Drug Approved for Illness That Responds Better to Older Drugs
One of the apparent contradictions inherent in medicine: Just when you think you’ve discovered something new and helpful, research comes out to suggest that it may be counterproductive.
Invega has now come out with a different formulation: the sustained release. Apparently, this is the first atypical to be approved for the once-monthly injection formulation, though there are other neuroleptics used in this fashion. Personally, I’d love a once-monthly instead of the everyday pill. Bring it, yo evildoers at AstraZeneca! I’m ready for my Seroquel shot!
Or maybe not. A new Lancet study says older antipsychotics, like clozapine, are safer over the long term than Seroquel, Zyprexa and Risperdal. From the L.A. Times health blog:
Researchers in Finland, where clozapine is still widely prescribed for schizophrenia patients, found that users of the drug were less likely to die than those who took any one of three other second-generation (also called “atypical”) antipsychotics — Seroquel, Risperdal and Zyprexa — or those who took the first generation schizophrenia medication pherphenazine (once marketed as Trilafon).
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Sufferers of schizophrenia have long been known to die earlier than the general population, markedly more often by suicide and by complications of diabetes. They are far more likely to engage in behaviors that lead to earlier death as well, including tobacco use, substance abuse and sedentary lifestyles. The Lancet article found that a schizophrenia patient who took any of the studied medications for seven to 11 years was less likely to die prematurely. And the longer she took it, the less likely she was to die an early death.
American physicians have largely abandoned Clozaril, which has been on the U.S. market since 1989, in favor of Zyprexa, Seroquel, Risperdal and Abilify — all newer drugs that have been aggressively marketed to doctors and patients as safer and more effective than the first-generation of antipsychotic drugs, including pherphenazine and haliperidol (better known by its commercial name, Haldol).
Meanwhile, the numbers of people being prescribed these powerful psychiatric drugs have skyrocketed. In 2008, 50 million prescriptions for antipsychotic drugs — overwhelmingly the newer ones — were filled.
liz | 10:07 AM | BIG PHARMA, SCHIZOPHRENIA
While clozapine is only one of two medications (the other is lithium) that have been shown to reduce the chance of suicide and it is more effective in alleviating treatment-resistant schizophrenia, it potentially has one serious, potentially fatal side effect: agranulocytosis. To detect and prevent onset of this condition requires weekly blood tests while taking clozapine. What a pain in the butt! I would think this would be a serious quality of life issue. Also, there is the expense of all those tests. That is why doctors have turned to the other atypical antipsychotics. I read over The Lancet study and saw that Zyprexa, while not as good as clozapine, did fare pretty well in reducing the chance of early death, better than Seroquel and Resperidal. Maybe other lifestyle changes have to be engaged while using these medications to ultimately prevent early death in patients like us? Switching to clozapine may not be the best option.
The clozapine study was completely flawed in its methodology. The truth is that none of these drugs are safe– and should only be taken when the risks and benefits are carefully weighed.
It’s a catch-22 with the antipsychotics—monitoring oneself for what seems like inevitable side effects that can be frighteningly damaging to body parts and systems(extensive rashes, hyperglycemia, lactation, diabetes, excessive sedation, thryoid and liver damage, on and on). Then working with doctors to reduce the dosage to try to eliminate these effects or find something else that controls episodes that can be equally damaging to one’s life. It is challenging and also challenging to accept these conditions. Acceptance and adaptation is how I plan on surviving this and helping my daughter to survive this.
Clozapine turned out to be the most helpful medication for my daughter who has schizoaffective disorder. Although she needed to take weekly blood tests for the first several years, the blood tests are only required now once each month.
My other daughter has MS and has to inject herself with medication every other day. It’s a little painful to do that and to try to find new areas on her slim body to use for each injection. Her medication also has potential side effects but without treatment, her MS could worsen.
I think most people do know to weigh the risks and benefits of medications, regardless of the disease or illness and I’m thankful that effective medications are at lease one of the options available for them both, at least until a cure is found.
…less likely to die…
I have yet to meet a single person who has successfully circumvented death.
Hunh.
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