Failed Drug Treatments for Schizophrenia--Letters to the Editor_NYT

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SSRI-Research@

Fri, 23 Sep 2005 18:21:09 -0400

[sSRI-Research] Failed Drug Treatments for

Schizophrenia--Letters to the Editor_NYT

 

 

 

(In my judgement, all of these drugs are nothing more than poisonous

crap foisted off on the unsuspecting public, so this study is

basically pitting one type of poisonous crap against another type of

poisonous crap. With the question being which type of poisonous crap

is better?. Real result is that they are still all poisonous crap.)

 

 

 

Failed Drug Treatments for Schizophrenia--Letters to the Editor_NYT

 

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

Promoting Openness, Full Disclosure, and Accountability

www.ahrp.org

 

FYI

Letters to the NY Times editor (below) demonstrate the combative

reaction of stakeholders in the psychotropic drug industry to the

evidence-based overthrow of psychiatry's treatment recommendations.

 

Psychiatrists who have financial contracts with psychotropic drug

manfuacturers, have been prescribing atypical antipsychotic drugs on

and off-label, as if they were jelly beans, only to be confronted with

evidence that they are, in fact, no better and no safer than the old,

cheap, generic drugs.

 

The landmark government sponsored study, CATIE, was conducted by the

pillars of the American psychiatric establishment who themselves have

substantial on-going financial ties to the manufacturers of these drugs.

 

Even these investigators could not deny the evidence contradicting the

false and unsubstantiated claims made about these drugs' safety and

efficacy. Atypical antipsychotics have been promoted as safe and

improved and recommended in practice guidelines--such as TMAP--as

first line treatment. But when tested, they failed to demonstrate any

of the claimed improvements that have raised sales to $10 billion

dollar annually.

 

As more information will be brought to light--both when the CATIE data

is made available to other expert trial analysts, and company data is

uncovered during the course of discovery during court

proceedings--physicians and the public will learn just how the market

for these drugs was created by hype, misinformation, and out right fraud.

 

One letter among the 5 published by the Times, by psychiatrist, J.

Wesley Boyd, M.D., says it all--

It is the first one posted below --though it appeared as the last in

the Times.

 

Another letter by psychiatrist Jeffrey Kluggman, MD, reveals

psychiatry's culture of denia--about the ineffectiveness and hazardous

side-effects of the drugs they prescribe--and the utter contempt he

(and his colleagues) have for patients for whom they prescribe toxic

drugs that produce diabetes, raise cholesterol and blood pressure to

dangerous levels, cause blood clots, strokes and cardiac

abnormalities. Dr. Klugman defends the drugs, fails to recognize that

his profession has failed utterly to improve patients lives, and fails

to take responsibility for blindly prescribing drugs that are proven

to be defective:

 

" When three-quarters of the patients drop out, all that is

demonstrated is that you're treating a very difficult population. "

 

In 2000, a major British meta-analysis of 52 clinical trials in which

more than 12,500 patients participated--found that the atypical

antipsychotic drugs--(amisulpride, clozapine, olanzapine, quetiapine,

risperidone, and sertindole), are no more effective than the older

drugs at low doses. Comparing the efficacy (i.e., symptom reduction),

tolerability (i.e., drop out rates), and side effects (motor

movements, restlessness), the investigators concluded:

 

" When the dose was 12 mg/day of haloperidol (or equivalent), atypical

antipsychotics had no benefits in terms of efficacy or overall

tolerability, but they still caused fewer extrapyramidal side effects. "

 

 

 

See: Atypical antipsychotics in the treatment of schizophrenia:

systematic overview and meta-regression analysis by John Geddes,

senior clinical research fellow a, Nick Freemantle, reader in

epidemiology and biostatistics b, Paul Harrison, professor a, Paul

Bebbington, professor of social and community psychiatry c, for the

National Schizophrenia Guideline Development Group. BMJ

2000;321:1371-1376 ( 2 December )

http://www.bmj.com/cgi/content/full/321/7273/1371#related_editorials

 

 

 

 

 

Contact: Vera Hassner Sharav

212-595-8974

veracare

 

 

THE NEW YORK TIMES

Letters

September 23, 2005

Drug Treatments for Schizophrenia (5 Letters)

 

..

 

To the Editor:

 

As a psychiatrist, I welcome the study that found no appreciable

therapeutic differences between the older antipsychotic drugs and

newer ones. But I'm not too hopeful that this news is going to change

the prescribing habits of doctors.

 

Many of the psychiatric residents I work with know little about the

older medications, but this is not too surprising given that many of

their teachers are on the payroll of one or more of the major drug

companies.

 

Nobody who receives money from a pharmaceutical company should be

trusted to speak objectively about any medication.

 

We ask judges to recuse themselves from cases in which they have some

financial or other conflict of interest. Is it too much to ask doctors

to do the same?

