…and on to AstraZeneca's problems with Seroquel

Eli Lilly seems to be passing along its misfortune off to AstraZeneca, which now appears to be having issues with masking evidence of Seroquel side effects. From Furious Seasons:

A great article appeared in the St. Petersburg Times over the weekend, revealing that lawyers for AstraZeneca will argue in court later this month that the company wants documents introduced into a federal court hearing in a case over various allegations around Seroquel sealed and hidden from public view. They want an upcoming hearing in the federal class action lawsuit against AZ closed to the public as well. Lawyers argue that they are protecting patients and, oddly, the public at-large.

Read the rest of Philip's post.

"Quetiapine comes from the root word 'quiet'"

[UPDATE: I had some funky issues with my table. It should be fixed now. Sorry about that.]

The first time I visited my psychiatrist for my initial evaluation, he gave me the option of choosing one of three medications: Seroquel, Lithium, or Lamictal. He handed me information about Seroquel and Lamictal. I did some research on both meds (lithium was out of the question because I don’t have time to get my blood checked constantly) and Lamictal sounded like a way better deal than Seroquel. I found mental health blog Furious Seasons (probably via The Trouble With Spikol) and read numerous posts on Seroquel’s adverse effects and all the good stuff AstraZeneca doesn’t tell anyone. From Philip Dawdy’s “Seroquel, The Bipolar Pill?” post, here’s what stood out to me:

“He told her that he didn’t think Seroquel worked benignly for patients and that the increased blood-sugar levels and cholesterol levels associated with its use were unacceptable to him. She broke out a recent paper which claimed that there were no metabolic syndrome problems with Seroquel.”

The post got me thinking. One of the materials I received from my psychiatrist was an article on how Seroquel seems to help the depressive part of bipolar disorder. He had a stack of these articles. My guess is not that he’s an overzealous reader of various newspapers but received the glowing article from – you got it! – a pharma rep. The article was taken from the August 2005 issue of Clinical Psychiatry News. (NOTE: I received the article in November 2006.)

Clinical Psychiatry News’ publication goals:

“Clinical Psychiatry News is an independent newspaper that provides the practicing psychiatrist with timely and relevant news and commentary about clinical developments in the field and about the impact of health care policy on the specialty and the physician’s practice.”

Good thing they didn’t say objectively.

I don’t know much about ClinPsych’s reputation and whether they are generally a good paper that reports things objectively. However, the article, “Atypical Quetiapine Appears Effective for Bipolar Depression,” reads like a press release. I’m not happy about receiving (practically) PR material from my doctor when trying to make an unbiased decision.

The article’s lede:

“The atypical antipsychotic quetiapine led to significantly greater reductions in bipolar depression than did placebo within the first week of treatment and throughout an 8-week randomized, controlled study of 511 patients, Andrew J. Cutler, M.D., said.”

Dr. Andrew CutlerDr. Cutler? Who IS Dr. Cutler? No research necessary; look no further than the article itself:

“The differences between the placebo group and each quetiapine group were significant at each weekly assessment, said Dr. Cutler of the University of South Florida, Tampa. He is a speaker and consultant for, and has received research grants from, the company that makes quetiapine: AstraZeneca.”

At least they disclosed his financial affiliations.

It is also worth noting that Dr. Cutler also founded a clinical research company, CORE Research, which runs many of the clinical trials that he’s involved in. CORE Research’s background details:

“CORE Research, Inc. is a private research company with three offices in the Central Florida area. CORE specializes in pharmaceutical research and psychopharmacology for mental illnesses such as Bipolar Disorder, Depression, Anxiety, Schizophrenia, Attention Deficit Disorder, and Insomnia.”

Private + Pharmaceutical research + Psychopharmacology = Funding from Big Pharma Companies

I sound like I’m touting some grand conspiracy theory. (OK, maybe I am.) CORE’s background bio makes the company sound objective and unaffiliated, which isn’t the case. If Dr. Cutler has “received research grants from” not only AstraZeneca, but other companies, it’s in his best interest to make sure that their pharmaceutical products turn out OK. Namely in the interest of AZ – remember: he’s a consultant for them.

How can I expect to make a decision about which medication to take (remember it’s between Lamictal and Seroquel now) based on promotional materials from pharm companies and – oh – an article touting the benefits of Seroquel with quotes only from the study’s lead author who is paid to say good things about the company’s products?

