More Atypical Antipsychotics Used For Depression
> 4/15/2009 3:29:58 PM

Despite the best efforts of researchers, practitioners and drug companies, a significant share of depression cases require a trial and error period involving several different treatment plans before their subjects’ conditions improve. Many find that no currently available drug or therapy regimen can seriously improve their conditions, and they understandably seek alternatives.

An increasing number of persistently depressed subjects are now seeking unorthodox treatments by adding atypical antipsychotic medications to the equation. These extremely powerful drugs, designed to treat severe conditions like schizophrenia, bipolar disorder and related psychoses, are increasingly seen as viable compliments to current SSRI standards like Prozac and Zoloft.

One reason for this noticeable shift is the fact that certain drug manufacturers have persuaded the FDA to approve their antipsychotic medications for off-label uses, facilitating a series of commercials touting drugs like Abilify as an “add on” to standard treatment models for depression and related conditions. And while legal permission to use these drugs is a new development, the practice itself is not. Physicians have apparently prescribed these drugs for far less severe conditions like insomnia, anxiety and ADHD for some time. And in some cases the subjects taking these drugs are disturbingly young.

The commercials also list the severe and potentially fatal side effects of this and other antipsychotic drugs, among them increased anxiety, heightened diabetes risk and, most notoriously, extreme weight gain. All medications, of course, carry side effects. And these drugs often work wonders in patients with schizophrenia or other psychoses.  The fact that so many frustrated subjects have sought these medications highlights the need for ongoing research and more effective treatments. But the rapid rise in antipsychotic prescriptions (up 5% in 2008 alone) is worrisome. Many of these subjects simply do not need such powerful drugs.

Pharmaceutical producers understandably want their drugs to be officially approved for as many uses as possible. While doctors can prescribe these medicines for whatever purpose they see fit within the law, drug makers cannot advertise or encourage off-label uses for their drugs unless the FDA officially approves said uses. And they’re now doing just that. The FDA most recently approved the atypical antipsychotic Seroquel for use in standard mood disorder cases. The drug, designed primarily to treat schizophrenia and the severe depressions wrought by bipolar disorder, can now be prescribed to patients with no evidence of more severe disorders.  While the FDA tread cautiously in issuing this approval and refused to OK the drug to treat anxiety, a growing percentage of the public and the medical profession has accepted the once-unthinkable use of antipsychotics for unrelated conditions.

If this trend ultimately grants relief to some of the millions suffering from treatment-resistant depression, it may well be celebrated. In the meantime, subjects who are curious about the benefits of atypical antipsychotics should conduct their own research and seek the advice of medical professionals who have no personal stake in their cases. These are very powerful medications that should only be used if absolutely necessary. Most importantly, they should never be prescribed to children.

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