November 10, 2008

Antipsychotics Aren't Anti-Depressants

I saw the Abilify for depression TV ad again over the weekend and I continue to be concerned about how Bristol-Myers Squibb is very craftily making the drug, an atypical antipsychotic, sound as if it's an anti-depressant. Nowhere in the TV is it mentioned that the drug is an antipsychotic, at least not in what I've caught on-air.

I've written about the ad previously here and have also written about how the drug's clinical trials for depression show a greater chance for a patient to experience akathisia than to have his or her depression improved.

On the Abilify for depression website, which viewers are directed to, the drug is described thus:

"If an antidepressant alone isn't enough, maybe ABILIFY can help. ABILIFY is the first medication approved by the FDA for add-on treatment to antidepressants for adults with MDD. In clinical studies, when ABILIFY was added to an antidepressant treatment, many people experienced significant improvement of their depressive symptoms.

"If you're currently on antidepressant therapy and are wondering if adding ABILIFY could help you achieve additional symptom relief, ask your healthcare professional if ABILIFY could be right for you."

The site also includes text of the black box warning for anti-depressants.

It's only when the website details some of the warnings for atypical antipsychotics that there's even a hint that the drug is an antipsychotic:

"Elderly people with psychosis related to dementia (for example, an inability to perform daily activities as a result of increased memory loss), treated with antipsychotic medicines including ABILIFY, are at an increased risk of death compared to placebo."

That's it. Not much of a clue of what kind of drug potential consumers are dealing with--certainly not enough for them to make informed decisions in my opinion--and one they'd have to work pretty hard to find.

It's interesting to me that BMS is, in its advertising for Abilify for depression, now ignoring the fact that the drug is an antipsychotic when in other TV commercials for the drug (those would be the bipolar disorder ones targeted at women) it mentions that the drug is an antipsychotic. Why the difference now?

Regardless of the company's motivation, antipsychotics as a class have a host of problems associated with their use: diabetes, metabolic syndrome and heart problems to name a few. The drugs, including Abilify, are subject to black box warnings for diabetes and early deaths among seniors. That sort of information should be included prominently in the TV ad and the drug should be identified as an antipsychotic. That's my opinion.

I'm going to let the FDA know of my concerns.

Posted by Philip Dawdy at November 10, 2008 08:45 AM
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Comments

Just because a medication was developed with an eye toward one illness does not discount it from being useful for other illnesses if the evidence and/or clinical experience warrants it.

You're not making much sense here, Philip. Older tricyclic antidepressants, for example, are commonly used for chronic pain, migraine, bed wetting as well as depression. It's off label use. And it's usually not worth the bother of going through FDA approval if there are no issues with this.

If Abilify helps in augmenting an antidepressant for some people and it's found to be worthwhile given possible risks, then it's really the doctor and patient's business.

Posted by: A Believer at November 10, 2008 09:56 AM

It's imperative people know they are receiving an antipsychotic when being treated for depression; hell that's almost off-label use (like it used to be)by not disclosing this information it places innocent consumers at risk.

It's going to be the same way with Seroquel XR.

Antipsychotics are dangerous medications that should be reserved for psychosis and schizophrenia as they were originally "designed"; and then take a look at the stats and the people who have used them for that purpose and the less than efficacious results are right there.

IF Abilify worked so great for psychosis, my daughter would be well, fine and doing great. (for example, she has trialed ALL antipsychotics and like many readers here has had less than efficacious outcome with use)

This is reckless endangerment of lives of innocent people using antipsychotics as depression medication, and just as the placebo vs. antidepressant data comes in to wash out SSRI use, the new hot drugs come on the market to replace them....the problem is, these are not new drugs.

New marketing targets, that's all. (that's you)

I'd like to say I've witnessed dozens of people, on daily basis in hospitals and everywhere my daughter has been show the signs of a tough road lived on antipsychotics. The permanent tremors, the drugged looks on their faces, the loss of memory, the decline in body health, and the shortened life-span---and the FDA allows these DTC ads? where is the public safety commission?

