Suicides in Japan have decreased in light of the COVID-19 lockdown. According to The Guardian, “the suicide rate in Japan fell by 20% in April compared with the same time last year, the biggest drop in five years.” The stay-at-home mandates affected about 40% of suicide prevention organizations that shut down or reduced workers’ hours. Also seeming to contribute to this drop includes the lack of commuting vs many people working long hours in the office.

In May, The National Suicide Hotline Designation Act, a bipartisan bill, passed in the US Senate to make the national suicide prevention hotline a 3-digit number. Currently, the hotline is only accessible by the usual 10-digit number 1-800-273-TALK (8255). (If we’re honest, is not that easy to remember.) Should the bill pass in the House and get signed by the president, the number would be 9-8-8, however, the 10-digit number would still be valid.

A study published in General Hospital Psychiatry found that use of antidepressants among patients hospitalized with heart failure (HF) is associated with “minor depression, history of major depression, younger age, unemployment, white race, nonischemic heart failure, polypharmacy, and functional incapacity.” The study, held from 2014-2016, had 400 patients with HF enrolled and found that there was no increase in the patients with major depression taking antidepressants compared with those who did not have depression.

Loose Screws Mental Health News

According to an article in USA Today, researchers have found that siblings who argue could have negative effects on their mental health.

Researchers report that conflicts about personal space and property, such as borrowing items without asking and hanging around when older siblings have friends over, are associated with increased anxiety and lower self-esteem in teens a year later. And fights over issues of fairness and equality, such as whose turn it is to do chores, are associated with later depression in teens.

I’d like to tell these siblings to get over it, but I don’t have any siblings of my own to relate my experience to.

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PBS’s Frontline reports that most soldiers who commit suicide have never seen combat or even been deployed. According to the Defense Department, the Army has the sharpest rate of suicides of all the military branches. About 53 percent of military personnel who took their lives in 2011 had no history of deployment to active combat zones such as Iraq or Afghanistan. Even more troubling is that 85 percent of those who committed suicide may have been deployed but not involved in direct combat. Even though the military has invested $50 million to study mental health and suicide, a stigma of getting help still remains. It seems as though military personnel would rather take their own lives than seek help.

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An antidepressant called GLYX-13, currently under study, appears to work within hours and last for up to a week. The lead researcher reports little to no side effects on the drug, which is injected intravenously. The drug is in phase 2, which means that its effectiveness and safety are still being tested. I have my doubts about an intravenous drug. If doctors are not currently testing patients’ serotonin levels, how would they be able to prescribe an intravenous antidepressant?

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Depression has passed asthma as the top disability among North American (U.S. and Canadian) teens.

Asthma had been the largest contributor to YLDs (years lived with disabilities) for youths in that age range in the US and Canada in 1990, but the study published in The Lancet on Thursday led by researchers at the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, Seattle showed that in this group depression surpassed asthma to claim the number one spot in 2010.

Back in the 1990s, depression was not widely regarded or evaluated among teens. It was still “suck it up” and “pull yourself up by your bootstraps.” My depression was viewed as laziness or “senioritis” among my teachers. I had no sympathy and very little leeway. Now, mental health is being taken more seriously for teens, and I think that’s a good thing.

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See you if you can keep an elder person in mind during this holiday season. Senior depression is always on the rise during the holiday season due to problems with health, loneliness, or finances.

The Zoloft-rage connection

I’ve received a lot of hits from people looking to find a connection between Zoloft and rage/violence/irritability. Here’s what I have so far:

• The Zoloft-rage/violence connection

• Can Zoloft induce rage?

• Pittman, Zoloft, and akathisia revisited

Pristiq (desvenlafaxine) information

Here’s a list of compiled links providing information on Pristiq. These links include info from my blog and others.

• Pristiq posing as pristine

• Chemical Imbalance Watch

• Pristiq gains ground with FDA

• Pristiq’s FDA Chances: Depression – Yea; Menopause – Nay

• More on Pristiq

• Pristiq’s under-the-radar clinical trials

• Wyeth looking for Pristiq’s FDA approval in 2008

• Son of Effexor: Good News

• Wyeth: Less Mystique In Pristiq

• Top 5 Reasons to Forget about Pristiq

• Comments on Pristiq

• Pristiq receives approval from FDA

• Wyeth reps no like Pristiq

• Wyeth Pushing Pristiq Hard

• Pharma’s “me-too” drugs face skeptical docs and health insurers

• More comments on Pristiq

• John Grohol interviews Wyeth’s VP of Medical Affairs on Pristiq

• Pristiq’s side effects: Too close to Premarin and Prempro for comfort?

Comprehensive list of SSRI adverse effects

justAna posted a comprehensive list of SSRI side/withdrawal effects that can be found on TheEffexorActivist.org. And it's freaking crazy. I've bolded the ones that I've experienced. (I've been pretty lucky, though.) Here we go:

ANTIDEPRESSANT WITHDRAWAL SYMPTOMS.

