Posted by yxibow on December 16, 2006, at 17:54:10
In reply to Zyprexa in Sunday NYT?, posted by Talbot on December 16, 2006, at 15:32:43
> Just saw this on the Drudge Report, top of page.
>
> "Controversy develops around side effects of a schizophrenia drug... MORE... NYT Sunday: Drug maker Eli Lilly has engaged in a decade-long effort to downplay the health risks of Zyprexa, its best-selling medication for schizophrenia..."
>There may or may not be internal documents for all I know, but these are the sorts of things that you will get by looking at the Drudge Report.
Yes, the NYT article makes reference to the CATIE trial about old line drugs when the NY Times article makes reference to "new drugs" with their "own side effects". This is most very likely true, but I sure wouldn't want to be taking an old line neuroleptic regardless. The amount and especially variety of EPS and potential TD present in atypicals such as Seroquel has still so far been less than the older, much harsher agents like Haldol. Not that I relish taking Seroquel with the side effects I do get, but it remains one of the few agents that don't particularly give me akathisia (this isn't remotely for psychosis.)
Nonetheless, complete medical monitoring of a patient with schizophrenia or other psychotic disturbances where they cannot easily give informed consent should be challenged regularly with diabetes tests and regular liver panels/etc for adverse events by their caregivers.
So I think while the burden of possible "internal memos" may fall on Lilly and possible charges of gross mismarketing, the burden of monitoring someone on an agent that had just reached the market and is still fairly new, should also now and have been fallen on the doctors to be conservative and take lab tests. Psychiatry doesn't exist in a vacuum, and if both parties here create a double irresponsibility, 0+0=0.Pyschiatrists are responsible for seeing and testing that their patients are gaining weight more than they should be, if they fall in the category of people who are more susceptible to lipid changes in new line drugs. I speak for neither side, but I think that the "out to lunch" phenomenon can be placed a bit on both sides of the story. As for what you can say about drug companies, well -- that is for the individual. I mean I believe in better living through chemistry but I also know about prudence. We all want the perfect drug, yet when the drug that we find appearing on the market produces unintended consequences, the human instinct is to jump on the drug.
The result is more hurdles and fewer drugs reaching the market. Periodically people always ask, what is the next big thing -- I do too -- and the next big thing has to prove beyond more than new criteria (which may be prudent, not saying that it isnt) that it is more effective than current agents and even more safer. Its a vicious cycle and argument and you could easily paraphrase the above paragraph for the drug industry or for the patients who are seeking rare "orphan drugs."-- tidings
poster:yxibow
thread:714265
URL: http://www.dr-bob.org/babble/20061212/msgs/714328.html