 

J. Wesley Boyd, M.D.

Needham, Mass., Sept. 21, 2005

The writer is a lecturer in psychiatry at Harvard Medical School.

 

 

 

To the Editor:

 

Re " Comparing Schizophrenia Drugs " (editorial, Sept. 21):

 

The study you discuss was financed by the same government that gave us

the Food and Drug Administration of the Vioxx mess and a FEMA director

who knows a lot about horses.

 

This study used Trilafon (perphenazine) as the older-generation

antipsychotic. The vast majority of uninsured and state patients are

still given Haldol and Prolixin, drugs implicated in the revelations

about tardive dyskinesia, a disorder that causes involuntary movements.

 

The side effects of these medications became known only because

patients were institutionalized for an extended time.

 

To return to these drugs as a " cheaper " alternative reeks of the

business mentality in health care today. It is rehospitalization and

bureaucracy that eat up our mental health care budgets.

 

The real contradiction in your editorial is that Zyprexa, one of the

new drugs in the study, controlled symptoms better! Fix this drug to

reduce the side effects, and we are on our way to medications that

patients will take. That will cost a bit of money. But it will save

money, too.

 

M. A. Simmons

Southfield, Mich., Sept. 21, 2005

 

..

 

To the Editor:

 

Your editorial about schizophrenia drugs left out an important point.

 

The reason for the greater use of the newer, more expensive drugs,

besides their marketing, is that they cause a much lower incidence of

tardive dyskinesia, a movement disorder that occurred at a rate of 5

percent a year with the older drugs.

 

The study that you cite was too short for this difference to become

apparent, but the percentage of patients discontinuing the older drug

(perphenazine) because of a movement disorder was four times as high

as the percentage discontinuing the most effective of the newer drugs

(olanzapine) for the same reason.

 

Mark Abramowicz, M.D.

Editor, The Medical Letter

New Rochelle, N.Y., Sept. 21, 2005

 

..

 

To the Editor:

 

You say the study filled the gap in our knowledge about the relative

efficacy and tolerability of the second-generation of antipsychotic drugs.

 

When three-quarters of the patients drop out, all that is demonstrated

is that you're treating a very difficult population.

 

The issues of tolerability and especially the risk of tardive

dyskinesia are not addressed in an 18-month study with a 75 percent

dropout rate.

 

As a private practitioner who prescribes the newer medications for

bipolar disorder, not schizophrenia, I have followed patients on these

medicines for years at a time. I suggest that you ask the researchers,

" If a family member required an antipsychotic drug, which drugs would

you prefer? "

 

As a psychiatrist who is familiar with all these drugs, I know what my

answer would be - I'd prefer the new ones - and I would wager that the

answers of the researchers would be no different.

 

Jeffry Klugman, M.D.

New Haven, Sept. 21, 2005

 

..

 

To the Editor:

 

You mention that there's a need for better medicines, and certainly,

America's pharmaceutical research companies are striving to develop

new products to treat more effectively those suffering from

schizophrenia, depression, anxiety disorders and other mental illnesses.

 

Through the end of last year, there were 15 potential new drugs for

schizophrenia in human clinical testing, as well as 14 for depression

and 18 for anxiety disorders. Over all, there were 109 medications

being developed for all mental illnesses.

 

We recognize, as our critics should, that one medicine alone does not

work for everyone.

 

Ken Johnson

Senior Vice President

Pharmaceutical Research

and Manufacturers of America

Washington, Sept. 22, 2005

 

 

 

 

 

a.. Copyright 2005 The New York

[Guest guest]

I have yet to see informed discussion on alternative

treatments of schizophrenia on e-Lists including this

one. By contrast, there is a lot on depression.

 

Vitamin B3 is the only one or lately the omega3 that

have shown effectiveness in the treatment of schiz.

Also, if copper is high then that has to be chelated

out. Unfortunately, the B3 that is available here in

India by Dr. Reddy's Lab under the brand name Nialip

carries a label " Warning: To be sold by retail on the

prescription of a Registered Medical Practitioner

only " . Such labelling should be removed from vitamins

and omega oils and others. We the educated public at

large have the right to take what we think is the best

for our health. This freedom should remain with us. We

senior citizens should not be forced to pay the fee of

a " Registered Medical Practitioner " to get a

prescription for vitamin. We know how to titrate B3 to

level of nausea or vomiting. We are well-read

intelligent people. We will not harm ourselves.

Ratan.

--- califpacific <califpacific wrote:

 

> SSRI-Research@

> Fri, 23 Sep 2005 18:21:09 -0400

> [sSRI-Research] Failed Drug Treatments for

> Schizophrenia--Letters to the Editor_NYT

>

>

>

> (In my judgement, all of these drugs are nothing

> more than poisonous

> crap foisted off on the unsuspecting public, so this

> study is

> basically pitting one type of poisonous crap against

> another type of

> poisonous crap. With the question being which type