Name changes; a new name = an untarnished reputation

As previously discussed, antipsychotics (the older class) were originally marketed in the United States as “neuroleptics,” and are still known by that name in Europe.  The neuroleptic label (literally meaning “brain seizure”) was dropped in favor of, first “anti-schizophrenics” and, later, “antipsychotics.”

In other words, the name for the class of drugs represented by chlorpromazine and all its relatives changed over time, and the change in name was a direct reflection of how drug companies wanted the drugs to be perceived.  Obviously, a name that implies the drug causes seizures isn’t too good for business; and “antipsychotic” is preferable to “anti-schizophrenic” because it allows for usage amongst other populations beyond schizophrenics (for example, those diagnosed with “bipolar disorder”). 

If it weren't highly illegal (false advertising, you see), they probably would've switched to "happy pills" next.

Drug classification is kind of unique amongst scientific systems of classification in this regard; a drug is assigned to a specific class based on either active ingredient or the condition it is meant to counteract.  This allows the same drug to belong to several different classes; for example Wellbutrin is both an “antidepressant” and a “smoking cessation agent.”  This also makes it possible for the same drug to be reassigned to new categories as new usages are approved.

Contrast this to the biological system of classifying life: once you are assigned to a specific category, that’s it.  If cats were both “mammals,” along with being “mice-eaters” and “milk-drinkers,” you wouldn’t really be classifying them; you’d be describing them.  Classification is definitive (one, unchanging label); description is much more subjective (what once was an “adorable kitty” becomes a “snarling furball” under certain circumstances). 

Only one label for this cat: "kittykatus furious"

So the pharmaceutical drug classifcation system isn’t a classification system at all; it’s a descriptive system.  And this is what pharmaceutical companies are really doing when they change the name of a drug class, or reassign a drug to a new class: they’re describing it differently, in order to affect the way it is perceived by potential consumers (or even the FDA).   Aside from being useful in avoiding patent expiration dates, this maneuver is a great way to escape bad press for a particular chemical in a particular context.

When I say “bad press,” you say “antipsychotics!”

That’s right… the past couple months have been one bit of bad news after another for antipsychotics.  Several recently published studies show that they cause brain shrinkage, weight gain, Parkinson’s-like symptoms, diabetes, seizures, heart problems – a whole laundry list of incredibly undesirable side effects.  And this is national news (though a few tenacious “researchers” – funded by pharma, of course – are still courageously arguing that brain shrinkage might not be so bad, after all.  Good one, guys.). 

Could it be that consumers are going to be a little wary when they hear the word “antipsychotic”?  Might they be a bit more apt to do some research, and not just click on the pharma-funded hits at the top of Google, but delve into the blogosphere, survivor testimonies, or perhaps some of the clinical literature?

Maybe, and that’s certainly a risk to the billions of dollars of profits these drugs bring in every year. 

I think it’s time for a name change, folks.

And that was my long-winded way of getting to the point, which is…

This is what I saw in my sidebar today:

Accompanied by this text [excerpt]:

Antidepressants have increased the risk of suicidal thoughts and actions in some children, teenagers, and young adults.  Patients of all ages starting treatment should be watched closely for worsening of depression, suicidal thoughts or actions, unusual changes in behavior agitation and irritability.  Patients, families, and caregivers should pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings.  This is very important when an antidepressant medicine is started or when dose is changed.  Report any change in these symptoms immediately to the doctor.  SEROQUEL XR is not approved for patients under the age of 18 years.

(from online SEROQUEL XR advertisement; emphasis added)

Wait, Seorquel?  The one classed as an “atypical antipsychotic”?  The one that is not and has never been classed as an antidepressant, nor has it been approved for use as an antidepressant?

[Note: it can be used as an augmentor, ie prescribed alongside another antidepressant if that antidepressant is not effective, and it can also be prescribed for “bipolar depression.” But it CANNOT be prescribed as sole therapy for clinical depression, and IS NOT an antidepressant.]

Seroquel, made by Astra-Zeneca, which just paid literally the biggest fine in the history of corporate America [$520 million] for deliberately marketing a drug for off-label uses?  And that drug was…

SEROQUEL?

Check it:

Seroquel is AstraZeneca’s second best-selling pharmaceutical and made sales of $4.87 billion in 2009, up 12% on 2008. The drug was first granted FDA approval in 1997 for the treatment of manifestations of psychotic disorders. Three years later FDA proposed narrowing the approval to the short-term treatment of schizophrenia only. In January 2004, U.S. approval was also given for the short-term treatment of acute manic episodes associated with bipolar disorder. Finally in 2006, the drug was sanctioned by FDA for the treatment of bipolar depression.

The government’s investigation was brought about as a result of a whistleblower lawsuit. The resulting allegations stated that between 2001 and 2006 AstraZeneca promoted Seroquel to psychiatrists and other physicians for disorders not covered by FDA approval. These off-label indications spanned a broad range of conditions including aggression, Alzheimer disease, anger management, anxiety, ADHD, bipolar maintenance, dementia, depression, mood disorder, post-traumatic stress disorder, and sleeplessness. Moreover, it is claimed, AstraZeneca promoted Seroquel to physicians who don’t normally treat patients with schizophrenia and bipolar disorder, the two approved disorders for the drug.

(from a recent news story)

Oh, ok.  That Seroquel.

