New advertising for antipsychotics forecasts another change in the language


The Internet wants me to take drugs.

I know this, because nearly every site I visit subtly whispers things like “Seroquel…” “Abilify…”  “Adderall, for adult ADHD…” to me from the sidebars.  It shows me pictures of a perfect life, happy smiling people trendily going about their business as “productive members of society” – everything, in short, that a well-trained, successfully socialized member of the system should be wanting by now.

Targeted advertising can often be a bit misguided.

Note to Google – you can track my keystrokes and correspondence if you like, but you need to work on interpreting those keystrokes better.  The reason I’m searching things like “antipsychotics side effects” is NOT because my doctor recently recommended them to me and I am doing a bit of Internet research.

[Note to people doing said research: be forewarned – pharmaceutical companies can and do manipulate search results so that their preferred websites come up first.  You’re going to have to dig deep to find unbiased information about these drugs and the possible side effects.]

These sidebar ads are designed to slip in under the radar (IE, your conscious mind).  They’re not meant to be the center of attention—so turning an attentive eye to them can yield some incredibly interesting results.

Name changes; a new name = an untarnished reputation

As previously discussed, antipsychotics (the older class) were originally marketed in the United States as “neuroleptics,” and are still known by that name in Europe.  The neuroleptic label (literally meaning “brain seizure”) was dropped in favor of, first “anti-schizophrenics” and, later, “antipsychotics.”

In other words, the name for the class of drugs represented by chlorpromazine and all its relatives changed over time, and the change in name was a direct reflection of how drug companies wanted the drugs to be perceived.  Obviously, a name that implies the drug causes seizures isn’t too good for business; and “antipsychotic” is preferable to “anti-schizophrenic” because it allows for usage amongst other populations beyond schizophrenics (for example, those diagnosed with “bipolar disorder”).

If it weren't highly illegal (false advertising, you see), they probably would've switched to "happy pills" next.

Drug classification is kind of unique amongst scientific systems of classification in this regard; a drug is assigned to a specific class based on either active ingredient or the condition it is meant to counteract.  This allows the same drug to belong to several different classes; for example Wellbutrin is both an “antidepressant” and a “smoking cessation agent.”  This also makes it possible for the same drug to be reassigned to new categories as new usages are approved.

Contrast this to the biological system of classifying life: once you are assigned to a specific category, that’s it.  If cats were both “mammals,” along with being “mice-eaters” and “milk-drinkers,” you wouldn’t really be classifying them; you’d be describing them.  Classification is definitive (one, unchanging label); description is much more subjective (what once was an “adorable kitty” becomes a “snarling furball” under certain circumstances).

Only one label for this: kittykatus furious

So the pharmaceutical drug classifcation system isn’t a classification system at all; it’s a descriptive system.  And this is what pharmaceutical companies are really doing when they change the name of a drug class, or reassign a drug to a new class: they’re describing it differently, in order to affect the way it is perceived by potential consumers (or even the FDA).   Aside from being useful in avoiding patent expiration dates, this maneuver is a great way to escape bad press for a particular chemical in a particular context.

When I say “bad press,” you say “antipsychotics!”

That’s right… the past couple months have been one bit of bad news after another for antipsychotics.  Several recently published studies show that they cause brain shrinkage, weight gain, Parkinson’s-like symptoms, diabetes, seizures, heart problems – a whole laundry list of incredibly undesirable side effects.  And this is national news (though a few tenacious “researchers” – funded by pharma, of course – are still courageously arguing that brain shrinkage might not be so bad, after all.  Good one, guys.).

Could it be that consumers are going to be a little wary when they hear the word “antipsychotic”?  Might they be a bit more apt to do some research, and not just click on the pharma-funded hits at the top of Google, but delve into the blogosphere, survivor testimonies, or perhaps some of the clinical literature?

Maybe, and that’s certainly a risk to the billions of dollars of profits these drugs bring in every year.

I think it’s time for a name change, folks.

And that was my long-winded way of getting to the point, which is…

This is what I saw in my sidebar today:

Accompanied by this text [excerpt]:

Antidepressants have increased the risk of suicidal thoughts and actions in some children, teenagers, and young adults.  Patients of all ages starting treatment should be watched closely for worsening of depression, suicidal thoughts or actions, unusual changes in behavior agitation and irritability.  Patients, families, and caregivers should pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings.  This is very important when an antidepressant medicine is started or when dose is changed.  Report any change in these symptoms immediately to the doctor.  SEROQUEL XR is not approved for patients under the age of 18 years.

(from online SEROQUEL XR advertisement; emphasis added)

Wait, Seorquel?  The one classed as an “atypical antipsychotic”?  The one that is not and has never been classed as an antidepressant, nor has it been approved for use as an antidepressant?

[Note: it can be used as an augmentor, ie prescribed alongside another antidepressant if that antidepressant is not effective, and it can also be prescribed for “bipolar depression.” But it CANNOT be prescribed as sole therapy for clinical depression, and IS NOT an antidepressant.]

Seroquel, made by Astra-Zeneca, which just paid literally the biggest fine in the history of corporate America [$520 million] for deliberately marketing a drug for off-label uses?  And that drug was…

SEROQUEL?

Check it:

Seroquel is AstraZeneca’s second best-selling pharmaceutical and made sales of $4.87 billion in 2009, up 12% on 2008. The drug was first granted FDA approval in 1997 for the treatment of manifestations of psychotic disorders. Three years later FDA proposed narrowing the approval to the short-term treatment of schizophrenia only. In January 2004, U.S. approval was also given for the short-term treatment of acute manic episodes associated with bipolar disorder. Finally in 2006, the drug was sanctioned by FDA for the treatment of bipolar depression.

The government’s investigation was brought about as a result of a whistleblower lawsuit. The resulting allegations stated that between 2001 and 2006 AstraZeneca promoted Seroquel to psychiatrists and other physicians for disorders not covered by FDA approval. These off-label indications spanned a broad range of conditions including aggression, Alzheimer disease, anger management, anxiety, ADHD, bipolar maintenance, dementia, depression, mood disorder, post-traumatic stress disorder, and sleeplessness. Moreover, it is claimed, AstraZeneca promoted Seroquel to physicians who don’t normally treat patients with schizophrenia and bipolar disorder, the two approved disorders for the drug.

(from a recent news story)

Oh, ok.  That Seroquel.

That Seroquel that’s getting really bad press as an antipsychotic; that’s the one they’re starting to call an “antidepressant” or an “antidepressant augmentor.”  Actually, they’re doing the same thing with Abilfy (another atypical antipsychotic), as demonstrated in this recent commercial.  Notice that they don’t use the word “antipsychotic” anywhere; the emphasis is on antidepressants:

It’s an antipsychotic wide trend.  They’re not really antipsychotics anymore (since they’re increasingly getting such a bad rap); they’re antidepressant augmentors, or maybe just plain ol’ antidepressants.  Or at least they will be, as soon as pharma can get the FDA fully on board.

Keep watching these Orwellian language changes.  It’s doubleplusgood fun, don’t you agree?

[to make comments, visit the original post here.]

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