{"id":15582,"date":"2011-11-01T12:53:46","date_gmt":"2011-11-01T16:53:46","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=15582"},"modified":"2011-11-01T14:57:20","modified_gmt":"2011-11-01T18:57:20","slug":"viibryd-ii","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/11\/01\/viibryd-ii\/","title":{"rendered":"Viibryd II&#8230;"},"content":{"rendered":"\n<p align=\"center\"><img decoding=\"async\" border=\"2\" src=\"http:\/\/1boringoldman.com\/images\/viibryd-8.gif\" \/><\/p>\n<p align=\"justify\"><img decoding=\"async\" width=\"95\" vspace=\"2\" hspace=\"4\" border=\"2\" align=\"left\" src=\"http:\/\/1boringoldman.com\/images\/viibryd-5.gif\" \/>Before launching in to the ins and outs of <strong><font color=\"#004400\">Viibryd<\/font><\/strong>&#8216;s march to market, I thought it would be important to talk about what&#8217;s happening out there in my front yard. This weekend, we drove up to Tennessee to a Craft Fair. It was Tennessee [my birth State] at its best. Driving back Sunday on as fine a day as ever was, I was awed as I always am at the beauty of Fall and feeling nostalgic for the Tennessee of my childhood, but when I got home and looked off the steps of my porch, Fall was there too. I expect there&#8217;s some lesson in that story, but I&#8217;ll pass on figuring it out and move on the the story of <strong><font color=\"#004400\">Viibryd<\/font><\/strong> and its circuitous route to FDA approval and final release into wide world. <\/p>\n<div align=\"justify\">It&#8217;s been a long time coming. This from the <u><a href=\"http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2011\/022567Orig1s000SumR.pdf#pge=2\" target=\"_blank\"><strong><font color=\"#000099\">FDA Medical Review<\/font><\/strong><\/a><\/u>:<\/div>\n<blockquote>\n<div align=\"justify\"><sup>The studies in support of this application were conducted under IND 54613. Several meetings  were held with the various sponsors over the course of its development. The IND has been held   by several different sponsors over its long course. The IND was initially submitted 11-21-97.   An early EOP2 meeting was held with the sponsor on 12-20-05, however, this was clearly  premature. This meeting focused on a proposed design for the first phase 3 study. Subsequent   meetings were held on 8-7-06, 8-20-07, and 5-11-09. The 8-7-06 meeting was another early   meeting to discuss CMP, OCP, and pharm\/tox issues. The 8-20-07 meeting was focused on their   genetic analysis plan, since at that time the sponsor hoped to utilize biomarkers in their   development program. The 5-11-09 meeting was to discuss their second phase 3 study and again   their plans for genetic analyses. A preNDA meeting was planned for June, 2009, however, this   was cancelled since the sponsor found our preliminary comments sufficient to answer all of their   questions. Ultimately, they dropped their plans to include analyses of genetic data as part of this   NDA.<\/sup><\/div>\n<\/blockquote>\n<p>It looks as if it was initially patented by <a target=\"_blank\" href=\"http:\/\/patft.uspto.gov\/netacgi\/nph-Parser?Sect1=PTO2&#038;Sect2=HITOFF&#038;p=1&#038;u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&#038;r=30&#038;f=G&#038;l=50&#038;co1=AND&#038;d=PTXT&#038;s1=5,532,241&#038;OS=5,532,241&#038;RS=5,532,241\"><u><strong><font color=\"#200020\">Merck<\/font><\/strong><\/u><\/a> in the mid 1990s:<\/p>\n<table width=\"95%\" cellspacing=\"0\" border=\"0\" align=\"center\">\n<tr>\n<td width=\"10%\" valign=\"TOP\" align=\"LEFT\"><strong><font color=\"#660033\">Inventors: <\/font><\/strong><\/td>\n<td width=\"90%\" align=\"LEFT\">  <strong>Bottcher; Henning<\/strong> (Darmstadt, <strong>DE<\/strong>)<strong>, Seyfried; Christoph<\/strong> (Seeheim-Jugenheim, <strong>DE<\/strong>)<strong>, Bartoszyk; Gerd<\/strong> (Darmstadt, <strong>DE<\/strong>)<strong>, Greiner; Hartmut<\/strong> (Darmstadt, <strong>DE<\/strong>) <\/td>\n<\/tr>\n<tr>\n<td width=\"10%\" valign=\"TOP\" align=\"LEFT\"><strong><font color=\"#660033\">Assignee:<\/font><\/strong><\/td>\n<td width=\"90%\" align=\"LEFT\">  <strong>Merck Patent Gesellschaft mit beschrankter Haftung<\/strong>  (Darmstadt,  <strong>DE<\/strong>)                             <\/td>\n<\/tr>\n<tr>\n<td width=\"10%\" valign=\"TOP\" align=\"LEFT\"><strong><font color=\"#660033\">Appl. No.: <\/font><\/strong><\/td>\n<td