August 07, 2008

Report: Patient Fakes Schizophrenia To Get Susie-Q Rx (Seroquel)

As I've been noting on this site for over 18 months, the blockbuster antipsychotic Seroquel is doing double-duty as a street drug. It's a downer-ish drug, snorted or injected, and is gaining some popularity as a replacement for OxyContin, which is apparently getting somewhat harder to get on the black market. So one of the top selling psych meds on the market is now becoming a new "hillbilly heroin."

From July's American Journal of Psychiatry, we learn that some doctors in the LA area have encountered some people so desperate to get their hands on Seroquel that they'll feign symptoms of schizophrenia.

"We present a case report of an individual who demonstrated classic drug seeking behavior, compulsive drug use, and diversion for resale of the atypical antipsychotic compound quetiapine.


"'Mr. A' was a 29-year-old divorced, unemployed, Caucasian man, with an unclear medical history, who presented himself as a walk-in to our acute psychiatric treatment unit with a medication refill request. He reported that he had been diagnosed with schizophrenia (for which he was being treated with quetiapine [600 mg nightly]) and the local police were disturbing his sleep by "electronically monitoring" his testicles. He received his "usual" dose of quetiapine and then slept soundly. On examination the following morning, Mr. A had become cagey about the details of his somatic preoccupation and, although still somnolent, he lacked evidence for either a thought or mood disturbance. His urine toxicology screen was negative. The profundity of his sedation prompted a pharmacy review, which revealed that he had been receiving different and excessive amounts of quetiapine from several sources during the past few months. Upon confrontation, he admitted to both the excessive use and sale ($3.00 per 100 mg tablet) of quetiapine."

Three bucks a pill? The black market is cheaper than drugstore.com, which sells Seroquel in 100 mg. slugs for almost $4 a pop.

The docs go on to comment:

"Quetiapine has come to dominate the atypical antipsychotic market, primarily through its use in the technically 'off label' circumstances described previously [anxiety and other mild mood disorders a la benzos in the 1960s and 70s and Miltown in the 50s]. The modestly sedating toxic profile and perceived absence of abuse liability of the drug have prompted many clinicians to use it in place of traditional benzodiazepines for anxiety and insomnia. There is currently an accumulating body of anecdotal evidence regarding the type of patient described in our case report, which questions both the accuracy of perceptions about the use of quetiapine and the wisdom of treatment practices. If the current misuse of the compound continues or expands, then the abuse 'signal' will predictably become more evident and could ultimately prompt federal regulators to declare quetiapine a controlled substance. Should such an unfortunate eventuality come to pass, we will be able to confidently lay the blame at the feet of our collective prescriptive imprudence."

In other words, they are saying that docs are a bit too free in prescribing Seroquel for whatever ails the American mood and that it's possible a fair number of people will end up addicted to the drug.

And, if someone is willing to fake symptoms of schizophrenia in order to get their dose, then that tells you something about the drug's addictive potential.

Posted by Philip Dawdy at August 7, 2008 12:03 AM
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Comments

sad. I almost wish Seroquel had done something for me other than the weird Peter Max/ Lichtenstein/Yellow Submarine dreams.


Posted by: susan at August 7, 2008 12:58 AM

So why is it that neither the media nor the medical establishment...are particularly concerned about the health risks from Susie Q but get their panties in a wad when they hear that some people enjoy taking it? If they really want everyone with a psych label to take a drug everyday for the rest of their lives, wouldn't making the drug extremely pleasant to taste be a good thing? But no, they only want to prescribe drugs that psych patients don't like and don't want to take. Why?

Sort of like the oft noted fact that the best way to get released from a psych hospital is to beg them to let you stay.

Posted by: Sally at August 7, 2008 03:57 AM

Geez, I had to take acid to get all that. Of course, with acid you don't have to wait to fall asleep...
{;>)

Posted by: Sherry at August 7, 2008 05:29 AM

3 bucks a pill!? YAY for free pharma rep samples! I can pay my house payment now! and this drug's main ingregient is made in China--outsourced to save AstraZeneca money--I wonder what's really in those pills.

Posted by: Stephany at August 7, 2008 06:21 AM

Doesn't surprise me in the least. Seroquel was a horse tranquilizer for me -- and heck, from what I understand, there's a black market for horse tranquilizers.

Posted by: Larry at August 7, 2008 08:09 AM

Sally, you said:
"If they really want everyone with a psych label to take a drug everyday for the rest of their lives, wouldn't making the drug extremely pleasant to taste be a good thing? But no, they only want to prescribe drugs that psych patients don't like and don't want to take. Why?"

Because (as I'm sure you've noticed) it's all about power and control.

Posted by: Sherry at August 7, 2008 10:14 AM

Sally, you said:
"If they really want everyone with a psych label to take a drug everyday for the rest of their lives, wouldn't making the drug extremely pleasant to taste be a good thing? But no, they only want to prescribe drugs that psych patients don't like and don't want to take. Why?"

Because (as I'm sure you've noticed) it's all about power and control.

