I was writing about Harlan Krumholtz’s paper in the BMJ, and took a break to watch The Blacklist episode I missed [on the DVR]. About two-thirds through, I was fast-forwarding through the commercials but I was stopped in my tracks as a logo I recognized flashed by – Rexulti®. So I watched the ad and found myself screaming at the television set. In case you forgot about it, it’s the Abilify clone, the one that had two articles in succession in the JCP that were cut and paste copies, only one academic author [KOL Michael Thase], and was approved by the FDA as an adjunct for Treatment Resistant Depression, in spite of not making it without jury-rigging the results. For review: December Tales
The ad was beautiful. Beautiful people looking winsome carrying fans with smiley faces holding them in front of their winsome countenances [the mask of happiness they wore because they still felt depressed after taking their antidepressants. "Only one third respond to antidepressants" "Rexulti® has now been shown to be beneficial" blah blah blah. Remember this?:
| SOURCE | MADRS/HAM-D [d] | IDS-SR [d] | ||
|
|
||||
| Spielmans et al |
0.32 | 0.14 | ||
| Ziprasidone |
0.25 | – | ||
| Brexpiprazole 1mg-3mg |
0.29 | 0.16 | ||
| Brexpiprazole 2mg |
0.29 | 0.20 | ||
I commented: "The observer rated MADRS/HAM-D numbers are in the weak to moderate range, but the self-rated scales are dramatically near-null – Statistically Significant, but trivial Effect from the Subject’s perspective". On December 28th, I wrote:
Both Seroquel® and Abilify® are now off patent, so the ads will disappear. But now the FDA has approved Rexulti® for this indication based on these lackluster-at-best clinical trials I’ve been reviewing, so we can count on seeing in Rexulti®-in-Depression ads soon. Even worse, it has gotten that approval at the beginning of its patent life, so it will be with us for a very long time, perpetuating this practice of Atypical-Antipsychotic-Augmentation-of-Treatment-Resistant-Depression. Can the Direct-to-Consumer ads be far behind?
And here they are! only seven weeks later! un-****ing-believable!…
No, it’s not a matter of being “un-f—ing-believable”, but, “In-f—ing-sensitive” to the needs of the public, and once again the nefarious antisocial driven greed of Big Pharma gets rationalized and defended, not by you Dr N, but, by too many others in our profession who should know F—–g better!
Hey, Fox News is now reporting about the rise of Benzo overdoses in the past couple of years, and today it’s a story?!
In-f—-g-credible. By the way, glad you have passion!
When you’re a corporation pushing a new product, you say whatever it takes to turn on the sales spigot… that’s what you do. When you’re a prescriber, you don’t switch to Geico, er, Rexulti… you stick with something tried and true.
I get the pull of capitalism on corporations but where is the objection- and I would argue for outrage – from our academic and organizational leaders? This is why people damn “psychiatry.”
Sandra,
No argument from me about that…
“When you’re a prescriber, you don’t switch to Geico, er, Rexulti… you stick with something tried and true.”
Amen
Sorry, but I take exception to the issue with as a prescriber you stick with what works. I think too many psychiatrists don’t really care and just go with whatever funds their needs du jour.
Just too many whores and cowards in Psychiatry, & I think that whIle most people who come here know that and probably do not practice such poor judgment, there’s too much silence, and the outcomes are deafening!
You missed the point… that riff was meant to be prescriptive, not descriptive. It also helps to keep a sense of humor.
All due respect to Dr. Carroll, while it does help to have a sense of humor about the painful realities of life; I believe it is you who missed the point. Your assessment of pharma’s corporate strategy is accurate. One wonders if you ever considered the fact that pharma’s financial windfall in sellling psychotropic drugs was and is so successful BECAUSE of the utter lack of ethical integrity of the psychiatric profession over several decades. I am not amused. I’m not impressed by your lack of outrage, it is despicable that the psychiatric profession aided and abetted what are in fact human rights crimes which defrauded Federal medical progams, i.e. robbed the American people. Your silence in my view is an added insult to the iatrogenic injuies sustained by psychiatric patients…to say nothing of the damage done to human society.