width=\"90%\" align=\"LEFT\">                     <strong> 08\/314,734<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"10%\" valign=\"TOP\" align=\"LEFT\"><strong><font color=\"#660033\">Filed:   <\/font><\/strong><\/td>\n<td width=\"90%\" align=\"LEFT\">                       <strong>September 29, 1994<\/strong><\/td>\n<\/tr>\n<\/table>\n<p>                     <\/p>\n<div align=\"justify\">So then <strong><font color=\"#990000\">Merck<\/font><\/strong> did a few Clinical Trials, and somewhere along the line, <strong><font color=\"#990000\">GSK<\/font><\/strong> picked it up and did three Clinical Trials. What&#8217;s interesting is that those early trials were all <a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/images\/viibryd-1.gif\"><u><strong><font color=\"#200020\">busts<\/font><\/strong><\/u><\/a> involving almost 2000 subjects, some 60% of them taking Vilasodone [they couldn&#8217;t even make Prozac and Celexa work in those trials!]. The licensing returned to Merck in 2003 after these disappointing studies. <a target=\"_blank\" href=\"http:\/\/biotechinvestmentparadigm.com\/2010\/12\/clinical-datas-vilazodone-offers-possible-blockbuster-returns\/\"><u><strong><font color=\"#200020\">But then<\/font><\/strong><\/u><\/a>:<\/div>\n<ul>\n<div align=\"justify\"><em>&quot;It was later discovered that patients exhibiting a specific genetic  biomarker responded better to treatment with vilazodone. The drug was  then licensed to <strong><font color=\"#990000\">Genaissance Pharmaceuticals<\/font><\/strong>, a company specializing in  pharmacogenomic therapies, or &lsquo;personalized medicine&rsquo;. Genaissance then  began additional Phase II trials in only those patients exhibiting the  desired biomarker.&quot;<\/em><\/div>\n<\/ul>\n<div align=\"justify\">in 2004. By 2007, they were talking to the FDA about doing Clinical Trials using biological markers. The first trial [Trial 4] started in early 2006. In the meantime, <em><strong><font color=\"#990000\">Genaissance Pharmaceuticals <\/font><\/strong><\/em>was acquired by a small company <strong><font color=\"#990000\">Clinical Data<\/font><\/strong> and became part of their genetics arm <strong><font color=\"#990000\">PGxHealth<\/font><\/strong>, explaining all the different sponsors along the way for Vilazodone. As best I can tell, this started as an attempt to get an antidepressant approved as a &quot;personalized medicine&quot; drug &#8211; a drug for people of a particular genotype. Certainly the companies involved were involved in genetics studies at the time. So Vilazodone started life as a antidepressant wannabe that didn&#8217;t pan out that got picked up by a small genetic company that was going to get it approved as the first personalized medicine psychiatric drug. They started their <a target=\"_blank\" href=\"http:\/\/clinicaltrials.gov\/archive\/NCT00285376\/2006_02_10\/changes\"><u><strong><font color=\"#200020\">Clinical Trial<\/font><\/strong><\/u><\/a> in 2006 stating:<\/div>\n<ul>\n<div align=\"justify\"><em>A Randomized, Double-Blind, Placebo Controlled Study Assessing the  Efficacy and Safety of Vilazodone <strong><font color=\"#200020\">and Discovering Genetic Markers  Associated With Response<\/font><\/strong> in Patients With Major Depressive Disorder<\/em><\/div>\n<\/ul>\n<div align=\"justify\">By the time the Clinical Trial 4 was ending, <em><strong><font color=\"#990000\">Genaissance Pharmaceuticals <\/font><\/strong><\/em>had become <strong><font color=\"#990000\">PGxHealth<\/font><\/strong>, a division of <strong><font color=\"#990000\">Clinical Data<\/font><\/strong> [all of these are small biotechnology companies]. They initiated Trial 7 with the biomarker discovery part still in the words, but not the music. Then <strong><font color=\"#990000\">Clinical Data<\/font><\/strong> submitted the drug to the FDA and it was approved in January this year. To complicate matters further, <strong><font color=\"#990000\">PGxHealth <\/font><\/strong>had become <strong><font color=\"#990000\">Trovis Pharmaceuticals<\/font><\/strong> and began to enter <a href=\"http:\/\/agreements.realdealdocs.com\/Requirements-Supplier-Agreement\/COMMERCIAL-SUPPLY-AGREEMENT-by-and-betwe-2842579\/\" target=\"_blank\"><u><strong><font color=\"#200020\">agreements<\/font><\/strong><\/u><\/a> to manufacture the drug in Taiwan and Puerto Rico, and <strong><font