Invega is repackaged generic Risperdal; Abilify is re--marketed schizophrenia drug...after one year on Abilify, my bet is the people who feel benefit from Abilify for depression will be singing a new tune, and hopefully it won't be that they have diabetes or permanent involuntary muscle movement of their face, tongue, legs or hands.

All of this is just my opinion, and it's based on seeing people suffer first hand on these drugs (including myself).

Posted by: Stephany at November 10, 2008 11:50 AM

srsly? are you kidding? this isn't about whether it's worthwhile to take certain risks, this is about lying to consumers.

Posted by: A Disbeliever at November 10, 2008 12:10 PM

Imipramine for bed wetting (antidepressant) was given to my daughter at age 11 and withinb 6 weeks she had suicidal/homicidal ideation/talk.

I was never told the drug was an antidepressant.

THAT drug is the one drug, that started my daughter's nightmare of misdiagnosis of Childhood Bipolar Disorder in 1999.The doctors immediately labeled her OCD, then within 2 months straight to Childhood Bipolar, including Zyprexa, Depakote,Risperdal,Zoloft and Luvox.

These drugs fry children's brains and I've witnessed it in my own child. SOmething I cannot live with very easily. She is 20 yrs old, and disabled on SSI.

Tell me, just try and tell me these drugs work!!!!

Posted by: Stephany at November 10, 2008 12:10 PM

A Believer: Because anti-psychotics are very STRONG, and overmedicating is very DANGEROUS.

Posted by: Sophia at November 10, 2008 12:13 PM

I have a friend who was put on Abilify for major depression in July. She was depressed but working full time & has never been manic or psychotic. What's the rationale? Her doctor told her it was because she had suicidal thoughts. Antipsychotics for depressed, but functional, people? Well, I guess if they hand them out for insomnia this shouldn't surprise me either.

Posted by: Lisa at November 10, 2008 12:33 PM

If you're all just going to get hysterical about this then that's pretty much the end of any useful discussion. And rants do not make a discussion.

Maybe you just need to do some more reading and educate yourself about these medications. They are genuinely helpful for some people.

My son would not be alive today and living the life he has now without Seroquel. He believes this and I hear many similar personal stories at the local support group.

Perhaps you are filtering out news and discussion that doesn't fit your point of view and so remain unaware of stories like my son's and others. Keep an open mind.

Posted by: A Believer at November 10, 2008 12:45 PM

Please Big Pharmas,

Do me a favor and put on the directions:

Indication: psychiatric drug.

I was prescribed Klonopin and just when i've read the directions I was informed it was for epilepsy.

Later, after being prescribed an antidepressant to help withdraw Klonopin I was put on many drugs because side effects mimic mental diseases.
I've benn on Lamictal, Paxil, Seroquel, Depakote, Zyprexa, Neurontim, Socian, Pamelor, Imipramine, Xanax, Effexor, Frontal, Halcion... many.
it's easier to name the drugs I have not taken.

I was never informed that it was antipsychotic...
and all side effects were seen as "normal" and totally ignored, or "-It's psychological...

I'm sick to death of my story.

I just wanted not to see anybody taking drugs that they don't need.
It seems impossible.

Posted by: Ana at November 10, 2008 12:50 PM

believer, while i respect your son's experience and your views, we are getting this second hand, ie not from him. also, i've found over the years that support groups tend to be little more than groupthink sessions, so the evidence from your local nami group isn't exactly reflective of the population as a whole.

there are loads of reasons to be concerned about the casual use of antipsychotics in our culture. brain shrinkage for one. how's your son's brain these days?

Posted by: Jones at November 10, 2008 12:50 PM

I don't see anyone getting "hysterical." What I see are people who are NOT informed they're being handed an antipsychotic for depression which if they were aware might affect their decision whether or not they want to take it. I see ads that don't mention it's an antipsychotic either. Don't you think people have a right to know? Isn't it deceitful to withhold information that would affect a person's decision?

