November 06, 2007

Antipsychotics Deemed Ineffective Alzheimer's Treatment

A new study in this month's Archives of General Psychiatry asserts that atypical, or second generation, antipsychotics used in patients with Alzheimer's disease produced about the same results as did placebos in the same patient cohort. Which is to say there were no results. The atypicals in the nine-month study were Zyprexa, Seroquel and Risperdaal. Some patients also got Celexa, an anti-depressant. Others, of course, got a placebo.

The study was part--and one assumes the final part--of the federally-funded CATIE study, which established two years ago that atypicals were no better than older antipsychotics in treating schizophrenia. I haven't gotten the full paper yet, but here's the abstract's conclusion:

"There were no differences in measures of effectiveness between initiation of active treatments or placebo (which represented watchful waiting) but the placebo group had significantly lower health care costs."

If this doesn't make readers shake with rage, then please go back and read the conclusion again.

We've been doping up old folks suffering from the agitation and wildness of dementia with atypicals for the last ten years or so because Eli Lilly, AstraZeneca and J&J did an awesome job of marketing these drugs to doctors and nursing homes for unapproved uses and with a very slim research base to support their use--and yet these drugs turn out to be totally worthless compared to placebo, have cost taxpayers and insurance companies billions of dollars, and have killed and injured thousands of patients. These are not wild assertions on my part. These are the wild assertions of many patients involved in class action lawsuits against these pharma companies (some of these lawsuits have already been settled), and the wild assertions of several states' attorneys general who are suing these three companies for, among other things, off-label marketing of these drugs for use in the elderly.

So far, the allegations are only civil in nature. I'm beginning to think it's time for a criminal investigation of these companies, and, where merited, criminal charges against the executives of these corporations.

Since federally-funded, independent, long-term studies have now concluded that the atypicals are next to useless in treating schizophrenia and dementia, I'll make a wild assertion: Atypicals aren't very good for bipolar disorder either. At this point, I don't think I need a federally-funded long-term study to prove that point.

Posted by Philip Dawdy at November 6, 2007 12:07 AM
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Then there was the case of Tom Warren (plug him into amazon or google), sent home and told to prepare of Alzheimer's who disregarded the advice of his doctors, and sought treatment for mercury and aluminum intoxications. He got well! Could it be that there are others?

Incidentally some organ or other of the federal government recently refused to certify the mercury-containing "silver" amalgam fillings as safe.

One more reason why I support Ron Paul and his Libertarian message.

Posted by: Gerald at November 6, 2007 04:34 AM

Bob Fiddaman and I (along with several others), were busy poking fun at Marty Keller, not long ago:

http://itsquiteanexperience.blogspot.com/2007/07/life-and-times-of-martin-b-keller-md.html

I really like this piece, because I'm still still impressed by the level of my wittiness, on this occasion, not to mention the quality of our teamwork. Anyway, drum-beating aside, I'm still struck by the idea of mind/body dualism. It's possible to tell what somebody's state of mind is, by their body language, I reckon.

Anyway, as to depression, I think it occurs, when a person needs to know something/anything. It will be a critical piece of information that they need, in order to accomplish some larger task, particularly a task that one has been ordered to do. Now, if one needs a piece of information from the person doing the ordering (in the workplace, or the childhood home, would be good examples), and that person refuses to give the information, such that one ends up making a balls-up of the job, at hand, then one has another problem to solve: why did they want one to fail? And then is snowballs.

The absence of Information. Critical information, more accurately. This is what makes depression peculiar to each and every individual, I think: everybody's "critical information," is going to be different.

Matt

Posted by: Matthew Holford at November 6, 2007 04:50 AM

Well this just proves, in my opinion they are worth nothing but an industry bottom line. And isn't there a blackbox warning on those regarding use in elderly /or those with dementia now? I always wondered what the hell difference was for those inbetween those categories, such as healthy young individuals, and psychosis, because really, dementia, Alzheimers and psychosis all sometimes appear the same. This I say based on experience of my own with people in all three of those categories. Also, let's not forget the agitation in Autistic kids this stuff is used[useless]for. What a rip off.
That conclusion is a smack in the face! "the placebo group had significantly lower health care costs." Talk about arrogance, and an industry out of control.

