Schizophrenia News: December 2010

  • Each month I'd like to report on breaking news in the mental health field.


    To begin:


    Dainippon Sumitomo is bringing Latuda to the U.S. market in February 2011.  It has a greater efficacy with less metabolic risks.  Unfortunately because the company knows it has a winner the drug is priced higher than its competitors like Zyprexa and Risperdal.  It will be $14 per dose and is formulated in 40 mg and 80 mg strengths.  This will be a cost of about $5,000 per patient per year.  It is priced higher because its cardiovascular risk issues are very good.


    Researchers at the Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center are identifying whether their research will help facilitate intervention at earlier stages in the progression of schizophrenia from prodromal symptoms to acute psychosis.  Immediate treatment is hoped to minimize functional deterioration and delay, attenuate or even prevent the transition to a psychotic episode.

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    The current definition of the prodromal or at-risk mental state of schizophrenia includes transient psychotic symptoms as well as different risk indicators and a recent significant deterioration in global functioning.


    Their data accumulated so far suggest rates of conversion to actual psychosis within two years in 25 to 40 percent of the cases, supporting the validity of these factors.  It is suggested that at this late stage of illness functional deterioration is often already significant so that there is a need for earlier intervention.


    It is thought negative symptoms and social impairments, cognitive deficits and functional decline can often be detected well before the at-risk mental state as currently defined.  Identifying specific criteria could help define a broader group of people for future research.


    The hope is that intervention will start at earlier stages that may in turn minimize functional deterioration and delay attenuate or even prevent transition to psychosis.


    Of course the anti-psychiatry contingent will have a field day with this if the research indicates earlier treatment will involve schizophrenia drugs.


    I can speak from my own experience and stand by the researchers 100 percent.


    I will tell you why.  I had a breakdown in the fall of 1987 after I graduated college.  A year earlier in the fall of 1986 I sought help from the counseling center in town.  The receptionist told me it was only for teens and she gave me the numbers of the student life center and the mental health center at my school.


    I met with a woman in the student life center for three sessions and stopped going.  It was likely I didn't click with her.  Most of all: I couldn't articulate why I felt something was out of place.


    Mental illness runs in my family on my maternal grandmother's line.


    What if I obtained treatment then?  It is possible I wouldn't have had my breakdown.  This is the great mystery.  I had the insight that I needed help.  The patient is always the first to know when something is wrong with her body.


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    I also correctly pegged my recent troubles as being a form of OCD in 2005 and a year ago when I obtained cognitive therapy that is exactly how the therapist treated my thoughts: as a form of OCD.


    Do you agree that earlier if not immediate intervention as soon as something is out of place in a person who is at-risk is the right way to treat schizophrenia in the future?


    This raises ethical concerns about medicating a person who exhibits the slightest deviation in thinking or behavior.


    It also needs to be noted that the high cost of drug treatment is bankrupting America.  Everywhere else the government negotiates the prices of drugs with pharmaceutical companies and here in the U.S. such pills often empty the wallets of individuals because their costs go unchecked.


    The book Fresh Medicine takes an original approach to health care reform.  The author is the Democratic governor of Tennessee who is not a Liberal partygoer and he makes the case for introducing economic tension into the health care marketplace as the only true way to drive down our costs.  He is not a fan of the Affordable Health Care Act.


    I will be candid: it puts a bandage on the already ailing system of health care.  I will review the book here when I'm finished reading it.


    I agree with the author.  We don't need to pay $14 per-pop for our pills.


    Yet as I suggested at the introduction of this SharePost for that price we might just have a miracle drug in the treatment of schizophrenia to add to our medication options.


    Comments?  I'd love to open this up to discussion right now.

Published On: December 27, 2010