color=\"#990000\">Clinical Data<\/font><\/strong> started to recruit a sales force. What came of the Biomarker search? This, from the <a href=\"http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2011\/022567Orig1s000SumR.pdf#page=12\" target=\"_blank\"><u><strong><font color=\"#0000cc\">FDA<\/font><\/strong><\/u><\/a>:            <\/div>\n<ul>\n<div align=\"justify\"><em>Genotype data were available for assessment of the relationships between genetic variations in CYP2C19, CYP2D6, and ACE with vilazodone response in the two phase 3 studies. There were no meaningful associations with MADRS by responder analyses or change at 8 weeks. There were also no robust associations with discontinuation rates or failure to reach target dose that could explain the similar responses in CYP2C19 UMs and PMs. Genotype data were not available for all pivotal studies in which DNA was collected. Given the complicated vilazodone metabolic pathway, it is uncertain whether genetic variation on pharmacokinetic-related genes would likely result in clinically meaningful differences in either response or adverse events. <\/em><\/div>\n<\/ul>\n<div align=\"justify\">So, in January, Clinical Data entered the world of PHARMA with this Press Release:          <\/div>\n<blockquote>\n<div align=\"center\"><strong><a href=\"http:\/\/www.biospace.com\/News\/clinical-data-announces-fda-approval-of-%3Cstrong%3E%3Cfont%20color=#004400%3EViibryd%3C\/font%3E%3C\/strong%3Etm\/208357\" target=\"_blank\"><u><font color=\"#200020\">Clinical Data Announces FDA Approval of <strong><font color=\"#004400\">Viibryd<\/font><\/strong>(TM) (vilazodone HCl) for Major Depressive Disorder<\/font><\/u><\/a><\/strong>  <br \/>         1\/24\/2011<\/div>\n<p>        <\/p>\n<div align=\"justify\"><sup>NEWTON,  Mass.&#8211;(BUSINESS WIRE)&#8211; Clinical Data, Inc. (NASDAQ:CLDA  &#8211; News),  today announce<\/sup><sup>d that the U.S. Food and Drug Administration (FDA) has  approved vilazodone HCl tablets, to be marketed under the brand name  <strong><font color=\"#004400\">Viibryd<\/font><\/strong>&trade;, for the treatment of adults with major depressive disorder  (MDD). <strong><font color=\"#004400\">Viibryd<\/font><\/strong> is a new molecular entity and the first and only  selective serotonin reuptake inhibitor and 5HT1A receptor partial  agonist. Clinical Data plans to make <strong><font color=\"#004400\">Viibryd<\/font><\/strong> available in U.S.  pharmacies in the second quarter of this year. &quot;When treating MDD, our goal is to offer treatment options that meet the  individual needs of each patient,&rdquo; said Stephen M. Stahl, M.D., Ph.D.,  Professor of Psychiatry, University of California, San Diego. &ldquo;<strong><font color=\"#004400\">Viibryd<\/font><\/strong>  is an important new treatment option with proven efficacy and a  demonstrated safety profile.&rdquo; <\/p>\n<p>         The mechanism of the antidepressant effect of <strong><font color=\"#004400\">Viibryd<\/font><\/strong> is not fully  understood but is thought to be related to its enhancement of  serotonergic activity in the central nervous system (CNS) through  selective inhibition of serotonin reuptake. <strong><font color=\"#004400\">Viibryd<\/font><\/strong> is also a partial  agonist at serotonergic 5HT1A receptors; however, the net result of this  action on serotonergic transmission and its role in <strong><font color=\"#004400\">Viibryd<\/font><\/strong>&rsquo;s  antidepressant effect are unknown. The efficacy of <strong><font color=\"#004400\">Viibryd<\/font><\/strong> as a treatment for MDD was established in two  8-week, multicenter, randomized, double-blind, placebo-controlled  studies in adults who met the criteria for MDD. In these studies,  patients were titrated over two weeks to a dose of 40 mg of <strong><font color=\"#004400\">Viibryd<\/font><\/strong> once  daily. <strong><font color=\"#004400\">Viibryd<\/font><\/strong> was superior to placebo in the improvement of depressive  symptoms as measured by the mean change from baseline to week 8 in the  Montgomery-Asberg Depression Rating Scale (MADRS) total score. <\/p>\n<p>         <strong><font color=\"#004400\">Viibryd<\/font><\/strong> was demonstrated to be safe in clinical studies. In the  placebo-controlled, Phase III studies, the most commonly observed  adverse reactions in <strong><font color=\"#004400\">Viibryd<\/font><\/strong>-treated