1. Crying spells
2. Worsened mood
3. Low energy (fatigue, lethargy, malaise)
4. Trouble concentrating
5. Insomnia or trouble sleeping
6. Change in appetite
7. Suicidal thoughts
8. Suicide attempts
9. Anxious, nervous, tense
10. Panic attacks (racing heart, breathless)
11. Chest pain
12. Trembling, jittery,or shaking
13. Irritability
14. Agitation (restlessness, hyperactivity)
15. Impulsivity
16. Aggressiveness
17. Self-harm
18. Homicidal thoughts or urges
19. Confusion or cognitive difficulties
20. Memory problems or forgetfulness
21. Elevated mood (feeling high)
22. Mood swings
23. Manic-like reactions
24. Auditory hallucinations
25. Visual hallucinations
26. Feeling detached or unreal
27. Excessive or intense dreaming
28. Nightmares
29. Flu-like aches and pains
30. Fever
31. Sweats
32. Chills
33. Runny nose
34. Sore eyes
35. Nausea
36. Vomiting
37. Diarrhea
38. Abdominal pain or cramps
39. Stomach bloating
40. Disequilibrium
41. Spinning, swaying, lightheaded
42. Hung over or waterlogged feeling
43. Unsteady gait, poor coordination
44. Motion sickness
45. Headache
46. Tremor
47. Numbness, burning, or tingling
48. Electric zap-like sensations in the brain
49. Electric shock-like sensations in the body
50. Abnormal visual sensations
51. Ringing or other noises in the ears
52. Abnormal smells or tastes
53. Drooling or excessive saliva
54. Slurred speech
55. Blurred vision
56. Muscle cramps, stiffness, twitches
57. Feeling of restless legs
58. Uncontrollable twitching of mouth

I've also gotten rashes coming off of Effexor. I was also on Lamictal as well so I don't think it's common. Ana puts it best when she says:

Reading these words does not give an idea of what does it really is to feel these symptoms.

Hoo boy, it sure doesn't.

Pristiq's side effects: Too close to Premarin and Prempro for comfort?

Back in January 2007, I’d mentioned that Wyeth was not only seeking to market Pristiq (desvenlafaxine) for depression but also for the use of vasomotor symptoms in menopausal women.

I just learned that Wyeth produces two major menopause drugs, Premarin and Prempro, that allegedly has produced hormones causing cancer in more than 5,000 women. This added up to a loss of 40 million users and $1 billion annually.

With Effexor going generic in 2 years and the introduction of Pristiq to the market, Wyeth hopes to lure some of those customers back and net an annual $2 billion. However, serious questions linger about Pristiq’s side effects in menopausal women.

Why did two women in the study group taking Pristiq have heart attacks
and three need procedures to repair clogged arteries compared with none
taking placebo? How can Wyeth assure long term safety when 604 of the
2,158 test subjects took Pristiq for only six months and 318 for a year
or more? And what about serious liver complications seen in the studies?

Martha Rosenberg, reporting on Pristiq’s use as a menopausal drug, culled comments from CafePharma’s message boards and found one thread rife with mixed comments on the new drug. From an Anonymous commenter:

John Grohol interviews Wyeth's VP of Medical Affairs on Pristiq

Dr. Grohol interviewed Dr. Phil Ninan, Wyeth’s VP of Medical Affairs on Pristiq, its efficacy, and surrounding issues. It was quite an interesting interview (and long) but here are some highlights that I chose to comment on. I’ll be making some comments in between Dr. Ninan’s answers due to the extensive length. Some parts of the answers have been truncated.

Pharma's "me-too" drugs face skeptical docs and health insurers

As patents expire on a variety of drugmakers’ moneymakers, pharma companies have gone to great lengths to structurally reinvent the successful drugs then tout the benefits that differ from their predecessors.

Case in point — Johnson & Johnson’s Invega. Invega is the successor to the popular antipsychotic drug, Risperdal, and competitor to AstraZeneca’s widely used antipsychotic Seroquel. Scott Hensley at The Wall Street Journal’s Health Blog (WSJ) reports that Risperdal is going generic in June. Gianna at Beyond Meds recently said it will not. According to the Dow Jones Newswires (DJN), these “junior” drugs face skepticism from health insurers and doctors. California-based Kaiser Permanente and Minneapolis-based UnitedHealth Group Inc. (UNH) are example of companies that have somewhat discouraged use of the drug. Kaiser doesn’t cover Invega at all, and members of UNH are required to pay higher copays for the brand name. The wire reports New York-based psychiatrist Jeffrey Lieberman wasn’t “buying it” the difference between Invega and Risperdal.

Invega is “basically a me-too drug, and the company hasn’t done the studies that would be required to really distinguish it,” Lieberman, chairman of the psychiatry department at Columbia University’s medical school told Peter Loftus of Dow Jones Newswires.

Ouch.

