![]() ![]() “I’ve had people gain 100 pounds” on Zyprexa and Seroquel, another atypical with wide crossover appeal as a mood stabilizer.Įach successive atypical has attempted to outdo the last: Eli Lilly’s Zyprexa followed Johnson & Johnson’s Risperdal, and then came AstraZeneca’s Seroquel, Pfizer’s Geodon, and finally Abilify, marketed by both Otsuka and Bristol-Myers Squibb of New York. In the case of Zyprexa, the first to be heavily marketed as a mood stabilizer and depression drug, “About two-thirds of people gain huge amounts of weight,” Diamond says, meaning 20-25 pounds in the first six months. But atypicals also tend to be much worse for weight gain. Overall, they have lower rates of “movement disorders” – uncontrollable jerks, tics and muscle stiffness caused by their suppression of dopamine receptors in the brain. A handful of companies have pulled off something like a marketing miracle by saturating the national market with a succession of expensive new atypicals. ![]() A quieter, but no less impactful, reshuffling of medications has centered on antipsychotic drugs, a powerful group of pharmaceuticals that carry not just the risk of temporary side effects but of permanent complications. Most people are familiar with the Prozac revolution – the wave of new SSRI (selective serotonin reuptake inhibitor) antidepressants that, beginning in the late 1980s, supplanted the older “tricyclic” antidepressants as the first line of depression medications, the first given to new patients before prescribing them more aggressive regimens. But the Tokyo-based drugmaker has fought a last-minute legal offensive aimed at extending its U.S. Abilify could go generic this spring and thus make less money for its developer, Japan’s Otsuka Pharmaceutical. The nearest other psychiatric drug was the antidepressant Cymbalta, which ranked eighth ($4.1 billion), a last gasp before it goes generic. sales, more than any other prescription drug in the country and enough to eclipse highly lucrative drugs for heartburn, arthritis and high cholesterol. Between April 2013 and March 2014, Abilify racked up about $6.9 billion in U.S. ![]() First designed to treat schizophrenia and other psychotic disorders (wherein people may experience hallucinations and powerful delusions), Abilify is now being prescribed for nearly every major mental disorder, especially depression, an illness believed to affect about 7 percent of the U.S. To some, it’s even stimulating.Īnd its sales have been remarkable. Whereas Seroquel, Zyprexa and most second-wave antipsychotics are heavily sedating, Abilify is not. But before Diamond’s skepticism set in, he worked as a paid speaker presenting to colleagues about the new antipsychotic Abilify, which has promoted itself as a kinder and gentler medication set to usher in a new era of safety. “They’ve been less of a breakthrough than we had hoped for,” he says, in improving the lives of patients who once took the first wave of side effect-heavy antipsychotics. In fact, he says, it “oversold” the benefits of the so-called “breakthrough” medications – newer “atypical” antipsychotics such as Seroquel, Zyprexa and Risperdal – all of which are believed to function differently than the older “typical” antipsychotics, including Thorazine and Haldol. Medications are the keys to recovery.”ĭiamond, still a psychiatrist practicing in Madison, and still a professor at the university, is less than thrilled to look back on Breakthroughs today. ![]() Don’t give up if the first medication doesn’t work … There are other medications to try. The illness locks you in … The only way out is to try every key. You have a ring of keys … That’s how it is with mental illness. On an early page, there’s an image of a key chain with the words “The Keys to Recovery,” followed by this: “Imagine you’re locked in a room with no windows and only one door. On the dedication page, Ronald Diamond, M.D., a professor of psychiatry at the University of Wisconsin-Madison, writes alongside his colleagues, “To my parents … who always knew I would eventually write a book.” Its red and yellow cover depicts a sun rising at the end of a long highway. In 1999, four leading mental health experts published a book, Breakthroughs in Antipsychotic Medications, intended as a guide for doctors, patients and families. ![]()
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