As I've mentioned before, I was given a low dose of an antipsychotic for antidepressant induced insomnia. I had already told my pdoc that I didn't want to take an antipsychotic. So, imagine my surprise when I get home & read up on Seroquel. A tad deceitful? For those who want to knowingly take the risks, go to it. Not everyone wants to take these risks, however, and should be given complete & truthful information.

Posted by: Lisa at November 10, 2008 01:13 PM

Chemicals that damaged my daughter's brain are:

Seroquel
Abilify
Haldol
Melleril
Clozaril
Cogentin
Zoloft
Luvox
Depakote
Imipramine
Trileptal
Risperdal
Prozac
Ativan
Lithobid
Lithium
Zyprexa

To witness a 17 year old 4.0GPA honor student with a reading comprehension level of age 29 go to a 2nd grade level, non-verbal,hand tremors, inability to think or read person by age 20; I claim the pain and suffering of watching this happen as my personal right to rant.

These are DANGEROUS chemicals, mind-altering, metobolic syndrome inducing, diabetes risk, stroke, permanent damage means: NO QUALITY OF LIFE.

Use at one's own risk, is all I can say, I've seen far too many people fucked up on these drugs sitting in chairs all day and that is not what the average person who is depressed would want to happen as a result of not knowing they are using one of these drugs.

Shuffling gait, drooling, yeah, that's a real good life.

Posted by: Stephany at November 10, 2008 01:32 PM

A Believer:

I was just going to let your first post slide; but then you had to come back and make another post complaining how unfair commenter’s here are.

Let me get out my handy shovel to load your teary eyed manure into the garden dirt hole where it belongs. Your ignorance is absolutely astounding; you use an argument of a single second hand success story as the end all of all end alls in your blind twisted belief system.

For your information there are many people that post here who lives or the lives of their love ones have been irreversibly damaged or destroyed by pharmaceutical psychiatric medications. What if that was your Son that was lost to these drugs? I bet you would be tooting up a whole different tune right now. Can you talk about that in your little la la land group, or is medication side effects and damage out of bounds?

I have some other questions for you "A Believer".

1. What drug company are you working for or representing at this time?

2. Have you personally taken any of the drugs being discussed here in recent post? If I was mean, cold hearted, and soulless I would truly wish that upon you.

3. What makes you think anyone would want to carry on a discussion with the likes of a close minded person like you? You already said you had all the answers anywise!

4. You tend to carry the bad smell of a not so anonymous poster of many names and faces?

If you don't like the responses you’re getting here? Why don't you go find one of your pro-pharma groups over @ NAMI and have a nice circle J--- party?


Yours Truly,
Stan

Posted by: Stan at November 10, 2008 02:04 PM

this is for A Believer,

antipsychotics nearly cost me life. I never took the stuff voluntarily, I was forced to take it under penalty of assault, restraint and injection as a teen.

It was a nightmare of mental anguish and spiritual suffering. I was harmed by that class of drug, I won't dignify it by calling it medicine.

I lost both my physical and mental agility and the entire time the real me screamed from inside trying to get free. This chemical lobotomy only increased my depression until suicide seemed to be the only way out.

I won my freedom from forced drugging after challenging my diagnosis and treatment plan in a court of law at the age of 15

If I had my way those compounds would come with this warning "quitting antipsychotics now greatly reduces serious risks to your health"

Needless to say, I don't get invited to speak at support groups.

:)

Posted by: Jane at November 10, 2008 02:34 PM

I agree with Philip's original post. I think it is irresponsible for the manufacturer (BMS) to not identify the drug as an antipsychotic in their TV ads, since consumers are aware that antipsychotics (especially second generation ones) can be associated with diabetes and other dangerous side effects, but they are probably not aware that Abilify is in this class. In my opinion they are a 'bigger gun' than antidepressants (not to detract from negative experiences some may have had with antidepressants) and should be identified as such.

Posted by: Doug Bremner (MD) at November 10, 2008 05:57 PM

Ok. Ok. I shouldn't lay everything at Seroquel's feet. I know.

