How does Saphris compare to other drugs for schizophrenia?
Last week, the FDA approved the drug Saphris to treat schizophrenia and bipolar disorder in adults. Saphris will compete with other drugs in the class known as “atypical antipsychotics,” which also includes Risperdal, Abilify and Seroquel.
So, how do you know which (if any) of these drugs is the best choice for you?
Unfortunately, the FDA does not require comparative effectiveness testing before approving new drugs. As a result, we only know that Saphris is more effective than a placebo. A June memo by the director of the FDA’s division of psychiatry products said efficacy results for schizophrenia were “not overwhelming” for Saphris. It also said the drug’s effectiveness in treating bipolar disorder was merely “sufficient.”
In other words, all we really know is this: It’s better than nothing. We’ll have to see over time how it compares to the other drugs on the market.
Schizophrenia affects about two million Americans. It is an incurable mental illness characterized by episodes of hallucinations, delusions, loss of contact with reality and difficulty functioning socially or at work. Bipolar disorder affects about 10 million Americans. It is characterized by alternation between episodes of depression that can last for several months and shorter periods of mania.
Currently, so-called “atypical antipsychotics” are the first choice in treating these conditions, even though the FDA says all have “significant risks,” including movement disorders, sedation, weight gain, and concerns about diabetes and other conditions related to weight gain. All must carry the FDA’s “black box” warning.
Additionally, in the case of Saphris, one FDA reviewer said there were indications that the drug “causes pulmonary arterial hypertension and cardiac effects” and that the drug’s maker, Schering-Plough, “knew about this toxicity and specifically tried” to prevent the FDA from finding out about it.
Schizophrenia and bipolar disorder are serious conditions, and all of these drugs can have serious side effects. One reason physicians (as well as the FDA) like to have a number of medications to choose from in treating patients is that individuals can react very differently to different drugs. One patient may do better on Risperdal; another may do better on Seroquel. And some may respond better to Saphris.
And it’s possible that none of these drugs is the best choice for you. The Los Angeles Times reports that “mounting research has made clear that the atypical antipsychotics are not only less safe than originally thought; they are not, on balance, any safer or more effective than older drugs for schizophrenia.”
The older drugs (as you might have guessed) are classified as “typical antipsychotics.” These drugs are significantly less expensive than atypical antipsychotics as well.
Whatever drug you end up taking, consulting with your doctor or psychiatrist is critical — because all these drugs are powerful stuff.
And let me add one more point. Think twice about using any of these drugs for simple depression. Currently, the makers of Abilify are spending millions of dollars in advertising to promote the drug as a depression treatment. The makers of other atypical antipsychotics are following suit.
But there is little evidence that these powerful drugs work very well in treating depression. And there is evidence that these drugs are being overprescribed to patients. The Clinical Psychology and Psychiatry blog reports:
According to a freshly published study, one in five depressed patients receiving services through the VA healthcare system in the United States is taking an antipsychotic. Of those taking antipsychotics, 43% were taking them at high doses … I’m aware that many of these patients are suffering much more than a simple case of the blues. That doesn’t mean we should throw heavy duty antipsychotics at them, particularly at high doses.
Frankly, if you’re suffering from depression and your doctor or psychiatrist recommends any of the atypical antipsychotics as a treatment, I would seek a second opinion.
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February 27th, 2010 at 2:23 pm
Yes, and you should try many different foods in small quantities. It used to be bored. Any kind of food, you should find your self to a different treatment or favorite food from your diet it will be easier and your free time to meet the weight remains. They are so much better, and another thing you should do is try to go it on sheets feel good about themselves.
May 29th, 2010 at 10:52 am
Schizophrenia is not incurable. Do your research (especially on niacin, vitamin C and the work of Abram Hoffer M.D.) and discover for yourself what I already have.