Posted by: Stephany at November 6, 2007 05:41 AM

I doubt this report will see much publicity. Though it is a possibility as the elderly are MUCH more liked than the regular mentally ill masses. And the retiring baby boomers perhaps don't want the same thing to happen to themselves in a few years.

It is going to be a tough one to decide for the TV general manager to decide. Ad revenue from Pharma Co. VS factual report of phamra drugs.

Posted by: mark p.s. at November 6, 2007 05:45 AM

I would be interested to know if there is a real study showing the effect of Zyprexa and the others on bipolar disorder (other than diabetes, hyperglycemia and death). What's also gotten lost in the shuffle of profit making is that the drugs were approved for short-term mania, but are often given for long term maintenance therapy of bp.

We know they have screwed up the lives of thousands, killed their share. But I don't remember one true confessions story that a person with bipolar was helped while on Zyprexa or the others.

Posted by: Turkey at November 6, 2007 05:00 PM

And yet we have psychiatrists pushing to keep the right to forcibly medicate and commit people with Alzheimers and dementia in our state and claiming they can "treat" Alzheimers in psych. units. I tried to get a recommendation to have Alzheimers excluded from the state definition of mental illness but that isn't going to happen unless the Alzheimer's lobby gets busy. For folks who think fanily are so important, when it comes to dementia many psychiatrists want the right to trump the wishes of the family/caretakers.

Posted by: Alison Hymes at November 6, 2007 08:48 PM

Imprisonment of the mind happens for unexplained reasons. This is the question, for which we have no answer.

So, people are medicated, and parked in institutions. Why is this acceptable?

It's getting worse with the affects of chemicals that change brain chemistry. So, the medications leave results less than best, and those ppl end up in the same place as traumatic brain injury patients.[TBI].

It's why the doc could "get away" with shipping my daughter to the state hospital "for long term" [care?]care".

Parking lot for the end of life. Period. Yeah drugs help so much. Tell me that again. Because I have living proof they don't. My daughter.

I have a suggestion for anyone loading their loved ones up on antipsychotics: let's see what you think in 8 years. I bet it's the same shit I'm writing. Seriously, this is a chemical restraint to create a calm environment in Alzheimer's/Dementia/TBI/Mental illness units and wards.[or homes, or at home].

It's not about the patient as much as it is about keeping the ward quiet. If we had answers they would be working.

Antipsychotics are not the answer, they are calming devices that actually create agitation, confusion and dementia.

So there. Just my opinion. Ask yourself what TBI is. Concussion? car accident? over-medication? all the same. You end up in the same long term care institution too.

Go visit one. Become a volunteer. You will sob.

Posted by: Stephany at November 6, 2007 11:02 PM

So far, the allegations are only civil in nature. I'm beginning to think it's time for a criminal
-------------------
That's been my opinion for some years now.

Regards,

Stuart.

Posted by: Stuart Jones at November 6, 2007 11:03 PM

Old guy shaking his cane with rage here.
1959 THORAZINE (Chlorpromazine) AD, "for prompt control of senile agitation", Smith Kline & French
LINK

Posted by: mark p.s. at November 10, 2007 07:45 PM

The AD has dissapeared. I have seen it as a joke, on another website. I didn't save a copy. It was a picture of an elederly man waving a cane, with "Thorazine" written on it. If you can find this historical ad. online please post the link/URL here.

Posted by: mark p.s. at January 26, 2008 08:52 AM

I found ANOTHER for thorazine for the elderly ad. original source is decodog.com. I assume these ads are legitamite historical pictures from magazines at the time. LINK

Posted by: mark p.s. at January 26, 2008 08:57 AM
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