{"id":41930,"date":"2013-11-30T07:30:56","date_gmt":"2013-11-30T12:30:56","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=41930"},"modified":"2013-11-30T07:31:19","modified_gmt":"2013-11-30T12:31:19","slug":"graphic-reflections","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/11\/30\/graphic-reflections\/","title":{"rendered":"graphic reflections…"},"content":{"rendered":"\n
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hat tip to jamzo…  
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I don’t really know anything about patents and drug exclusivity in the UK. I presume it’s somewhat similar to the US [on the left][if that’s wrong, someone let me know]. The upper graph is number of prescriptions and the bottom graph is overall cost. I thought it was pretty interesting and it mirrored my own experience. That big mound of profitability is somewhat paralleled in the upper graph in terms of usage. As the patent era ended, two drugs emerged as keepers – Citalopram [Celexa®] and Fluoxetine [Prozac®]. I don’t mean this as an endorsement, but Citalopram is the drug I prescribe in patients for a trial of SSRIs. It’s because if an SSRI is going to help, it seems to be the one – and the side effects occur, but seem less common or pronounced. It looks like that’s the consensus across the pond as well. Doctors tend to factor in their own experience with usage. In my case, that happens almost automatically.<\/p>\n

I posted this in part to show the magnitude of advertising on prescribing. SKB\/GSK put a ton of effort into their marketing of Paroxetine [Paxil®, Seroxat®], and it worked. But when the doctors were left to their own devices, look at it plummet [perhaps some of the bad press had something to do with that]. Sertraline [Zoloft®] followed a similar trajectory. It fared better in the US. But I have to say that for me, Zoloft® is the most disillusioning of all the antidepressants. Earlier this year, I ran across a suit, Laura A. Plumlee et. al. v. Pfizer<\/a> [see a wide net…<\/a>], that said that Zoloft was  essentially inert and sued to get a refund. That seemed far-fetched even to me, doctor-disillusioned-with-antidepressants. So I went looking in Drugs@FDA for the NDA Approval documents and they weren’t there. So I submitted an FOIA request to the FDA and got them, which lead to these posts:<\/div>\n