What really brought him back to Earth in the end was his ECT treatments. There was memory loss, yes, but he has such a better life now.

He didn't have the competence to choose at the time so my wife and I had to make the hard one. I think it was the best for everyone in the end.

He hasn't been in the hospital for 3 years now whereas before it seemed to be every 4 or 5 months.

I guess we all have our war stories.

Posted by: A Believer at November 10, 2008 05:58 PM

Jane, I was asked to speak for NAMI as an advocate, and I told them they wouldn't like to hear what I had to say. I'm not pro-med, I do not agree with NAMI national taking HUGE amounts of pharma money for funding, and I disagree with how they have homes for ppl to reside and yet have MANDATORY release forms to remain med-compliant to ever be considered as a client on their application.

In the end, it is known to most of us in this system, that there is only one way this system works:

Medication compliant. You have to be that to get out of a psych ward, you have to be off meds to get inpatient in one.

I admire your strength Jane, to get through what you endured and am glad you survived it.

As a mom, I have witnessed horrible things, in the system, and the worst part is feeling so fucking responsible for my daughter's outcome, that though she chose hospitals, chose so many things on her own, I feel I am equally ruined from this ordeal.

Posted by: Stephany at November 10, 2008 06:23 PM

I almost died this year from Haldol. In fact, technically I did. I did flatline.

Stephany, I was aware of your daughter's story from here, and your blog, but did not know Jane's.

I have been on 37 psych meds in 23 years. Most of them have caused damage. I look at the girl I was when I got this diagnosis, someone with the world in front of her and hope for a bright future.

And now I look at me,, and the damage that has been done, and I just want to cry. And scream. And I feel with the exception of this site, no one understands my feelings and frustrations.

Posted by: susan at November 10, 2008 07:01 PM

Dear Philip:

Troll Alert: "A Believer" touts the miracle of anti psychotics and then the blessing of ECT as a follow up! Something smells rotten in this neighborhood, sniff sniff!! "A Believer" doesn't pass the smell test. Her/his post are absolute and complete BULLSHIT! Herbie, Troll, TF, or whoever you are this time; Mr. Wizard says go home and F--- yourself!

Stan

Posted by: stan at November 10, 2008 07:21 PM

Seroquel and ECT generally don't keep people out of the hospital for 3 years, statistically speaking.

Posted by: Sophia at November 10, 2008 07:50 PM

I am reading this with a sick, empty feeling. I was sickened to see the Abilify ad. What a sales pitch. If your anti-depressant is not enough. Give me a break. I am a survivor of not the drugs but of a suicide. Our child was prescribed clonzepam and Lexapro and campral in one visit to an internist. Our child was not an alcoholic. But had drank a red bull and thought having heart problems after a heart palipatation. Reason for doctor visit, drinking a stupid Red Bull. Went to a psychiatrist and in one visit was taken off the two drugs and he decreased Lexapro. These two doctors were even located in same building. No communication. Our child was gone in a week after dosage change and 33 days from initial doctor visit.

Posted by: anounymous at November 12, 2008 09:15 PM

I was on Abilify when I was a teenager for a little while. It gave me terrible akathisia. I had to miss a lot of school, I didn't k know what the hell was going on, I thought I had the jitters or restless leg syndrome. I didn't know what was going on. I remember looking up restless leg syndrome and stuff like that. If I had known it was akathisia from the pill at the time, it would have helped me a lot. I found out it was from the pill, but I still didn't know what it was. Eventually, the akathisia went away after a couple weeks. Abilify does work to cure illnesses ironically, the akathisia will make you so freaked out you will forget about your OCD, generalized anxiety disorder, depression. That akathisia was sos cary, I was a teenager and I didn't know why I suddenly had to keep moving. I couldn't sit still for more than a minute, my legs and arms just came alive and wouldn't stop moving. I couldn't rest or sit still. It was scary stuff.