That Seroquel that’s getting really bad press as an antipsychotic; that’s the one they’re starting to call an “antidepressant” or an “antidepressant augmentor.”  Actually, they’re doing the same thing with Abilfy (another atypical antipsychotic), as demonstrated in this recent commercial.  Notice that they don’t use the word “antipsychotic” anywhere; the emphasis is on antidepressants:

It’s an antipsychotic wide trend.  They’re not really antipsychotics anymore (since they’re increasingly getting such a bad rap); they’re antidepressant augmentors, or maybe just plain ol’ antidepressants.  Or at least they will be, as soon as pharma can get the FDA fully on board. 

Keep watching these Orwellian language changes.  It’s doubleplusgood fun, don’t you agree?

source

Harm Reduction Guide To Coming Off Psychiatric Drugs & Withdrawal

Gwen Olsen – the Rx Reformer

 Gwen Olsen spent fifteen years as a sales rep in the pharmaceutical industry working for health care giants including Johnson & Johnson, Syntex Labs, Bristol-Myers Squibb, Abbott Laboratories and Forest Laboratories.

In Confessions of an Rx Drug Pusher, Gwen Olsen brings together the
knowledge of an “insider” trained to sell doctors on the merits of pills;
the personal experience of having taken psychiatric medications and
seen how they altered her life; and the deep grief of having lost her
niece—following her treatment with psychiatric medications—to suicide.
This book has both an intellectual and emotional punch that readers
will long remember.

Robert Whitaker,  Author of “Anatomy of an Epidemic”

Everyone is at risk for a prescription drug tragedy:
Gwen offers an insider’s knowledge of dangers from the pharmaceutical industry.
Her poignant autobiographical journey through the darkness of mental illness and the catastrophic consequences that lurk in medicine cabinets around the country offers an honest glimpse into alarming statistics and a health care system ranked last among nineteen industrialized nations worldwide. As a former sales rep for Pharma, Gwen learned firsthand how an unprecedented number of lethal drugs are unleashed onto an unsuspecting public.

It is easy to disregard prescription drug deaths, medical errors, and
U.S. health care crisis statistics as just numbers. However, they are
not. In a well researched, impeccably documented, finely written
manner Gwen Olsen has given us account of the gripping details
of real people hurt by the failures of modern health care. A former
pharmaceutical representative herself, the information is as credible
as it is compelling. It is vital for those currently taking prescription
medication to read and understand this book.

 Dr. Ben Lerner,  New York Times best selling-author of “Body by God”

When you realize what is being sold to you as a “remedy” you will realize
how you are playing Russian Roulette with yours and your children’s lives.
This book is a MUST read for every American and every parent in the country.

Meria Heller, Producer/Host–The Meria Heller Show

lots of great handouts for anyone who wants to try / learn about using cognitive behavioral therapy for psychosis

Key Points – describes some of the key features of cognitive therapy for psychosis

Resources for CBT for Psychosis – lists many books and some websites that are either directly about cognitive therapy for psychosis, or present related approaches.

Resources for trauma and psychosis – lists books, articles & websites specifically about the intersection of trauma and psychosis.

Coping with Voices List: this is a collection of coping ideas people have used for voices.

Spectrum of Voices: This handout describes the continuum between “normal thoughts” and “voices,” by listing a variety of intermediate phenomena, from intrusive thoughts to “channeling.”

Stories of kids and voices: Some short case examples offering hope to anyone working with kids. Note the key intervention is just to get the kids to use their imagination in a positive way to counter troublesome voices.

How can we tell whether our suspicious thoughts are justified: A great one page handout encouraging more thoughtfulness about suspicious thoughts (paranoia)!

Common misconceptions: this handout compares common or traditional beliefs about schizophrenia and psychosis with the cognitive therapy perspective.

Safety Behavior Comparison: This handout shows how the current approach to neuroleptics is based on the same kind of faulty logic as that used by many people with psychological problems: the system focuses on short term benefit while ignoring long term problems.

Participatory Approach Neuroleptics: This article explains why a new approach to neuroleptic (“antipsychotic”) medication is needed, and then describes some features of a new approach.

Harm Reduction Guide to Coming Off Psychiatric Drugs is written to help consumers compare risks of staying on psychiatric drugs with the risks of reducing or getting off them, and then to provide information for those who may choose to attempt to reduce or discontinue the drugs.

How I tamed the voices in my head: An article, including a good case example, that explains some new perspectives on voice hearing.

The Mad Doctor Rufus May: this is an inspiring story of a once “hopeless schizophrenic” who ignored the doom-sayers, became a PhD psychologist and now an international leader in alternative approaches.

Diagram on healthy emotions: This handout illustrates a middle way between being either being dominated by or attempting to block out, both emotions and voices.

A fairly recent article in the American Journal of Psychiatry, 163:365-373, March 2006 was written by two of the leaders in the cognitive therapy for psychosis field, introducing the method to an American audience.

Paranoia: the website. Lots of information, personal experiences, and coping ideas.

Fidelity with cognivite therapy for psychosis: This is a fidelity scale for use with cognitive therapy for psychosis.

'......."Who breaks the Law--" said Moreau, taking his eyes off his victim, and turning towards us (it seemed to me there was a touch of exultation in his voice).

"Goes back to the House of Pain," they all clamoured,--"goes back to the House of Pain, O Master!"

"Back to the House of Pain,--back to the House of Pain," gabbled the Ape-man, as though the idea was sweet to him. ......'

from: The Island Of Dr Moreau by H. G. Wells