The death of atypical antipsychotics

The British Journal of Psychiatry has just published the latest in a long line of studies to find that the newer ‘atypical’ or ‘second generation’ antipsychotic drugs are barely better than the old style medications and has a stinging editorial that accompanies the piece calling out years of drug company marketing spun as an illusory advance in medical science.

Unfortunately both are locked (after all, you’d just worry yourself with all those facts) but here is the last paragraph of the editorial. It leaves no ass unkicked.

In creating successive new classes of antipsychotics over the years, the industry has helped develop a broader range of different drugs with different side-effect profiles and potencies, and possibly an increased chance of finding a drug to suit each of our patients. But the price of doing this has been considerable – in 2003 the cost of antipsychotics in the USA equalled the cost of paying all their psychiatrists.

The story of the atypicals and the SGAs ['second-generation antipsychotics'] is not the story of clinical discovery and progress; it is the story of fabricated classes, money and marketing. The study published today is a small but important piece of the jigsaw completing a picture that undermines any clinical or scientific confidence in these classes.

With the industry reputation damaged by evidence of selective publishing and its deleterious effects, and the recent claims that trials of at least one of the new atypicals have been knowingly ‘buried’, it will take a great deal for psychiatrists to be persuaded that the next new discovery of a drug or a class will be anything more than a cynical tactic to generate profit. In the meantime, perhaps we can drop the atypical, second-generation, brand new and very expensive labels: they are all just plain antipsychotics.

 

Link to locked editorial ‘The rise and fall of the atypical antipsychotics’.

5 Comments

  1. Paul Hutton
    Posted October 3, 2011 at 11:46 am | Permalink

    Hi Vaughan

    I’d say it’s also worth your readers having a look at the other editorial in that issue by Leucht and Davis, which I think is probably more balanced and circumspect in its conclusions.

    Cheers
    Paul

  2. Anonymous
    Posted October 3, 2011 at 2:12 pm | Permalink

    $GAs have damaged many patients’ lives, while enriching unscrupulous doctors (e.g. Nemeroff) and pharmaceutical companies.

    I was fortunate – my experience with Seroquel was short-lived and cost nothing as it was back when it was being sampled. It also taught me an important lesson: Do not take a few hundred mg Benadryl to treat swollen lips, tongue, and cheeks – go to the ER, no matter how much you hate it or believe you can’t afford it. (The state of American health care and health insurance is truly abysmal, and it will get worse if a Republican/TeaBag becomes President.)

    I told my psychiatrist I want to stick to generics, unless there is a new, non-$GA on the market with a demonstrated benefit for treatment of bipolar II. The way pharma is going, I don’t believe this is likely to happen.

  3. Primula Brandybuck
    Posted October 4, 2011 at 5:57 am | Permalink

    One of my family members were on these new meds for about 2 years. The voices didn’t stop but the side effects were worse. After discontinuing the medications, one was just happy things weren’t as bad as they had been on the meds. Psychotic episodes become a pleasant reminder that things could in deed be worse. The person also stopped complaining about the symptoms since the only option would have been to go back on the medications again. “No it’s Ok, I know the dead lady walking around our front yard isn’t real. She doesn’t bother me at all anymore. Thank you for asking though.”

  4. Posted October 19, 2011 at 5:08 am | Permalink

    As someone who’s been off & on Zyprexa(an atypical anti-psychotic) for 10 years, I can tell you this MKUltra drug(Eli Lilly, manufacturer of Zyprexa also made some of the originol CIA MKUltra drugs) can be horrifying, especially at high doses. To support your claim that these drugs are lethal is the fact that a over $1 billion law suit against Eli Lilly, which they lost, also had prosecutors saying that doctors were getting away with murder by proscribing this medication. Crazy world, huh?

  5. Ava
    Posted March 23, 2013 at 7:53 am | Permalink

    I agree that atypical antipsychotics are dangerous and not ideal – but they are far superior to older style typical medications. Anti psychotics kill thousands of people per year and have been shown to cause brain damage, however, the newer drugs are so much easier to tolerate. I, personally, have experience of both atypical and typical antipsychotics. Older style, typical antipsychotics completely destroyed my mind. I felt like half my brain had been destroyed, and I was in constant pain. I was dead inside – the side effect akinesia. I had horrible akathisia – an inner restlessness. They turned me into a shell of a person. I was in torment, despite having a very pleasant life. On top of that, they didn’t help my symptoms of psychosis – merely incapacitated me and antagonized and agitated my brain. No one would want to take those drugs. These “side effects” are not symptoms of schizophrenia, as I have bipolar disorder. On olanzapine, my symptoms of psychosis have dissappearred and I am regaining my emotions, and my dignity. Treatment of a whole human being should take into account how the person feels generally, and whether the medication enables them to live their life, not merely the symptoms of psychosis they may be experiencing (which can incidentely be treated with CBT, and as low a dose as possible of a newer style drug.) The older style drugs are sometimes referred to as a chemical lobotomy, and I am still trying to recover from what they did to me. The olanzapine is relatively pleasant to take, wheras the older style medications are a living hell. I should mention also that I have since recovered from my symptoms of psychosis, with the help of a low dose of olanazapine, lithium, vitamins, (especially fish oil and a multivitamin), CBT, and a healthy diet, rich in foods are good for the brain. I have maintained a healthy weight while being treated with olanzapine, (which can be an issue for some people on antipsychotics.) In the early stages of being treated with olanazapine, the drug created a healthy appetite for healthy foods, wheras the older style depos created a constant knawing hunger which you could not get away from. I eat a diet rich in fish, especially tuna and salmon, fruit and vegetables, nuts and seeds, legumes and pulses, good carbs, healthy oils,some dairy, eggs, green and black tea, dark chocolate, anything healthy really. I try and eat free range too. This helps with the health of my brain, as well as my weight. Now that I am on a decent drug, I no longer have an issue with taking medication. I admit that olanzapine isn’t perfect, but the typical antipsychotics are horrible, primitive drugs, which, in my opinion should be banned. In my experience, they constitute torture. Obviously, patients are more willing to take newer style medications, such as olanzapine. Why not just let them do that? They are adults with no intellectual impairment, and deserve access to modern, safer and more pleasant drugs.


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