... No, no , no , it's not a power and control thing, it's a punishment thing. See even though the Bio model has been widely accepted and many more people today think "well it's not the patients fault, they just have a screwy brain"... there are still a lot of people that think "well maybe if we make it suck so hard to get treatment and to have the disease, maybe then these people will stop "acting out".

Yeah, I do honestly think there are still many people in this world who believe that us mental folks somehow derive some sort of pleasure or benefit from "acting out"... and that we are not *really* suffering so much as we are putting on a show to get attention, care and special favors. So I think that there are still enough people who think of the mentaly ill in this way that they do a lot to influence all the systems and treatments to be "unpleasant" as a way to try and punish us into "snapping out of it".

I mean really, if psych units were as comofortable as regular hospital units, you know with Tv's in every room to help distract the patient from constantly thinking about how sick they are and how much it sucks to be in the hospital, with the same sort of respect and attention paid to the treatment of the illness they are dealing with... to help make them confortable... well then all us crazy folks would of course choose to stay crazy longer.

I mean it only makes sense to take people who are "acting out" and put them in a place where there is absolutely nothing to do but deal with all the other crazy people who are acting out and to be so board out of your mind with no distractions to help you de-stress, that you get to take a good hard look at yourself and all your choices of acting out and being crazy that lead you to be put in the hospital in the first place... so you "learn your lesson" real quick and want to do whatever you can to get out of there as fast as you can, even if that means having to pretend that you're doing better than you actually are and end up deneying yourself the extent of treatment and support that you actually need just to be able to get out of the sh*t hole that all psych hospitals are.

I feel bad for the people who really are soo ill that they have to stay in the hospital long term, what a horrible place to try and recover. You either have a room to go sit or lay in alone, with no tv, or you have one tv to share with all the manic chattering scizophrenics, which does nothing to help you get some respite and distraction from your situation and your own mind (which really, if you've been thinking about killing yourself and your mind is sooo extreemly out of whack, it can be helpful to be distracted from that sort of hellish pain for even a few moments here and there ya know?). And just try and get any "special treatment" in the psych hospital such as asking for access to the activities room or some crayons and paper so you can draw... good luck with that, if you even get to use the activities room at all, if the people who work there actually care enough to do their jobs and give you an hour of group therapy a day, a walk outside, or if you can even get more than two visits with a doctor durring your entire stay to get some *actual help* with your issues other than the wonderful help that is being locked up in a psych unit with nothing to do.... No, psych hospitals are definately NOT designed to actually give people the type of supportive help they need to actually get better, they are designed to be such a sucky place to stay that your being punished into learning your lesson about "acting out" and so that you will think twice the next time you feel like killing yourself or are *choosing* wether to "act" like a crazy person. (as if we have much of a choice at that point)

Same goes for the drugs. They are called "treatments" and we are all tricked into believing that these drugs are designed soley with the intent of making us feel better and be better... but it's a lie. The sh*ttyness of the drugs that are available for use in treating mental illness is no mistake.

There have been DOZENS of medications that have been created for the treatment of depression and such that have been waaaaaaay more effective than the drugs we actually have available to us now... but they were either pulled off the market or never made it to the market in the first place because, well, they made us carzy folks feel too well, too good.
So what if a drug can aleviate depression within 24 hours and can have a lasting effect... it simply can not be offered as a treatment option to us crazy folks if it is known to be able to make us feel better than well... especialy if it can make regular folks feel better than well, because, well, it's not fair to put normal healthy people at risk of being exposed to any drug for mental illness that could possibly get them high. Sure it's fine to pose the same risk to general population by putting drugs for the treatment of physical pain on the market no matter how HUGELY addictive they can be... but those drugs ar for treating people with *real* problems and *real* pain, so the risk is justified... but to pose the same risk in the name of helping nuttcases with *mental problems*, well that's just insane.

Abuse *potential* isn't a reason to withold a PAIN med for those with physical pain, it's just a reason for doctors to be more careful of who and how they precribe it to. But if an antidepressant has ANY (known) abuse potential at all that is very much a reason to keep it from coming ot the market and being offered as a treatment.
Does that seem like an unfair double standard? To me it does.

It sure does say a lot about how the government and even the medical field thinks about our "emotional pain and suffering"... that we can not be allowed to have a medication, no matter how highly effective it is (some of the depression meds that have been witheld from the market have been 80% effective within 1 week of use), if there is ANY risk of "abuse potential". Yet people with physical pain are allowed to make that choice for themselves and take that risk if they so wish in order to alleviate thier physical pain. But us crazies? Oh no, we can not even be allowed to make that choice as to wether or not our mental suffering is bad enough that we are willing to risk addiction in order to get relief.

No instead the government and the medical field gets to decide that our pain is not worthy of effective relief. We can only be allowed access to medications that have horrendous side effects and even if they do get rid of the depression, or psychosis etc., that we are taking them for, they must at least cause one or two other bothersome and even crushing side effects... and that's fine cause that's what we deserve since we are "choosing to be this way" and so need to be taught that it just doesn't pay to be crazy.