patients were diarrhea, nausea,  vomiting and insomnia. No single adverse event led to discontinuation of  treatment in greater than 1% of patients. Overall, 7.1% of the patients  who received <strong><font color=\"#004400\">Viibryd<\/font><\/strong> discontinued treatment due to an adverse reaction,  compared to 3.2% of placebo-treated patients. <strong><font color=\"#004400\">Viibryd<\/font><\/strong> has not been  associated with any clinically important changes in laboratory test  parameters including liver function tests, ECG including QT interval, or  vital signs. In addition, <strong><font color=\"#004400\">Viibryd<\/font><\/strong> had no effect on body weight as  measured by mean change from baseline in the 8-week studies. Among the  common adverse reactions (=2%) related to sexual function with <strong><font color=\"#004400\">Viibryd<\/font><\/strong>  compared to placebo were decreased libido (4% vs. &lt;1%), abnormal  orgasm (3% vs. 0%), delayed ejaculation (2% vs. 0%, males only), and  erectile dysfunction (2% vs. 1%, males only). <\/p>\n<p>         &ldquo;While there are currently available treatments for MDD, no one therapy  works for every patient and side effect profiles vary, which may impact  both compliance and treatment success,&rdquo; said Carol R. Reed M.D.,  Executive Vice President and Chief Medical Officer of Clinical Data.  &ldquo;<strong><font color=\"#004400\">Viibryd<\/font><\/strong> will be a new choice for healthcare providers and their  patients who are suffering from depression.&rdquo; &ldquo;<strong><font color=\"#004400\">Viibryd<\/font><\/strong> is the only antidepressant that is a selective serotonin  reuptake inhibitor and 5HT1A receptor partial agonist,&rdquo; said Drew  Fromkin, President and CEO of Clinical Data. &ldquo;It is also the first drug  that the Company has developed, and to have received marketing approval  from the FDA on its first review is a significant milestone for Clinical  Data.&rdquo;<\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" vspace=\"5\" hspace=\"4\" height=\"136\" border=\"0\" align=\"right\" src=\"http:\/\/1boringoldman.com\/images\/viibryd-9.gif\" \/>But in February 2011, barely a month after FDA Approval of <strong><font color=\"#004400\">Viibryd<\/font><\/strong>, <strong><font color=\"#004400\">Forest Laboratories<\/font><\/strong> acquired <strong><font color=\"#990000\">Clinical Data<\/font><\/strong> and <strong><font color=\"#004400\">Viibryd<\/font><\/strong> along with it [I expect my rendition of this story is flawed in some temporal details, but it&#8217;s the best this old man who still can barely spell <em>business<\/em> without a dictionary is able to muster]. My point is that <strong><font color=\"#004400\">Viibryd<\/font><\/strong> was not developed and tested by one of the big pharmaceutical companies. It was moved through the Phase 3 Clinical Trials by a series of small entities in the business of genetic testing, and only acquired by <strong><font color=\"#004400\">Forest Laboratories<\/font><\/strong> after FDA Approval.<\/div>\n<blockquote>\n<div align=\"center\"><u><strong><font color=\"#200020\">Is Clinical Data\/Forest Labs Deal Bad for Biotech?<\/font><\/strong><\/u><br \/>       <strong><font color=\"#200020\">Seeking Alpha<sup>a<\/sup><\/font><\/strong><br \/>       By M.E. Garza<br \/>       February 23, 2011<\/div>\n<p>      <\/p>\n<div align=\"justify\"><sup>The news that Clinical Data sold to Forest Laboratories&nbsp; for only $30 a share plus incentives sent some minor  shockwaves  through the biotech community.      It wasn&rsquo;t that the news wasn&rsquo;t  highly anticipated, in fact, going as far back as 2007, the man who  engineered the biotech sale was already polishing CLDA for deals. The   thing that left investors scratching their heads was the unexpected   $1.2 billion buyout price &#8211; $30 a share in cash plus $6 per share more  if  sales milestones are met &#8211; a discount of nearly 12 percent from  Friday&#8217;s  closing price of the stock.<\/p>\n<p>        Randal J. Kirk, is the man  behind the scenes at CLDA that everyone has  been second-guessing  for  weeks leading up to the deal is the same  billionaire who structured a  $2.4 billion sale of biotech company Scios  Inc. to Johnson &amp;  Johnson in 2003 and a $2.6 billion  sale of New River Pharmaceuticals to Shire&nbsp; four years  later- both while pocketing a huge chunk of the proceeds  along the way.  