Friday, March 23, 2007

Seroquel for Everthing Update: WHAT??

AstraZeneca has reported that its trials with quetipaine (Seroquel) for generalized anxiety disorder and depression are going well, to the point that it plans on filing for FDA approval for said conditions in 2008. As you may recall, Seroquel is currently being studied as a remedy for, well, just about every mental condition (1, 2, 3, 4, 5). Here's what I'm betting is happening...

You conduct enough studies using a drug that is mildly better than a placebo, making sure to usually enroll a large sample of people. At least two of the studies will turn out to be "statistically significant" and who cares what happens in the other studies -- just don't publicize them or include them in your FDA application! If there are seven or eight studies examining Seroquel in depression currently, then we shouldn't be surprised if two of them yield somewhat better results for Seroquel. Considering that some depression rating scales rate an improved appetite as an improvement in depression, then Seroquel-induced weight gain actually counts in its favor.

Hat Tip: Furious Seasons


. said...

Thank you so much for this blog. I think it is very interesting to me academically an personally.

I agree with this assessment. It is amazing, that the other week, when I was suffering from work related stress, I was advised by very prominent and policy determining psychiatrists to take Seroquel for my anxiety. I asked them if they thought I had psychotic symptoms... negative or positive sxs of any other disorder that wasn't GAD and reaction based, but they could make a rational case for me having those type of sxs. I was very sad to see that this "off label" indication is already taking off.. without any, and I repeat any solid statistical evidence of its efficaciousness.

Thanks for letting me rant.


CL Psych said...

Rant all you want -- that's why this site is here. Should Seroquel be mildly more effective than a placebo in the short-term and gain regulatory approval, then I'm sure you'll change your mind?? What's the harm in increasing your risk for diabetes and feeling like you have "fifth of whiskey head" (to roughly quote Furious Seasons) if you can be a couple points better off on an anxiety rating scale than if you had taken a sugar pill?

herb said...

Dear Dr. Russo,

So I’ll gentlemanly lambaste you, CL Psych and others of your profession as I have done in the past and continue to do so currently to do something about it.

Yeah, yeah and rah, rah, rah you can blog all you want and rant and rave but how about getting up in one of your professional conferences and/or meetings and start expressing your views and outrage in those professional forums. Maybe y’all start a sanity movement.

I don’t have your education and/or professional qualifications as I’m only a lowly and very, very long time support person and health care advocate for my spouse but I do speak my mind so how about y’all trying to do the same, where and especially when it counts.

By the way CL Psych, you already know my position on VNS Therapy for TRD and while on the subject of gentlemanly lambasting some of you professionals I wanted to share a recent communication I fired off to some of your Psychiatric honchos and/or colleagues and associates. Here’s the link:

As always, thanks for allowing me the opportunity to share my thoughts and more importantly for the free education and enlightenment I’ve been obtaining from your thoughts and that of others.



CL Psych said...


Some people are speaking out at professional conferences as well as writing about these issues in journals, though it is true that many of the activities and presentations at conferences and most journal publications are a ringing endorsement of the status quo.

Re: the VNS link you passed along. I read the press release. I'd be interested to know what percentage of people showed a response in the first place and if there was some sort of control group that received an alternate treatment or "fake" VNS. When the article is published, please send along a link. Thanks for your comments.

Anonymous said...

Dear Clinical Psych,

I would like to clarify to Herb, that I am not an MD. I do speak out often and with such passion that I am often diagnosed by my comrades as having a psychiatric diagnosis. THEY KNOW I don't really make criteria for any disorder, because I run circles around them research and intelligence wise. It is why they won't let me quit. However, Herb, if you had my background of abuse and many many very severe life events, you would maybe understand that I do stand with you on alternative treatments for psychiatric symptoms. I have literally (and perhaps unfortunately to the blog world) hundreds of papers where I essentially show the relationship between the mind and body in stepped care interventions for treatment of depression, anxiety, ptsd... etc.

If I WAS clinical like the blog's author, I would NEVER use medications as the first step in any treatment plan. PERIOD. So for the future, please understand, that my first line treatments are many, and I would love to discuss them stratified by demographic and clinical characteristics... but alas.. I have to work to pay the bills. I don't advertise on the web nor take any money from PHARMA. Haven't in 25 years, and will not.

Herb, we are on the same side...


Joan Russo, Ph.D.