want to have fecal leakage due to my meds.

All I can say is, if this is the best... there is tons of room for improvement. I believe, that the only way we will EVER get improvement, is to have all the psychiatrists, TRY, a dose (an actual pill) of some of the meds they give out so casually.

Posted by: Dr. Black Kitty at May 10, 2007 12:31 PM

You wrote: "I've begun to wonder what role that wonder drug's hangover may be playing in my current chronic back situation."

This rings a bell. After I had my dose of chlorpromazine increased as a teenager, my entire neck and face and especially my jaw seized up. I couldn't open my mouth, and it felt like I couldn't breathe. Of course, this is a well-known side effect of the older anti-psychotics, but the apparent difference in the side-effect profiles of the 'dinosaurs' and the atypicals has a lot to do with experimental jiggery-pokery, and... more than ten years later, I still can't open my mouth more than a few centimetres.

"Ruth never made it as a White House intern..." :(

Posted by: Ruth at May 10, 2007 10:05 PM

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