Tuesday, May 6, 2008

Depressed? Try an Antipsychotic...

Furious Seasons reports today that AstraZeneca, manufacturer of the atypical antipsychotic Seroquel, is seeking approval from the FDA to have Seroquel XR approved for the treatment of both depression and generalized anxiety disorder. It is, apparently, already approved for bipolar depression.

What disturbs me about this is the idea of using an antipsychotic medication as maintenance therapy for anything. I was under the impression that these drugs were designed/intended for the short-term treatment of psychosis, which can occur during both acute mania and severe depression.

Now, I'll be the first to admit that these drugs do have their place. Zyprexa (another atypical antipsychotic medication) knocked my manic ass right down when I took it during my last big mania. I took it for about six weeks, and it really helped. But it's not the sort of thing you want to be taking long term. Antipsychotics are psychiatry's big guns, and they are very scary drugs. They work by shutting down higher brain functions. In addition, these drugs all carry with them the risk of tardive dyskinesia (a movement disorder which can be permanently disfiguring). Not to mention the risk of weight gain, diabetes, and metabolic syndrome (which all of the atypical antipsychotics can cause, to varying degrees). And sedation. Which is the last thing anyone needs when depressed--something to sap even more of your energy.

I don't know which scares me more: the thought of psychiatrists (or even, I shudder at the thought, GPs) handing out antipsychotics like candy, or the thought of the American public seeing ads for them on TV and actually asking for them.

18 comments:

Shiv said...

I fear a time when it will be "trendy" to take these drugs. I've already seen a "it's cool to be crazy" culture growing with more and more people determined to get diagnosed with *something*.

I'm honored by the inclusion on your blogroll! I've included you on mine too now :)

~Shiv

Jazz said...

This is something I see happening, too, and it is scary. This culture is so messed up, with everyone being so concerned with What Other People Think.

I don't think people (or their doctors, many times!) realize what they're getting into when they start messing with these drugs. Lamictal was hell to stop taking, and trazodone withdrawal isn't going awfully well, either.

Thanks for putting me on your blogroll!

--Jazz

Gianna said...

I was on twice the recommended highest dose of Risperdal, plus some seroquel for many many years. Drugging for maintenance with anti-p's is not new. I wasn't even psychotic when it was given to me. Instead they kept upping the dose to treat irritabilty which it is now clear to me was caused by the damn anti-p's.

I will never take an antipsychotic again...I will ride any possible mania out. My neuro-psychologist says that anti-p's just mask the symptoms and a mania has a life of it's own and it comes to an end...also my "manias" are spiritual and I want to see the whole journey.

Have you seen Sean---this is the first of a 5 part video series--

http://www.youtube.com/watch?v=Az9SCgaeKdc

Jazz said...

I know so many people who are on antipsychotics as maintenance meds...and it looks like pharma wants to replace antidepressants and anti-anxiety drugs with them, too.

So many people put blind faith in their doctors...and as I'm learning, not even the docs always have the whole story.

I wish I had known what I know now back when I was diagnosed. I never would have started taking meds.

lily12 said...

Thank goodness I was an R.N. You learn fast not to trust doctors when you doublecheck everything they do (If you don't, YOU could get sued for administering the wrong med).I took Seroquel for a short while and hated it. I can't imagine non-schizophrenics taking it for maintenance. Thanks for the add, and I think I've added you, too. I better check! (I am an airhead).
Lily12

Jazz said...

Hi, Lily! Thanks for stopping by, and thanks for adding me.

It's much worse for those of us who don't have someone in the medical field around...Once I got on that medication merry-go-round, I was quickly medicated so heavily that I didn't have the spirit to question...and even if I had, I probably wouldn't have had the mental acuity to understand the answers...assuming honest answers were forthcoming...

Stephany said...

Just like gas prices at the pump thr drug lords keep up w the times.

Tilting at Windmills said...

