Mass Psychosis In the USA? 542
Hugh Pickens writes "James Ridgeway writes in Al Jazeera that with over $14 billion in sales in 2008, antipsychotics have become the single top-selling therapeutic class of prescription drugs in the U.S., surpassing drugs used to treat high cholesterol and acid reflux. While once upon a time, antipsychotics were reserved for a relatively small number of patients with hard-core psychiatric diagnoses, today it seems, everyone is taking antipsychotics. 'Parents are told that their unruly kids are in fact bipolar, and in need of anti-psychotics, while old people with dementia are dosed, in large numbers, with drugs once reserved largely for schizophrenics,' writes Ridgeway. 'Americans with symptoms ranging from chronic depression to anxiety to insomnia are now being prescribed anti-psychotics at rates that seem to indicate a national mass psychosis.' By now, just about everyone knows how the drug industry works to influence the minds of American doctors, plying them with gifts, junkets, ego-tripping awards, and research funding in exchange for endorsing or prescribing the latest and most lucrative drugs. According to Marcia Angell, former editor of the New England Journal of Medicine, under the tutelage of Big Pharma, we are 'simply expanding the criteria for mental illness so that nearly everyone has one.'"
Re:Expensive drugs? (Score:5, Informative)
Most brand-name antipsychotics can go WHOLESALE for 400-500/month, some are even more than that. Most cholesterol drugs are now on the $4 list, or have a $4 equivalent, except for lipitor (debateable whether or not it could be substituted for another statin because of all the studies..) which will be generic soon. Acid-reflux drug sales bottomed out as omeprazole (Prilosec) went generic and over the counter - the PPI class used to be the big money maker here because there were no generic alternatives. The new generation of antipsychotics are ALL still on patent except for Risperidone.
Also of note: "antipsychotics" are used to treat more than psychosis. They have been shown to be very helpful in several other psychiatric illnesses.. although I must say there are a *LOT* of cheaper/better alternatives for insomnia. These are not "off label" uses, by the way - many antipsychotics have been researched and gained FDA approval for more than one disease/condition. The class name is being substituted for the indication here to cause a stir.. "if you are on an 'antipsychotic,' then you must be psychotic!" A better name would be "selective d-2 receptor blockers with varying serotonin and anticholinergic receptor activity" but its a bit lengthy
The real headline here should be "PPI and Statin drug sales wiped out by generic replacements, antipsychotics still under patent. Also, some people havent heard about ambien yet."
Re:Americans are generally psychotic (Score:4, Informative)
and europeans are weak willed socialist groupies! yay we can all come up with fun adhominems!
It's not an ad hominem, it's an insult you moron. Oh, and "you moron" was also an insult. I'm not saying your argument is invalid because you are a moron, I'm saying you are a moron because your argument is invalid.
The headline is definitely misleading (Score:5, Informative)
TFA's headline talks about anti-psychotic medications, yet the article itself is about the entire class of psychoactive drugs.
Antipsychotics are a small sliver of the class of psycoactive drugs.
Antidepressants are psychoactive, but they are not anti-psychotic. The same applies for anti-anxiety durgs, such as Xanax, mood stabilizers for bipolar disorder (such as lithium), and for drugs used for Attention Defecit, such as ritalyn.
The problem is TFA lumps drugs used for depression and anxiety disorders in the same category as drugs used for treating schizophrenia.
In other words, the headline is misleading. Psychoactive != antipsychotic. The headline is purposefully misleading the reader into thinking that because someone takes a psychoactive drug, they are psychotic, and since americans take a lot of psychoactive drugs, Americans are psychotic.
This isn't a surprising headline for a news service whose primary audience isn't fond of Americans.
I'd expect to see the same sort of headline in a Scientologist publication.
I'm a shrink and I can tell you why this is... (Score:5, Informative)
The expansion of antipsychotic use has nothing to do with the number of people being diagnosed with psychotic disorders. AFAIK, that number hasn't increased much.
The real reason is that over the past 10 or 15 years, antipsychotic meds (i.e. dopamine antagonists) have been used with increasing frequency in patients who do NOT have psychotic symptoms. ("Psychotic symptoms" basically means either hallucinations or delusional thinking). Many of these meds are marketed as "mood stabilizers" for bipolar disorder-- and the criteria for bipolar disorder are so broad and so subjective that just about anyone can be diagnosed with it. Indeed, one of the popular "screening tools" for bipolar disorder is something called the Mood Disorders Questionnaire, which is a bit like those Scientology quizzes that tells you whether Scientology is right for you. (It always is). The MDQ was designed by doctors who work for drug companies-- I've met one of them.
There are three other groups who tend to get lots of antipsychotics-- the elderly (especially in nursing homes), the mentally retarded, and people with plain old depression. The last one is actually the easiest to justify, since there are some studies which suggest that certain antipsychotics can work as adjunctive treatment for depression-- they have managed to get FDA approval for that indication. The first two-- elderly and MR-- are impossible to defend. They don't benefit the patient, they cause cognitive slowing and deterioration of functioning, and they increase overall mortality. Lilly in particular has been guilty of marketing their antipsychotic (Zyprexa) to nursing homes and claiming that it improves "behavioral disturbances of dementia". It doesn't, and they eventually had to pay out billions of dollars in fines.
Any psychiatrist with half a brain knows what's going on here. In the mid 90s all the new antidepressants (Prozac, etc) started to go off-patent and the drug companies lost a major cash cow. Ever since then, the drug companies have sought new indications for dopamine blockers, since they are mostly still on-patent, and most of them are fiendishly expensive.