Yes, Kirk has been positioning himself for the windfall  from today&rsquo;s  Clinical Data deal for years and  just as it did back  then, the media  attention will now turn to the next company that Kirk  has been molding  into a more valuable asset &#8211; his new synthetic biology company  Intrexon.  Forbes and others are already calling the venture far bigger   than anything Kirk has done before. Kirk predicts the new company will   someday be &quot;the Google of the life sciences.&quot;<\/p>\n<p>        Nobody  can fault  Kirk, or his method for means and prosperity, but some are  left  wondering whether the CLDA\/FRX deal is good for the rest of the  biotech  sector given the broad-reaching sentiment that he should have  held out  for something sweeter. Yes, CLDA was a $14 stock just a few  weeks ago,  but speculators had hoped for a buy-out somewhere north of  $40. In fact,  one analyst had even set a price target of $46 per share  of Clinical  Data stock. After all, the Massachusetts-based  biotech had just  gotten FDA approval for the antidepressant Vilazodone [marketed as  <strong><font color=\"#004400\">Viibryd<\/font><\/strong>], which Kirk himself calls &quot;the first genuinely new  antidepressant in 14 or 15 years.&quot;   The market felt <strong><font color=\"#004400\">Viibryd<\/font><\/strong> offered Big  Pharma a very special  proposition: The drug does not have the negative  impact on sexual  associated with most of the current therapies available  to those  suffering from depression. Those rooting for the stock argue  that the  market potential could be tremendous given that as many as 40%  of  patients currently taking some of the best-selling depression   treatments report sexual side effects, which often leads to   discontinuation of therapy. In fact, clinicians observed a slight improvement in sexual function for patients treated with <strong><font color=\"#004400\">Viibryd<\/font><\/strong>, although those improvements did not  reach statistical significance. Even Kirk said, &quot;I haven&rsquo;t spoken to  anyone who doesn&rsquo;t appreciate the differentiation this has.&quot;<\/p>\n<p>        Theoretically,   a big drug company desperate for new products would have offered a   better deal. Sources told BioMedReports that some at the company were   hoping for a deal with Eli Lilly  &#8211; who markets Cymbalta- late  in the game.  Even now, some feel that  there is still a window for  another firm to come in and top the priced  deal, but given his track  record and the fact that Kirk is sitting on a  52% stake worth over $600  million (common stock, convertible notes and  warrants), it looks to most  of us like the dealin&rsquo; is done and that  Kirk is ready to move on&#8230;<\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">This all has a terribly familiar feel. It happened in the 1990s with Internet Companies. By the end, companies were being started just to have something to sell before they even went live in the boom now known as the <em>Internet Bubble<\/em>. That was followed by the buying and selling of Mortgages on the ethereal derivatives market that is now known as the <em>Housing Bubble<\/em> &#8211; responsible in large measure for our current <em>Great Recession<\/em>. <strong><font color=\"#004400\">Viibryd<\/font><\/strong> is a lightweight antidepressant in a lightweight class of drugs being hyped as being free of sexual side effects and weight neutral &#8211; claims likely to evaporate with use. I guess we&#8217;re in the era of an <em>Antidepressant Bubble<\/em> [<strong><font color=\"#004400\">Viibryd<\/font><\/strong>] or an <em>Atypical Antipsychotic Bubble<\/em> [<strong><font color=\"#660033\">Latuda<\/font><\/strong>], maybe a <em>Psychopharmacology Bubble<\/em> &#8211; a time when values are becoming inflated way beyond their true worth. Like any Ponzi-esque scheme, such things end with a big bang sooner or later. My thinking is along a different axis. <strong><font color=\"#004400\">Viibryd<\/font><\/strong> comes to us untouched by the hands of academic medicine and the real world of neuroscience. It arose in the domain of PHARMA [<strong><font color=\"#200020\">Merck<\/font><\/strong>, <strong><font color=\"#200020\">GSK<\/font><\/strong>] where it was abandoned for