This Drug Versus That Drug Bipolar Treatment Study

I was startled to run across an article in HealthNewsDigest.com with the heading Adults With Bipolar Disorder Needed for Study Comparing Two Treatments. This article is about a study being conducted at Stanford University. What treatments are being compared at Stanford? Well, actually both the “treatments” this article mentions are drugs.

Next question: does the pharmaceutical industry have its hooks deep into Stanford University? Given a cursory internet search on the subject I would have to say yes. I think so.

We hope to determine the better foundational treatment for the contemporary management of bipolar disorder,” said Terence Ketter, MD, principal investigator of the Stanford arm of the study and director of Stanford’s Bipolar Disorders Clinic. “Is it lithium, the classical mood stabilizer, or quetiapine [brand name Seroquel], a second-generation antipsychotic with broad efficacy in bipolar disorder?”

This drug versus drug approach begs the question of how well any non-drug approach to therapy might work. Would a non-drug approach out perform either of the two pills being tested? The question isn’t even getting a hearing.

Now let’s look at some of the bad effects of these drugs being used to “treat” patients.

Two commonly prescribed medications for bipolar disorder are lithium and the antipsychotic quetiapine. Neither drug is perfect: Lithium is associated with the risk of long-term thyroid and kidney problems, and quetiapine carries the risk of drowsiness and weight gain and increases the risk of cardiovascular disease and metabolic problems such as diabetes. But, Ketter noted that these risks can be managed by careful attention to dosage and, on occasion, use of other medications.

Lithium

    1. thyroid
    2. kidney problems (I don’t know about you, but I think calling organ failure “a problem” is a bit misleading.) I know that brain damage can also come of lithium toxicity, and I’m wondering why it isn’t mentioned.

Seroquel

    1. drowsiness
    2. weight gain
    3. cardiovascular disease
    4. metabolic problems such as diabetes (2 through 4 “imperfections” could be laid at the feet of metabolic syndrome. Metabolic syndrome is a big reason studies have found people in mental health treatment are dying on average at an age 25 years younger than the rest of the population.)

As for attention to dosage, no dose could be safer than 0 mg. The problem with bringing in other drugs is we have to then ask how these additional drugs are going to negatively impact the patient’s physical health. Polypharmacy, the practice of prescribing multiple drugs for multiple conditions, is notorious for its lack of good outcomes.

A leading researcher in this study offers his suspicion that the reason for the shift from lithium to quetiapine as a “treatment” is due primarily to the aggressive advertising efforts of drug manufacturers.

Ketter pointed out that industry-sponsored efficacy studies, aimed at assessing treatments for bipolar disorders in order to gain FDA approval, usually allow participants to take one other medication at the most. But, Ketter said, this comparative-effectiveness study is different because participants can be treated with almost any other medication — except lithium for patients randomized to quetiapine, or quetiapine for patients randomized to lithium. (Most bipolar disorder patients need combinations of medications to manage their disease.)

Then again it’s not so different because none of the patients in the study are given the option of going without psychiatric drugs.

The authors of the study being conducted want to know which subjects respond better to lithium and which subjects respond better to quetiapine. I have to wonder why they aren’t interested in knowing which subjects, as with most people, respond better to no drugs at all.

There’s a very good topic indeed! Why do some people labeled bipolar do better on no drugs? First, you have to acknowledge that this is the case, and then you might be able to explore the matter. Unfortunately, as in this instance, the facts of the matter are mostly ignored by the medical establishment, and this indicates, if not drug company kickbacks, much denial on the part of the doctors studying these “treatments”.

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3 Responses

  1. Studies which are structured like this one are IMHO, unethical. The primary purpose of the study is to expand the market for quetiapine–not because there is any valid scientific basis for using this drug to “treat” bipolar disorder–alone or in combination with other drugs. This “drug trial” is simply part of a marketing strategy for the drug maker, nothing more—

    • Should Stanford University be engaging in practices that are, in your opinion, unethical? Do the parents of students enrolled in Stanford University know that these unethical practices are taking place?

      You are saying that the stated purpose of the “study” (i.e. comparing lithium to Seroquel “treatment”) is not the real purpose (i.e. that of expanding the market for Seroquel). They are asking for volunteers to participate in their “study”. I don’t suppose the volunteers are being told of the real purpose either.

      I can’t help thinking of Charles Nemeroff being canned by Emory University for not revealing drug companies payments only to be picked up by the University of Miami.

      I’d like to see a top ten list of those Universities with the closest ties to Big Pharma. I wonder just where Stanford University would be on such a top ten list, and whether it would even register.

      AstroZeneca, BTW, is the company that manufactures Seroquel.

  2. let me talk to them about lithium use and kidney damage…..

    Seroquel and it’s side effects.

    I’ll take my chances with the only thing that will cure depression- chocolate.

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