When I recently read my medical records I was surprised to find that I was originally prescribed zy.prexa for anxiety, likely induced by the other drugs I was on. The anxiety and panic attacks I endured getting off the drug were astoundingly worse than the anxiety it had been prescribed for. Have you read Robert Whitaker's Mad in America? He does a nice job describing the role of marketing in the development of anti-psychotics. That was 5 or 6 years ago, and it has only gotten worse since.

Jazz said...

I haven't read it, and I probably should...but I fear that if I do, it will only make me even more furious...

superlagirl said...

I'm curious to see how their marketing department spins this. I know I did not react well when I found out my "anxiety" pill was really an antipsychotic. (I believe my exact words were "I'm not effing psychotic!")

There's still a lot of stigma around the word "psychotic," and as much as I hate stigma, I think it might actually be useful in this case.

Jazz said...

I'm not sure that they are even using the term "antipsychotic" in their ads. I don't think the Abilify ads mention it...although I must admit, I've never read the fine print!

Also, I think that there is a lot of blind faith placed in doctors. The average person just doesn't ask what it is they're getting. If Seroquel is given to them as a sleeping pill, they won't question that. Hell, I didn't question, when I was first put on bipolar meds. It was only later, when I realized that all the meds were doing was making me sicker, that I started doing some research.

I suspect that advertising that the medication is an antipsychotic might well hurt their sales! As you say, there is still a lot of stigma.

Gianna said...

they really aren't antispychotics. They very often don't do a thing to make one not be psychotic. They are essentially heavy tranquilizers aptly known as chemical straight jackets. One of the doctors involved in early thorazine use actually called thorazinhe a chemical straight jacket and I think in todays climate it's nice to call it for what it is.

What these drugs are are neuroleptics ---that is the class of drug that they are---again, a heavy tranquilizer. And psychiatrist use them for anyone they'd like to shut up.

Antipsychotic is truly a misnomer.

Jazz said...

...psychiatrists use them for anyone they'd like to shut up.
That seems to be an awfully fast growing segment of the population, doesn't it?

Antipsychotic is truly a misnomer
Well, I guess they do stop psychosis (and pretty much everything else that might be going on in your head)...by hammering your brain so hard you can't think...

discoverandrecover said...

Frightening....

Clueless said...

Okay, I happen to know a lot about psychotropic medications and take an antipsychotic for depression. One Seroquel is used for depression as well as the other things mentioned. The class, antipsychotics, is confusing and alarming to most people. But, most of the time depression can have anxious features, thought "disorder," or when you just feel like you are barely holding it together. It is in these cases that an antipsychotic is generally used. For me, it helps to quiet the suicidal thoughts and my "negative" thoughts, helps to reduce my anxiety and helps me to feel more put together in addition to helping me to sleep. It is not unusually for an antipsychotic to be used for depression. I should say that I am not psychotic although depression can have psychosis. I know complete stranger comes in and gives advice. All, I know is that today the thoughts of suicide and self-harm and hopelessness are a bit high today, so I also have a PRN that is in the same, antipsychotic class...I will be taking it because it just takes the edge off enough for me to relax and everything becomes a little more manageable. I hope this helps.

Jazz said...

Clueless--
I'm glad you've found something that works for you. It is important for all of us to use whatever tools are available to us in our quest for wellness.

I do not doubt that Seroquel is very helpful for some people, and if people find it helpful, they should certainly use it. But they should use it only with informed consent, and I don't think enough is known about the long-term effects of these medications for anyone to be able to give truly informed consent regarding their use over a period of years.

It concerns me that the pharma companies seem to be trivializing the dangers associated with these medications, and it concerns me that GPs might be prescribing them without the proper knowledge base.

Gianna said...

one thing we do know about long term atypical antipsychotic use is that it shorten the average lifespan by 25 years...I've never had a doctor tell me that...or heard of anyone else whose doctor told them that. I was also not told of the very high incidence of diabetes associated with atypical neuroleptic use.

People should know these things before they are offered them and before they become addicted to them as I am. I am almost off all this stuff but it's taken 4 years to withdraw and my lifespan is probably already cut short after 20 years on the stuff.

I would have liked to know.

Jazz said...

Yes--that is something worth fighting for--the availability of information so that patients can make truly informed decisions.