Maybe that seems like too harsh of a way to view things but I honestly believe that no matter how hard the psych industry and the drug companies have pushed to make the public and the medical profession believe that mental illness truel is an illness, there are still many people who believe that crazy people are just choosing to be the way they are in order to ge sympathy or special treatment or to mess with other peoples emotions (yeah there are a lot of narcassists in this world who actually think that people who are suffering emotionaly are doing it to themselves in order to get a reaction out of them/the people around them).

If this wasn't the case then all those psych meds that could have been, the ones that showed great promise and effectiveness that far outwieghted any risk of addiction, well we would have the option of taking those. Instead the drug companies have been shown by the government that it doesn't pay to develope drugs that are so effective because in order for a drug to be really effective in treating mental or emotional suffering it is going to have to have some sort of abuse potential. I mean think about it, what do addictive drugs do and why do people use them? - they lift peoples moods and people use them because the drugs make them feel better. Now think about what the whole point of treating depression is? - To make the person FEEL better.

I'm not saying that everyone who's depressed and such should be risking addiction by taking potentialy addictive drugs, but I think that they, we, should have the option if the non-addictive meds are just not working well enough. IF a person has chronic physical pain and they've tried all the non-addictive non-opiate medications for thier pain and they still have not gotten enough relief they have the option of trying a drug with abuse potential and taking that risk... why don't people with emotional pain that is not satisfactorily relieved by the usual non-addictive meds have the same choice? I mean anyone who has suffered with depression can vouch for the fact that emotional pain can be just as debilitating as physical pain... so why don;t we have the sme choice? Well it is because everyone in thier life has at some point felt physical pain and therefor can not deney it's existance... but when it comes to depression, well what everyone has felt is "feeling sorry for themselves" at some point in thier life or feeling sad about some life event or situation that thier suffering could be alleviated by making changes in thier lives. So they just assume that people with depression are simply being "wimps" and choosing to creat a life situation and do nothing to change it that causes them to be depressed and that we are all just sitting on our pitty pots. And of course the solution to that problem is to "give us something to really cry about" and to "teach us a lesson about how much worse things can be"... such as being in a mental hospital or choosing the "easy way out" and using meds to alleviat our suffering (and therefor having to deal with real sh*tty side effects) instead of learning our lesson and choosing to "get over ourselves".

If people really believed that mental illness is not some sort of choice then we would be offered effective treatments and DECENT hospital facilities when we are seriously ill. Instead the most effective medications with the least amount of side effects are taken off the market and hospitals are designed to make an ill person even more uncomfortable in thier own skin.

So, as far as I am concerned, the reason it's considered a bad thing to make meds for psych patients that are actually somewhat enjoyable to take is because the world does not think we deserve such a luxury since we are obviously choosing to be ill. ... And I guess that sherry was right in a way about it being about control because the system is set up to punish us for being ill in an attempt to control our behavior and to somehow influence us to not "choose" to act so insane. Obviously that approach has never worked, cause if it did there would be a lot less crazy people, like people would stop being crazy after thier fisrt or second visit to the hospital and after their fifth or sixth horrendous experience with a serious side effect from the medications. But I guess normal people would just rather see us as Drama queens who deserve what they get than as sick people who deserve adequate effective treatments.

Posted by: BipolarBunny at August 7, 2008 03:38 PM

Bipolarbunny,

What a wonderful, well written, thought provoking comment. Thanks!

Posted by: Sally at August 7, 2008 05:41 PM

Reminds me of a quote from the show Frasier:

"I'm not trying to make the man happy, I am trying to cure his depression."

Posted by: Pineapple at August 8, 2008 09:18 PM

My doc just prescribed Seroquel (300mg)for me. He believes I am bipolar. Whatever the case, I also have an eating disorder, so when I read the info on the drug online, it said that it causes "significant weight gain". I am very afraid of that. I don't want to take the meds but I am a cutter so my doctor feels I must take the meds. I am in a dilemma. Any ideas anyone?

Posted by: Island Fever at August 9, 2008 11:54 AM

One of my druggie friends and I tried snorting Seroquel (after reading the website called Legally Bombed). It didn't do anything for us except put us to sleep. However, I'm on a psych ward right now and the drug dealers cruise by the hospital. And you can trade Seroquel for crystal meth which I'm not interested in. If you can sell it or trade it, it's a narcotic.

Posted by: Francesca Allan at August 9, 2008 11:58 AM

You got it right!

Posted by: David Luoma at August 16, 2008 01:44 PM

Damn, I'll sell what seroquel I have left.

Posted by: Kara at August 27, 2008 08:47 PM

I take 300 mg and I had this dream the walls were bleedin.

Posted by: Richardo at May 4, 2009 06:05 AM

I have 50mg Seroquel that i will gladly sell to anyone who wants them. I can't take them they make me whacked out. Email me mindymakaylin@hushmail.com

Posted by: Kim at September 22, 2009 06:31 AM
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