Antipsychotic Newspeak

Not nearly enough space has been devoted on this site or others to discussing how manufacturers of antipsychotic medications have used euphemisms to gloss over the side effects of their products. No, euphemism is too weak. It’s much closer to Newspeak. If you’ve forgotten, Newspeak was the language used in Orwell’s classic ‘1984.’

Part 1: Zyprexa. Consider this. Lilly referred to Zyprexa (olanzapine) as a “safe, gentle psychotropic” in an attempt to lure more doctors into prescribing it for a broader variety of problems. I suppose they could have also said: “Zyprexa, It’s not just for psychosis anymore,” but that would not have been nearly as sexy. Lilly also recently said that there is “no scientific evidence establishing that Zyprexa causes diabetes.” As one of my readers pointed out in an email, that claim is reminiscent of Bill Clinton stating that that oral sex does not constitute “sexual relations.”

Here are some results from research regarding Zyprexa and diabetes. In one study, patients assigned to take olanzapine had a much higher rate of diabetes one year after starting medication compared to those talking Haldol. In another study, bipolar patients receiving either three months of meds or three filled prescriptions of meds had a much higher rate of diabetes on Zyprexa (as well as other atypical antipsychotics) compared to those receiving older, conventional antipsychotics. Another study also found elevated diabetes incidence with atypical antipsychotics compared to those who used Haldol. I could go on for much more space citing more and more studies linking Zyprexa to poor safety outcomes. You can also do it yourself. Go to PubMed. Type in “olanzapine and diabetes” (without quotes) into the search term box and look at the plethora of studies that demonstrate that Zyprexa causes diabetes. You don’t need a Ph.D. or M.D. to interpret many of the study abstracts. Go ahead, look for yourself, then reconcile your findings with the statement that Zyprexa does not cause diabetes.

Part 2: Risperdal. In a recent press release, Risperdal (risperidone) was referred to as a “broad spectrum psychotropic agent” thrice. Gee, that sure sounds better than “atypical antipsychotic,” right? It’s a clever marketing ploy as the term “broad spectrum” suggests that, wow, this med helps to alleviate a whole bunch of symptoms! Well, does it? I wrote at length about a recent study where Risperdal was used to treat depression. There was very little evidence that it actually helped alleviate symptoms of depression, as the only evidence that Risperdal may be effective came in a phase of the study that did not utilize any sort of placebo control. When the placebo was implemented, Risperdal did very little in comparison.

Does risperidone have evidence as a long-term treatment for bipolar disorder? Nope. There is some evidence for Risperdal in the short-term treatment of mania, though it is no more effective than (much less expensive) Haldol. There is certainly evidence that it has greater efficacy than placebo but it is not more effective than older meds in treating schizophrenia. There is no well-designed study addressing the use of Risperdal for anxiety and one placebo-controlled study showed that Risperdal was not effective in reducing cocaine cravings.

So, despite being labeled as a “broad spectrum psychotropic agent,” Risperdal only shows evidence of treating schizophrenia and short-term evidence of treating mania. That ain’t “broad spectrum” by any reasonable definition.

Zyprexa is a safe, gentle psychotropic and Risperdal is a broad spectrum psychotropic agent – psychiatry's Newspeak.