The blog also quotes Daniel Carlat from the The Carlat Psychiatry Report.

Dan Carlat, a psychiatrist and a tough critic of Invega, wrote that J&J’s “marketing team apparently missed the fact that the word in the English language that sounds most like “Invega” is “inveigle,” meaning “to entice, lure, or ensnare by flattery or artful talk or inducements.’ ” He asked doctors: “Will you be doing your patients a favor by taking the plunge? Or will you simply be giving them the same wine in a fancier bottle?”

Even J&J’s Group Chairman of Pharmaceuticals, David Norton, admitted that Invega is a tough sell.

“We need to do a better job at drawing a differentiation in a difficult-to-treat population.”

So far, Invega sales have been incredibly disappointing compared to the Risperdal blockbuster.

Wyeth (antidepressant Effexor XR cum Pristiq) and Shire (ADHD drug Adderall XR cum Vyvanse) face the same uphill battle. Wyeth’s Effexor faces generic competition from Teva Pharmaceuticals despite efforts to halt generic sales of the drug and the patent on Shire’s Adderall is set to expire next year.

Hensley, in his analysis, raises a question in which the answer remains to be seen:

Cheap generics abound to treat a broad assortment of illnesses these days. What’s the point, the critics ask, of paying more for drugs that are at best only slight improvements over tried and true medicines available at bargain prices?

It’s something that I’ve questioned myself.

In an attempt to have the “me-too” drugs compete with its derivative, both Wyeth and Shire are slashing their prices, or as the DJN reported, “emphasizing improved dosing for the newer drugs.” Although Pristiq’s efficacy comes at higher doses, it’s being priced 20 percent lower than Effexor.

[Deutsche Bank pharmaceutical analyst Barbara Ryan] thinks the odds of
Pristiq’s success are slim because it appears to offer few benefits
beyond those of Effexor.

That remains to be seen. So far, a few patients have commented on my blog that Pristiq has already begun to help them. I haven’t seen any DTC ads for Pristiq so I can only assume that drug reps are doing a fine marketing job at selling the different benefits of the drug to doctors.

Vyvanse, on the other hand, is looking promising for Shire, already having 7 percent of U.S. ADHD drug prescriptions. Chief Executive Matthew Emmens says the drug is chemically different from Adderall (aren’t they all?) and has better pricing. Shire expects to beat Adderall’s 26 percent peak market share. Seems like a lofty goal to me.

As for Invega, J&J is currently seeking FDA approval to use the drug for bipolar disorder and not just treatment for schizophrenia. It is also l0oking to get approval for an injectable Invega XR.

(Invega logo from Janssen.com)

Wyeth Pushing Pristiq Hard

The Wall Street Journal reports that Wyeth, desperate to make money off of its Effexor XR-knockoff, Pristiq, says it will slash the antidepressant at a 20% discount compared to Effexor’s price. The price slash, CNN money reports, is a result of less-than-impressive clinical trial data on Pristiq’s “safety and effectiveness.”

Wyeth SVP Joe Mahady told analysts that Pristiq will sell for a flat $3.41 per tablet for both mid- and high-dose, Dow Jones Newswires’ Peter Loftus reports.

Wyeth, apparently, has done this in the past. Back when it was known as American Home Products, the company slashed its price on Protonix, its heartburn drug, to compete with AstraZeneca’s Prilosec. The drug generated $1.9 billion in profits for Wyeth last year. CNN Money reports that Teva Pharmaceuticals and Sun Pharmaceuticals began selling the generic version of the drug and handily cut into Wyeth’s profits: the company reported a 4.6% decline in profit and a 66% drop in sales for the drug for the first-quarter. What will happen with Pristiq remains to be seen. I’m not sure that doctors in 2010 will want to dole out prescriptions for Pristiq when they can save patients—and insurance companies—money by prescribing what will then be known as venlafaxine. WSJ also notes:

A month’s supply of sertraline (Pfizer’s old hit Zoloft) or fluoxetine (Lilly’s Prozac) goes for 50 cents a day at drugstore.com.

$3.41 or $0.50 per tablet. It wouldn’t surprise me if some insurance companies choose to exclude Pristiq from its list of covered drugs. Regardless, Wyeth expects sales of the drug to exceed $1 billion in its first year.

The drug will hit the shelves in May.

I hate to brag, but…

I hate to brag, but…

February 28, 2007
Pristiq's FDA Chances: Depression – Yea; Menopause – Nay

It wouldn't surprise me if they said yea to antidepressant use and nay to vasomotor use because of lack of evidence in improved symptoms.

April 19, 2007
Wyeth looking for Pristiq's FDA approval in 2008

I'll follow Pristiq as the information continues to trickle out but don't expect to hear much about it until next year when Wyeth becomes the proud papa of a brand new (and approved) product.

This is one of the few times I can actually say I was right. (Teenage-like "squee!" goes here.)

More recent posts from:

• John M. Grohol at PsychCentral
• Silverman at Pharmalot