"The People's Pharmacy" Criticizes Atypical Antipsychotics

Some of you are likely aware of the syndicated column "The People's Pharmacy," which I often find interesting, and which has often taken a deeply-skeptical stance on various psych meds. In this week's column, the authors go after atypical antipsychotics and note that they are used for a whole host of mental disorders that have nothing to do with psychosis.

"Despite the initial enthusiasm, there is growing consternation about the safety and effectiveness of these powerful mind medicines. A few years ago, a study found that the newer and far pricier drugs were no more effective or less likely to cause troublesome side effects than an older antipsychotic (New England Journal of Medicine, Sept. 22, 2005). A new study in the same journal (Jan. 15, 2009) reported an alarming rate of sudden cardiac death linked to the newer drugs.

"It’s no wonder that patients and families are nervous about these medicines, especially when you consider that they can cause other complications such as dramatic weight gain, diabetes, strokes and irregular heart rhythms. Children and older people may be particularly vulnerable."

I've been making this same basic point for over three years on this site and almost five years in print (albeit a bit more quietly)--the atypical antipsychotics are as lame as the first-generation drugs they replaced and their widespread use in our culture for non-psychotic disorders represents one of the biggest scams ever pulled by Big Pharma on the American people (and peoples of other lands as well).

To date, the companies foisting these drugs upon the public have largely remained unaccountable. Sure, Lilly has paid out--or is supposed to pay out--$2.7 billion in settlements (with more to come) and has pleaded guilty to a criminal misdemeanor charge, all of it related to Zyprexa. Bristol-Myers Squibb has paid a $515 million fine to the feds, some of that related to off-label marketing of Abilify. J&J/Janssen (Risperdal), AstraZeneca (Seroquel) and Pfizer (Geodon) have escaped unscathed so far. One hopes their days of reckoning are coming soon.

Of course, it's not just with antipsychotics where supposedly-safe new drugs have proven to be utter train wrecks in a pill. When SSRIs and other new anti-depressants were introduced in the late-1980s and 1990s, they were touted as being so much more effective and so much more safe than the older tricyclics and MAOIs. But they weren't.

In both instances, some of the chief cheerleaders for the drugs were doctors and mental health workers, and not just the ones who landed speaking gigs for the drugs themselves, but your average run-of-the-mill clinician and mental health worker. While it's nice to see continued skepticism about antipsychotics and anti-depressants from some quarters, I know there are still plenty of mental health workers out there who think these drugs are a boon.

Last week, I ran into a young man I know and he told me he'd recently developed sweats and shaking on Effexor. He told his psychiatrist about this and, no lie, the doctor told him he was either exaggerating or making the whole thing up.