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Cut on the bias

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At the recent meeting of the American Psychiatric Association, there was a presentation of results of "clinical studies" of Seroquel XR revealing that it's better than placebo for major depressive disorder and generalized anxiety disorder.

Guess who gave the presentation? AstraZeneca, of course. From Andrew Eder's article on DelawareOnline.com:

Opening Seroquel XR for treatment of major depressive disorder and generalized anxiety disorder would greatly expand the market for the drug. About 15 million American adults suffer from major depressive disorder, and about 6.8 million suffer from generalized anxiety disorder.

In the first quarter, AstraZeneca said U.S. sales of Seroquel were $702 million, up 7 percent from a year earlier. The company said prescriptions of Seroquel were up 8 percent, with 25 percent of the growth attributable to Seroquel XR. Its top-selling drug, Nexium, meanwhile, saw its U.S. sales drop 15 percent due to increased competition from cheaper alternative drugs.

I'm glad the APA continues the tradition of non-biased presentations.

Comments

It disturbs me to see the drug companies generating demand where it may not exist otherwise (Nexium is a great example--there are many clinical opinions that would suggest it is just not the wonder drug it is advertised to be and that older cheaper drugs are just as effective). The direct-to-consumer advertising drives me crazy.

Yet I am torn in that as biploar, Depakote/Zoloft has saved me. But are we drugging society so that we are all the same? no outliers (if that term is not too offensive)? do we drug away talent like Van Gogh, Pollock?

Where is the line? How do we know when we have crossed it?

EVERY study that is used to determine whether a drug gets FDA approval is a drug company funded study. Just because AZ funded the studies of Seroquel doesn't mean the the data is biased, falsified, or misrepresented.

I started to type up a reply about how we need pharmaceutical evaluations to come from non-biased entities; then I realized I couldn't come up with even a hypothetical entity that couldn't eventually be bought or otherwise influenced.

Now I'm depressed as well as paranoid.

Got some personal experience. Frankly, seems to me that it simply makes it impossible to sleep without it. Funny dreams too, not all of them pleasant.

Course, I have been thinking I look fantastic lately.

Cheerio!

ON SEROQUEL for a long, long, time

I was diagnosed with glaucoma 4 days ago and cataracts. I went to get checked when the FDA made AstraZeneca put glaucoma on their warning label. I'm 41. I am an author, former attorney, and researcher so my eyes are very important to me. Throughout my life as a mad hatter I have told myself, "You're not blind, you're not in a wheelchair, stop feeling sorry for yourself and get out of bed and get going". Now I guess I'll have to think of something worse than going blind. Any suggestions?

One thing to be reassured by is that doctors don't prescribe because of the picture on the advertising. They prescribe because of the results of clinical studies on the safety, efficacy, tolerability and toxicity of a medicine. "New and improved" doesn't cut it.

The publication of scientific information involves a period called peer-review where many different scientists go through the proposed findings of a study and, quite literally, shred the shit out of anything they think is less than completely proved even to the point of ruining the publishing doctor's reputation.

Even doctors under the employ of pharmaceutical companies won't put their names on things that will cause them to lose the standing it takes decades to build. And if they did they'd be fired from the pharmaceutical company anyway as their reputation is their central value to the company.

It's almost impossible even for the supposed influence of a pharmaceutical company to get falsifications or misrepresentations through that system and if they do (and some certainly have) they are vilified and sued to the point that they lose both their profit and development funds (as they bloody well should).

The result of this vicious system of peer-review is that it protects the highest degree of scientific ethics in the data presented to doctors.

My doc prescribed this for me, but I didn't notice much of a difference (on top of all the other meds I'm taking). Once I ran out I didn't order a refill because it was too damn expensive (not in my insurer's formulary).

Although I rely upon certain meds, I truly detest pharmaceutical company tactics. Especially funding their own biased studies. I've come to a point where I don't rely upon their information because I don't believe I can trust it. Seroquel is a case in point. I know it works for some, but it made me much worse. The side effects were so horrendous that this period marks a low point in my treatment history. My experience was so bad I don't think I'll ever forget it. Even after more than a year since taking it I still shudder when I think about it.

I used to work for a medical "communication" firm for a while - and these articles "writen" by MDs were actually first ghost written by PhDs who directly billed the pharm co for the time spent on writing, preparing, and submitting anti-depression/anti-anxiety medical articles to medical meetings and magazines. The MDs are a tool to give the article legitimacy, credibility, star appeal, etc. and the point is to promote the sale of the drug. They were done carefully and technically correct and often. So often that they flood the medical meetings with this material and blanket any opposing materials out there who can't afford to submit to these medical mags and meetings because they are not backed by the major drug companies (why would they say anything negative about themselves on purpose) who hold the purse.
There's just such saturation of marketing material out there disguised as real study on the drugs that rake in the cash that I really feel they’re making a mockery of the whole system that should be providing help and saving lives.