lack of efficacy. It was picked up by a tiny biotech company whose Chief Medical Officer was Pulmonologist Carol Reed MD who served as Principle Investigator on both of <strong><font color=\"#004400\">Viibryd<\/font><\/strong>&#8216;s Clinical Trials. From <a target=\"_blank\" href=\"http:\/\/people.forbes.com\/profile\/carol-reed\/20374\"><u><strong><font color=\"#000066\">Forbes<\/font><\/strong><\/u><\/a>:<\/div>\n<ul>\n<div align=\"justify\"><em>Carol R. Reed, M.D. joined Clinical Data in October 2005 as Senior Vice  President and Chief Medical Officer following the completion of its  merger with Genaissance Pharmaceuticals, Inc., where Dr. Reed had served  as Vice President, Medical Affairs since 2003. In April 2008, Dr. Reed  was appointed Executive Vice President and Chief Medical Officer of  Clinical Data. Dr. Reed joined Genaissance from Bayer Pharmaceuticals,  Inc., where she was an Associate Medical Director in Pulmonary Medical  Research. Previously, she was the Associate Director, Section of  Pulmonary and Critical Care Medicine, at the Hospital of St. Raphael and  directed its Medical Intensive Care Unit. Dr. Reed received a M.S. in  biology from the University of Illinois and a M.D. from Rush Medical  College in Chicago.<\/em><\/div>\n<\/ul>\n<div align=\"justify\">It breezed through the FDA on its first pass [<em>&ldquo;It is also the first drug  that the Company has developed, and to have  received marketing approval  from the FDA on its first review is a  significant milestone for Clinical  Data.&rdquo;<\/em>], yet that same medical staff of the FDA that approved the drug was moved to publish its own disclaimers about some of the claims being made about it [<u><strong><a href=\"http:\/\/carlatpsychiatry.blogspot.com\/2011\/10\/fda-slams-viibryd-better-sexual-profile.html\"><font color=\"#200020\">FDA Slams <\/font><font color=\"#004400\">Viibryd<\/font><font color=\"#200020\">: Better Sexual Profile Claim &ldquo;Not Supported by the Data&rdquo;<\/font><\/a><\/strong><\/u>].<\/div>\n<p align=\"justify\">So what happens now? Will our literature be flooded with <strong><font color=\"#004400\">Forest Laboratory<\/font><\/strong> funded articles with the usual suspects signing on as <em>guest authors <\/em>singing the praises of <strong><font color=\"#004400\">Viibryd<\/font><\/strong>? Will the KOL Speakers Bureaus send out their legions of mercenaries with creative CME programs? Will our television viewing be punctuated with beautiful people recovering from depression, smiling at their new-found sexual prowess? And what of our old friends, the review articles with <em>novel innovative promising<\/em> new treatments, including <strong><font color=\"#004400\">Viibryd<\/font><\/strong> &#8211; maybe even augmenting <strong><font color=\"#004400\">Viibryd <\/font><\/strong>with <strong><font color=\"#660033\">Latuda<\/font><\/strong>?  <\/p>\n<div align=\"justify\">Or maybe this is like the beauty of Fall &#8211; a giant burst of color preceding the long restorative Winter &#8211; a time for a much needed rest&#8230; <\/div>\n<hr size=\"1\" \/>\n<div align=\"justify\"><strong><font color=\"#200020\">Note:<\/font><\/strong> Speaking of <em>conflict of interest<\/em>, all authors on both published studies that I could locate were either employees of PGxHealth or one of the Clinical Research Centers involved in the Clinical Trials.<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Before launching in to the ins and outs of Viibryd&#8216;s march to market, I thought it would be important to talk about what&#8217;s happening out there in my front yard. This weekend, we drove up to Tennessee to a Craft Fair. It was Tennessee [my birth State] at its best. Driving back Sunday on as [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-15582","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/15582","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=15582"}],"version-history":[{"count":65,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/15582\/revisions"}],"predecessor-version":[{"id":15650,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/15582\/revisions\/15650"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=15582"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=15582"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=15582"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}