I didn’t.

Then how did I decide on Lamictal over Seroquel? Wikipedia‘s outline of each medication’s side effects, of course, in addition to other materials. (Don’t EVER overlook the Patient Safety Information of any medication. Unless you’re reading about the molecular structure – ignore that.)

Lamictal (lamotrigine) side effects Seroquel (quetiapine) side effects
Headaches Sedation
Insomnia Agitation
Insomnia Constipation
Major weight loss Memory problems (i.e. anterograde amnesia)
Blurred/double vision Headaches
Muscle aches Abnormal liver tests
Lack of coordination Dizziness
Sleepiness Upset stomach
Nausea Substantial weight gain
Vomiting Stuffy nose feeling
Rash (Stevens-Johnson syndrome) [uncommon in adults] Neuroleptic malignant syndrome [rare]
Binds to melanin-containing tissues (i.e. iris of the eye) Tardive dyskinesia [rare]
Diabetes [unclear]
Cataracts [possible]

Not that Lamictal’s side effects looked like a walk in the park, but considering that I’d already had awful trouble with weight gain on Paxil and Lexapro – nearly 50 lbs. – Seroquel was a serious no-go on my part. That and I don’t mind major weight loss from Lamictal. (Although I have been told Lamictal has no effect on weight.) Below is a copy of the article I received from my psychiatrist or you can just go and read the archived full text at Clinical Psychiatry News.

Quetiapine article

An Interesting Observation

Time’s Quote of the Year:
“Actually, I thought we were going to do fine yesterday – shows what I know.” – President Bush on the midterm elections

CLASSIC.


An interesting observation I don’t know if anyone has already made or if anyone will pay attention to – Time‘s 2006 POTY issue carried 14 medically- or pharmaceutically-related ads. Two of those ads were full-color spreads related to two major pharma companies: AstraZeneca (an ad letting you know they can help/care) and Eli Lilly (touting the benefits of Cymbalta). I couldn’t help but stop and stare at Ambien CR’s ad pages. Ambien CR, a version of the popular sleep aid developed sanofi aventis has a WHOPPING 3.5 pages. Three-quarters of the first page is the Ambien CR color ad and the bottom quarted is  “Important Safety Information” in a blue box. Turn the page and there is nothing but fine print black text streaming across TWO pages. As if a quarter-page of safety information and a FULL two pages weren’t enough, flip the page again, and more “information for patients” continues for a half-page. I’d like to  know someone that’s actually read ALL those warning/safety information things. How many people actually READ all two and three-quarters (2 3/4) of safety information? I’ll be honest with you; I sure don’t. I skip all that stuff. But it’s there so when people suffer side effects, the company can say, “Hey! We  included this in our advertisement! It’s everywhere; you have no basis to sue.”

AstraZeneca, the maker of antipsychotic drug, Seroquel, writes in its ad (click on the thumbnail to see the modified scanned version):

AZ“A pharmaceutical company saving you the money on the medicines it makes.Imagine that. [larger font]

If you take any AstraZeneca medicines, you may be surprised that there’s someone you can turn to for help if you can’t afford them: Us. A family of four without prescription covrage making up to $60,000 per year may qualify for patient assistance. The AstraZeneca Personal Assistants can assist you in signing up for programs that can provide you free medicines or significant savings IF you qualify. [emphasis mine]
We’ll be the first to admit we don’t have all the answers. But as a pharmaceutical company, we recognize that when you trust us to help you, we feel we owe you the same trust in return. That’s what AZ&Me is all about. A place we’re creating to put the personal touch back into healthcare.

Please visit AZandMe.com or call 1-800-AZandMe.”

AstraZeneca Personal Assistants??? What is this? A department store? I can hear it over the loudspeaker now: “Now, calling all patients who use AstraZeneca medicines, we have personal assistants who can help you select the right care and plan to help you get the medicines you need.” And the cute slogan AZ&Me slogan. How adorable. It just makes you want to cuddle right up to Big Pharma! Because remember, they’re putting the “care” back in “healthcare.”  (sarcasm)

If anyone has used AZ&Me to get Seroquel for free or at a discount, e-mail me ASAP at suicidal.recovery AT gmail.com. I’d love to communicate with you.