Posted by: Princess at March 8, 2009 08:22 AM

I am in two minds over this (though I am anti-meds for me) . .When I was 17, I was on valium, prozac, risperidone, and a handful of other anti-psychotics. I must say first that I was not ill - mildly anxious but in control. . and my therapist had been a bit ambiguous with his advice to me about meds and what effect they have on you. . which didn't help. Anyhow I sought out the meds and I wish I'd read this prior. . because kids don't know, they really don't know what can happen to you.

It began with the valium - and I have to say that this does not always work as a muscle relaxant - it can have paradoxical effects (it acts as a stimulant) and interacts with other drugs (eg. prozac). My initial hell ended and another began, with a psychiatrist who I'd never seen before who gave me stelazine . . and my life changed. . my mind changed. .I am functioning, but it seems like there is something missing. . I have held a job, moved out, etc and I'm 30 now, so I don't know if it is psychological. But what I felt at the time, the very day I took my first does of anti-psychotic - I will never forget it. . my brain "collapsed" in on me. . I was in agony, I still think I have akathisia sometimes, and I freak out constantly - could be post-traumatic from the "treatment" or it could be me - I don't know. But I do know that it's not good to take anti-psychotics after taking other mind-altering drugs. My advice to anyone out there, stop the initial drugs, see if things improve. But if you really, really can't then make sure you go to a doctor who knows you before he gives you the hard stuff. I personally would never touch them again with a ten-foot pole - they didn't work for me, I didn't need them - a doctor just took a stab and gave me the meds: yes, they do that if you are hysterical, and drugged up and they are stupid. And as for the permanent "brain damage" I am still researching this, but I wouldn't be at all surprised considering how I feel sometimes.

Posted by: Kitty at May 30, 2009 11:19 PM

There is a sense of panic anytime a person is prescribed a medication for any ailment. The concern of addiction, overdose, the medicine not working or worse....death. Of course anything taken in excess can cause major issues, but when a doctor prescribes a medication they are doing it for the good of that person. No malice intended. However, I think there are too many factors to consider when trying to diagnose a person with depression. People react to depression in so many different ways and medication can too. I have been suffering from severe depression most of my life and have tried suicide more times than I can remember. I have been on every drug on the market from A-Z and from anti-psychotics to anti seizure. I have had a few physical side effects but nothing that has made me less capable of managing my own life. I am more angry at myself for needing to be medicated to live, and less angry at those trying to help. There are so many drugs that can do multiple things and finding the one that works is all trial and error. My suggestion is to be totally honest about your health, how you feel and get a total check up and bloodwork before you let a doctor medicate you. A doctor may not know there is an underlying medical condition and prescribe something that makes matters worse. Find out if something else is causing your problems, such as diabetes, high blood pressure, cancer, or organ failure. Do not be so quick to blame the doctors or drug companies because you let somebody try 20 different medications that eventually caused a permenent disability. Take responsibility for your own person and do more research about the drug before you start popping them in your mouth. If you are suicidal, and the drug can increase these feelings, you might not want to take them. The meds I am on now fry my brain if I miss a dose, but the benefits outweigh the negatives and side effects and I learn not to forget to take it. Don't blame others for your own ignorance. Do not take a drug until you read about it, and if you can post to this you can investigate any drug. Just because the TV (oh mighty TV) doesnt say it doesnt mean it cant be something else. If we believed everything the TV said than I would have bought everyone of Billy May's products.

Posted by: Kim at July 1, 2009 12:42 PM

I took Oxi-Clean for obsessive blog comment reading and it worked great.

Thank You Billy

Why the FDA has not rubber stamped it yet for "everything that ails you" is beyond all rational reasoning.

Posted by: Spoof at July 1, 2009 02:20 PM

Kim, while I agree that there is no malice intended, I can't help but question why a psychiatrist would put a depressed person on drugs that make them sluggish and fat. I can't say that would have done much for my depression. If people want to take these drugs for depression I have no beef with that, but I hate to think it's becoming standard of care.

Posted by: Lisa at July 1, 2009 04:51 PM
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