In June 1999, soon after I was first diagnosed, I sent out my first email Newsletter, McMan’s Depression and Bipolar Weekly, to all of about 10 people. Today, I emailed volume nine, issue four of what is now called McMan’s Depression and Bipolar Report to some 18,000 subscribers.
My Newsletter will always be my calling card, in part because it is something I can call my own, but mainly because everything else I do is derivative of the research I put into in cranking out my email Reports. As a general rule, when I come across something new, I first write it up in the form of a quick Newsletter piece. Later, some of that same material may find its way into more polished articles on my Website, McMan’s Depression and Bipolar Web (www.mcmanweb.com). My book, Living Well with Depression and Bipolar Disorder (HarperCollins), was the result of six years’ of unremitting attention I lavished on my modest little publication.
Believe me, I could not write these blogs for BipolarConnect at HealthCentral without the insights I picked up serving hard time at McMan.
This year’s major running story has involved taking a critical look at the clinical trial evidence involving Lamictal. The articles I have published would hardly be mistaken for a GSK infomercial, but several days ago my investigations turned up a study that kind of let the drug off the hook. Of all things, it was a study funded by the opposition.
Eli Lilly has a bipolar depression drug of its own, Symbyax, which is Zyprexa and Prozac rolled into one pill. GSK’s own clinical trial results with Lamictal had proved somewhat less than flattering. Apparently Lilly saw an opening and decided to fund its own study that would pit its Symbyax against GSK’s Lamictal.
Since Lilly was conducting the study, that meant that Symbyax enjoyed considerable home field advantage. Lilly would be setting the rules and spinning the results any way it wanted to. For instance, previous Symbyax studies had lasted eight weeks. This one went seven. As Lamictal takes six weeks to dose up to full strength, there would be virtually no time left on the clock to catch up to the faster-acting Symbyax.
The study did not use any standard depression measure as the primary outcome. That way, Lilly would have a lot of statistical wiggle room to play around with. On and on it went. Lamictal was walking into a Symbyax ambush. The poor drug stood no chance.
But the God of Irony was smiling upon Lamictal. Not only did the Pride of GKS prove as effective as the Lilly Homey, but it performed the job with considerably fewer side effects, and worked surprisingly fast. Lilly tried burying the true results in a lot of statistical gobbledygook, but nothing could hide the fact that based on its own study, a clinician would have to be crazy to prescribe Symbyax over Lamictal. The double irony is that in an opposition study specifically designed to make it look bad, Lamictal turned in the performance of its life.
I was going to have a field day with this.
It took me two days to write up the story, double-checking and triple-checking my facts. Then it was time to assemble other news pieces I had dug up. But when I read my draft Newsletter from beginning to end, something was missing. Two hours later, I still hadn’t found the right piece to complete my issue. It was late evening and I was working to a morning deadline. Then I noticed the American Journal of Psychiatry had placed its entire archives online - back to 1844, when it was known as The Journal of Insanity.
On a hunch, I clicked open the inaugural issue, hoping to find a nugget, and there it was, a gold mine, a lengthy psychiatric take on Shakespeare’s works. Here's a small sample: “Disordered mind is sometimes called by Shakespeare Brain Sickness, the result of a hot, boiled or dried brain – terms which are pathologically correct.”
This was too good to be true. “The Bard of Bedlam,” I began typing, knowing there could be no better way to end my Newsletter and my day. I love this job.
Published On: February 20, 2007
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