I only learned of this blog today…thanks!

After being diagnosed with war (Vietnam) induced PTSD in 2003 I have been a test case for “let’s try” this medication, dose, etc., yes BIG PHARMA is certainly one of the biggest perpetrators and contributors of a long running scam on the public. The stilted and twisted results of the large pharmaceutical companies have too long been the dogma by which Doctors base their “opinions.”

While some claim to be saved by pharmaceutical intervention, I suspect that in the long haul more have been irreparably damaged. I know for certain that I have.

I wish I had read this earlier - I would like to know how many have been affected by Seroquel. I am going off it tomorrow - I have gained 30 pounds and being thin all my life, I can't take the extra weight on my joints. I don't think it's working anymore. I hate taking drugs and I am not looking forward to getting used to a new drug - what will be the side effects? Will the new drug make me crazy? I am so glad I found this site in the NYT. While I have never had ect I feel I have finally found a friend. I was reading another girl's site because she suffered from depression but she was so into what she did every single second - it was so "all about me." This site seems so much more respectable. Thank you.

Dearest Liz:

I'm back now after a long moving process, internet provider battle, and conquering a few other dubious obstacles. I’m sure you missed me with great passion and concern; and probably stayed up at night crying endlessly Liz (laughing}. Especially after that last long winded political comment I sent that never got posted??? I know! Dang Spammers! {Smirk}.


It’s nice and a joy to see you up and posting like the wonderful talented women you are again. (I’m starting to wonder if you’re doing self ECT with a toaster in bath tub. I tried that only twice or three times, but only got Drain Bramage and a bad hair day {laughing}).


As far as this transformation from antidepressants, anti-anxiety meds, to atypical antipsychotics sounds to me like it is a no brainer and pure unadulterated genius. Thanks to seroquel I'm diabetic to add to bipolar disorder. If anyone thinks Big Pharma is thinking about helping those with depression through this magical medication treatment process; as kind, caring, compassionate hearted medication manufacturers; and NOT THIER ALMIGHTY BOTTOM LINE $$$$$ with new uses for these drugs. They need to take seroquel in large doses, because they are far crazier than I {laughing}.


But then that's my personal opinion, which at this time has not been approved by the FDA {Smirk}. Good thing that the number crunchers over at AstraZeneca have analyzed the advertizing, legal cost, and settlement payouts into the price of these drugs, or they would only be making 2 or 3 billion a year in pure blood money profit off of them. I'm not even going to say seroquel isn't an effective horse tranquilizer. It definitely does its job with all those pesky little side effects we shouldn’t really worry or be concerned about (diabetes, cardiovascular risk, tardive dyskinesia, and so forth). Just what every patient expects, loves, and hopes for from their medications. I say let's just get congress to write a nice fat pork barrel bill, and place large quantities of these drugs in the drinking water supply and get it over with {laughing}.

Geez, that would be suicidal and I would get me locked away {befuddled look comes across Stan’s face}. I guess I better finish this post and go into hiding before the CIA genetically white coat wearing Penguins track me down and place me in five points @ the Rubber Ramada {smirk}.

Yours Truly
Stan

A few years ago--maybe five--I was in a psyche unit at a Boston-area hospital (Harvard-affiliate like all the rest of them) and having "rounds" on a Monday morning. There were five of us patients in a group, and we sat at a conference table in a small room with one psychiatrist, a man none of us had ever met before. No matter what anyone said about how he or she was feeling, what was going on, any of that, this doctor prescribed Seroquel for EACH AND EVERY ONE OF US. Depression? Seroquel. Mania? Seroquel. Bulimia? Other eating disorders? Seroquel. Detoxing? Have some Seroquel.

I had been manic, but on the Seroquel I got suicidally depressed and gained about 40 pounds. I'm normally small, 5'4" and 125 or so. It's a total miracle drug! No more mania, that's for sure.

No more of that for me. In fact, with bi-polar and PTSD, I refuse all anti-psychotics now. They don't help, and they make me feel stupid and tired, and fat.

Pass the Seroquel, please!

Kitty

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About

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Liz Spikol is senior contributing editor of Philadelphia Weekly. She writes the award-winning column The Trouble With Spikol, which began as a chronicle of her struggle with mental illness, and has since expanded into humorous musings on everything from graphic novels to how to use a mop. She also writes the paper's book review column, Lit Gloss. This blog -- named one of the Top 10 Bipolar Blogs of 2007 by PsychCentral -- is about mental illness policy, news, personal journeys and more.